• Title/Summary/Keyword: semicoma

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Spontaneous Intracranial Epidural Hematoma Originating from Dural Metastasis of Hepatocellular Carcinoma

  • Kim, Byoung-Gu;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.166-169
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    • 2010
  • Spontaneous intracranial epidural hematoma (EDH) due to dural metastasis of hepatocellular carcinoma is very rare. A 53-year-old male patient with hepatocellular carcinoma, who was admitted to the department of oncology, was referred to department of neurosurgery because of sudden mental deterioration to semicoma with papillary anisocoria and decerebrate rigidity after transarterial chemoembolization for hepatoma. Brain computed tomography (CT) revealed large amount of acute EDH with severe midline shifting. An emergent craniotomy and evacuation of EDH was performed. Active bleeding from middle cranial fossa floor was identified. There showed osteolytic change on the middle fossa floor with friable mass-like lesion spreading on the overlying dura suggesting metastasis. Pathological examination revealed anaplastic cells with sinusoidal arrangement which probably led to spontaneous hemorrhage and formation of EDH. As a rare cause of spontaneous EDH, dural metastasis from malignancy should be considered.

Radiological assessment of pectus excavatum in a Pekingese dog

  • Cho, Sung-Jin;Hong, Sun-Hwa;Chung, Yung-Ho;Kim, Ok-Jin
    • Korean Journal of Veterinary Service
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    • v.35 no.3
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    • pp.251-254
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    • 2012
  • Pectus excavatum (PE) is a ventral chest wall deformity, also known as funnel chest, sunken chest, chondrosternal depression or koilosternia. The 4 months old, 1.3 kg intact-female Pekingese dog was evaluated for acute semicoma and convulsion. The client reported that this patient have had chronic loss of appetite, intermittent dyspnea and palpable sunken breast. The other littermates did not show any abnormalities. On physical examination, cachexia (BCS 1/5), concave sternum, flatten thoracic cavity and cardiac murmur were observed. On radiographic study, the caudal sternum cave to vertebrae and narrowing thoracic cavity. The severities of thoracic deformity were evaluated by deformation indices such as-Frontosagittal index (FSI) and vertebral index (VI). Moderate to severe PE was founded by the radiological measurements.

A Case of Acute Respiratory Failure After Trichloroethylene Inhalation (트리클로로에틸렌 흡입으로 인한 호흡부전 1례)

  • Park, Jae-Seok;Jeon, Young-Woo;Kim, Young-Il;Gil, Hyo-Wook;Yang, Jong-Oh;Lee, Eun-Young;Hong, Sae-Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.30-33
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    • 2011
  • Trichloroethylene (TCE, $C_2HCl_3$), which was introduced as a gas for general anesthesia and analgesia in early 1900's has been widely used in industry as an organic solvent. Occupational exposure to TCE is an important medical problem. Manifestations of acute exposure to TCE include mucocutaneous irritation, hepatotoxicity, cognitive impairment, sleep, headache, respiratory insufficiency and death. We report a 38-year-old man who was admitted to a department of emergency medicine after occupational inhalation exposure to TCE. He rapidly developed semicoma and respiratory depression. After mechanical ventilation, hypercapnea and hypoxemia disappeared and his mental state again became alert. Careful evaluation and proper respiratory support are important for respiratory failure after occupational TCE inhalation.

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A Case Report on a Patient with Intracerebral Hemorrhage with Intraventricular Hemorrhage Suffering from Deep Stupor to Semi-coma Treated by Korean Traditional Medicine (뇌실내출혈을 동반한 뇌내출혈로 인한 중증 의식장애 환자의 한방 치험 1례 : 뇌내출혈의 한의학적치료)

  • An, Yu-min;Lee, Yoo-na;Baek, Kyung-min;Jang, Woo-seok
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1225-1236
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    • 2019
  • Objective: This is a case report on the effect of Korean traditional medicine on deep stupor to semi-coma with intracerebral and intraventricular hemorrhage. Methods: The patient was treated by Korean traditional medicine such as acupuncture, moxibustion, and herbal medicine. The change of mental state was evaluated by the Glasgow Coma Scale (GCS). We used the Modified Medical Research Council Scale (MRC scale) and the Modified Barthel Index (MBI) to evaluate the effectiveness of the treatment. Results: After treatment, the physical function and ability to perform activities of daily living were improved. The Modified Barthel Index increased from 0 to 40 after treatment with Korean medicine. Conclusions: According to this study, Korean traditional medicine can be effective for the treatment of quadriparesis in patients with deep stupor to semi-coma in intracerebral and intraventricular hemorrhage.

A study on The Applying of Training Program to Facilitate Deglution -On spontaneous intracerebral hemorrhage patients with nasogastric tube- (자발성 뇌내출혈 환자의 비위관 제거시기에 관한 연구)

  • Kim, Myung Hee;Kim, Young Hee;Kim, Young Mi;Ju, Young Hee;Lee, Yun Mi;Chung, Eun Hae
    • Korean Journal of Adult Nursing
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    • v.13 no.1
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    • pp.136-147
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    • 2001
  • Dysphagia is common and serious problem in intracerebral hemorrhage patients. Nasogastric-tube intubation is an important method for dysphagic patients who have an intracerebral hemorrhage. But many discomforts develope in patients with a nasogastric-tube. Therefore, it is necessary to decide when to remove the tube and as early as possible. The purpose of this study is to decide the applying time of training program to facilitate deglution for dysphagic patients who have intracerebral hemorrhage. Among the 343 patients with intracerebral hemorrhage who had been admitted to P-university hospital from April, 1994 to December, 1998, the medical record of the 110 patients with nasogastric tube were reviewed retrospectively. Results from the study were as follows: 1. Nasogastric tube insert duration of improved patients was a mean of 23.2 days 2. When a L-tube was inserted and removed, the L.O.C. of improved patients was $2.6{\pm}0.8$(in the midst of stupor or a semicoma),$1.9{\pm}0.5$(close to drowsy), respectively. This was signifcantly different(P=0.000). 3. When a L-tube was inserted and removed, GCS of improved patients was $9.3{\pm}2.9$, $12.1{\pm}2.2$ respectively. This was significantly different (P=0.000). 4. The duration of nasogastric tube insertion was the longest when in a stupor(L.O.C), 6~8 points(GCS).

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A Study on Needs of the Families of Head Injury Patients (두부 손상환자 가족의 간호요구에 대한 연구)

  • Cho Gyoo-Yeong;Park Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.414-433
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    • 1999
  • The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

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