• 대한한방내과학회지
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• 제23권2호
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• pp.253-259
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• 2002

Medial medullary infarction is caused by occlusion of vertebral artery or lower basilar artery. In this report, one case had impaired pain and thermal sense over half the body, and complained of dizziness, nausea and vomiting. The other symptoms were slippery pulse(脈滑), pale tongue with whitish coating(舌淡苔白), white face(面白), obesity(體肥) and unchanged skin color(肌色如故). We diagnosed this patient as the Gastrointestinal Phlegm(食痰) and prescribed Jengjengamiyijin-tang (Zhengchuanjiaweierchen-tang). The symptoms of impaired pain and thermal sense, dizziness, nausea, and vomiting were improved. So, we suggest that Jengjengamiyijin-tang (Zhengchuanjiaweierchen-tang) could be effective to the patient with the symptom of the Gastrointestinal Phlegm(食痰)

• The Korean Journal of Pain
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• 제19권1호
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• pp.51-55
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• 2006

Background: A cervical transforaminal steroid injection is an effective therapeutic modality for radiculopathy of a herniated cervical disc or a cervical foraminal stenosis. However, there is some debate regarding the safety of the transforaminal approach under C-arm guidance compared with the posterior interlaminar approach. We report a new technique for cervical transforaminal steroid injection guided by MDCT. Methods: Patients presenting with radiating pain on their shoulder or arm were diagnosed using CT or MRI of a cervical herniated disc or a foraminal stenosis. Each patient whose symptoms were compatible with the image scan was enrolled in this study. They received a cervical transforaminal steroid injection under CT guidance, and the effectiveness and complications of this technique were evaluated over a 2-month period. Results: According to the CT scan, none of the participants had an internal jugular vein or a carotid artery invasion during the procedure. No vertebral artery injection was noted, and no patient developed a hematoma after the injection. The VAS score had improved significantly by 2, 4 and 8 weeks after the injection. Conclusions: While a conventional C-arm guided cervical transforaminal steroid injection does not appear to differentiate between the major vessels and structures in images, a CT guided approach is a more useful and safer technique for the precise placement of a needle.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.352-355
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• 2001

The authors report two cases of familial hemifacial spasm according to the clinical and three dimensional shortrange magnetic resonance angiography(3D-SRMRA) findings. In the family of the first case, there were five patient's with acquired hemifacial spasm in successive generations. Three male and two female patients in successive generations of the same family developed acquired hemifacial spasm. Four patients were on the left side and one was on the right side. In the family of the second case, there were three patient's with acquired hemifacial spasm in successive generations. Two brothers developed left-sided hemifacial spasm. 3D-SRMRA finding of the probands demonstrated that both anterior inferior cerebellar artery in first case and anterior inferior cerebellar artery & vertebral artery in second case offend the 7th cranial nerve respectively. The presence of familial clustering of these rare disorders suggest an underlying genetic predisposition. All family pedigrees suggest that a pattern of autosomal-dominant inheritance with partial penetrance.

• 대한임상검사과학회지
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• 제53권1호
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• pp.131-136
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• 2021

이중초음파는 반복적으로 검사를 실시할 수 있고, 비교적 저렴하기 때문에 다양한 진료분야에서 널리 이용되고 있다. 그중, 목동맥이중초음파는 뇌혈관질환을 진단하고 예후를 예측하는데 매우 유용한 비침습적 검사이다. 임상에서 목동맥이중초음파의 소요시간을 줄이고 결과의 정확성을 높이는 것은 매우 중요한 작업이다. 일반적으로 환자의 정보를 미리 숙지하는 것만으로도 신속히 정확한 검사를 수행할 수 있다. 하지만 예상과 달리 새롭게 발견되는 목 혈관질환으로 인해 검사하는데 종종 어려움을 겪기도 한다. 따라서 목 부위에서 발생할 수 있는 다양한 증례들을 숙지하는 것은 신속히 정확한 검사결과를 산출하는데 큰 도움이 될 것이다. 이러한 맥락에서, 본 연구는 목동맥이중초음파를 시행하던 중 예기치 않게 발견된 목 혈관질환 증례 3가지를 소개하고자 한다. 증례1. 속목동맥 폐색과 바깥목동맥으로부터 분지된 대뇌혈관; 증례 2. 속목정맥에서 관찰된 혈전; 증례 3. 척추동맥에서 관찰된 미세색전.

• The Journal of Korean Physical Therapy
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• 제12권3호
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• pp.349-359
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• 2000

The aim of study was to evaluated the possible role of cranial artery velocity in headache pathogenesis. The present study was studied of five headache(F=5. Mean $age=29.80\pm6.76yrs$) were compared to 4 controls(F=4, Mean $age=29.00\pm5.48yrs$). Transcranial doppler ultrasonography(TCD) is a new non-invasive and easily applicable method to evaluate flow velocities of the intracranial and extracranial cerebral arteries. TCD was performed with standard method to measure the mean Flow Velocity(MFV) of the middle and posterior cerebral arteries, the internal carotid artery, the vertebral and the basilar artery. We reviewed the whole TCD results performed at Taejon Veterans Hospital from October. 11. 2000 to November. 10. 2000. Mean flow velocities in headaches and controls at their 6 decades are $28.00\pm3.61cm/sec$ and $41.25pm1.71cm/sec$ in lent PCA (P<0.01), $50,000\pm23.07cm/sec$ and $82.75\pm15.59cm/sec$ in right MCA(P<0.05), $26.20\pm4.82cm/sec$ and $45.50\pm4.51cm/sec$ in fight PCA(P<0.01). $26.60\pm4.56cm/sec$ and $38.25\pm4.92cm/sec$ in right VAC(P<0.01). After treatment for 2 weeks, mean of velocity on pre treatment and post treatment and post treatment are $28.00\pm3.61cm/sec$ and $38.20\pm5.81cm/sec$ in left PCA (P<0.05), $26.20\pm4.827cm/sec$ and $39.20\pm5.54cm/sec$ in right PCA(P<0.05), $40.60\pm9.18cm/sec$ in right VA(P<0.01). It is concluded that Electrical Therapy for two weeks was effected to promote Mean Flow of Velocity in cranial artery. Mean of velocity in cranial artery with headaches observed in this study was lower than controls, but MFV was promote after treatment for 2 weeks.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.387-390
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• 2006

We report a case of C1-2 instability with a bilateral high-riding transverse foramen that was treated with rod-screw fixation using a technique of translaminar rigid screw fixation of the axis. It is believed that a C1-2 fixation with bilateral C-2 translaminar screws has an important advantage over previously reported techniques of C1-2 fixation by eliminating the risk of injury to the vertebral artery during C2 screw placement.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.134-136
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• 2010

Bow hunter's stroke is a rare symptomatic vertebrobasilar insufficiency in which vertebral artery (VA) is mechanically occluded during head rotation. Various pathologic conditions have been reported as causes of bow hunter's stroke. However, bow hunter's stroke caused by facet hypertrophy of C1-2 has not been reported. A 71-year-old woman presented with symptoms of vertebrobasilar insufficiency. Spine computed tomography showed massive facet hypertrophy on the left side of C1-2 level. A VA angiogram with her head rotated to the right revealed significant stenosis of left VA. C1-2 posterior fixation and fusion was performed to prevent serious neurologic deficit from vertebrobasilar stroke.

• Journal of Korean Neurosurgical Society
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• 제55권3호
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• pp.152-155
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• 2014

Dural ateriovenous fistula (DAVF) at the craniocervical junction is rare. We report a patient presenting with brainstem dysfunction as an uncommon onset. Brainstem lesion was suggested by magnetic resonance image study. Angiogram revealed a DAVF at a high cervical segment supplied by the meningeal branch of the right vertebral artery, with ascending and descending venous drainage. Complete obliteration of the fistula was achieved via transarterial Onyx embolization. Clinical cure was achieved in the follow-up period; meanwhile, imaging abnormalities of this case disappeared. Accordingly, we hypothesize that a brainstem lesion of this case was caused by craniocervical DAVF, which induced venous hypertension. Thus, venous drainage patterns should be paid attention to because they are important for diagnosis and theraputic strategy.

• Journal of Korean Neurosurgical Society
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• 제43권2호
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• pp.119-122
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• 2008

The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.279-283
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• 2021

Traumatic spinal cord infarction is a rare condition that causes serious paralysis. The regulation of spinal cord blood flow in injured spinal cords remains unknown. Spinal cord infarction or ischemia has been reported after cardiovascular interventions, scoliosis correction, or profound hypotension. In this case, a 52-year-old man revisited the emergency center with motor and sensory abnormalities in all four extremities 56 hours after a motor vehicle collision. Despite the clinical presentation and imaging examination, there were no specific findings on the patient's first visit to the trauma center. Cervical spine computed tomography angiography showed a narrow vertebral artery, and diffusion-weighted imaging revealed spinal cord infarction from C3 to C5 with high signal intensity. It should be kept in mind that delayed-onset spinal cord infarction may occur in minor or major trauma patients as a result of head and neck injuries.