뇌혈관질환과 심근경색증에 관련된 요인의 비교분석

박종구,김헌주,박금수,이성수,장세진,이은경 연세대학교 원주의과대학 1994 원주의대논문집 Vol.7 No.1

전산화단층촬영에 의한 뇌졸중의 병형별 임상상에 대한 연구

정문성,양인석,주신배,김건중,한경아,지영구,한형수,박원,문성수,유병희,이홍순,이학중 대한내과학회 1990 대한내과학회지 Vol.38 No.4

Clinical features were analyzed in 585 patients with cerebrovascular disease who were admitted to the National Medical Center between January 1984 and June 1988 and whose subtypes were diagnosed by computed tomographic brain scan. The results of the stady were as follows: 1) The 585 cases consisted of 13% subarachnoid hemorrhage, 31% of cerebral hemorrhage, 35% of cerebral infarction, 13% of transient ischemic attack and 3% of cerebral embolism. 2) Both cerebral hemorrhage and infarction were most frequently seen in their seventh decade, followed by the sixth and fifth decades in hemorrhage, and sixth and eighth decades in infarction. 3) In the cerebral hemorrhage group, 55.8% of the subjects were associated with a known past history of hypertension and 5.4% of the subjects with diabetes. While 73.7% of the hemorrhages occured in the basal ganglia and thalamic area, only 19.2% of the subjects with diabetes. While 73.7% of the subjects with diabetes. While 73.7% of the hemorrhages occured in the basal ganglia and thalamic area, only 19.2% of the hemorrhages occurred in the subcortical lobar area. 4) In the group of cerebral infarction, 48.6% of the cases were associated with a known history of hypertension and 15.4% of the subjects with diabetes. The lesion sites of the infarction were the lobar area involving the cortex in 51.8% and the basal ganglia and thalamus in 42.6%. The former were mainly large in infarct size and wedge-shaped, while the latter were small and round in the shape of the infarction. The site, size and shape of the cerebral infarcts may suggest the presence of different mechanisms in the pathogenesis of cerebral infarction.

경동맥 영역의 열공경색증 환자에서 중뇌동맥 협착의 중요성

방오영,조정훈,허지회,김동익 대한신경과학회 1999 대한신경과학회지 Vol.17 No.4

Cerebrovascular Events in Pediatric Inflammatory Bowel Disease: A Review of Published Cases

Pejman Rohani,Nazanin Taraghikhah,Mohammad Mehdi Nasehi,Hosein Alimadadi,Hamid Assadzadeh Aghdaei 대한소아소화기영양학회 2022 Pediatric gastroenterology, hepatology & nutrition Vol.25 No.3

Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3–6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn’s disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

Remote Cerebellar Infarction after Supratentorial Craniotomy and Its Management: Two Case Reports

Seon-Jin Yoon,홍창기 대한뇌종양학회 2015 Brain Tumor Research and Treatment Vol.3 No.2

The cerebellar infarction resulting from supratentorial craniotomy is uncommon event and its management has been controversial. After removal of space occupying lesion on right frontal area, two cases of remote cerebellar infarctions occurred. We reviewed each cases and the techniques to manage such complications are discussed. Early extraventricular catheter insertion and midline suboccipital craniectomy were effectively performed in obtunded patients from cerebellar infarction.

CASE REPORT : Remote Cerebellar Infarction after Supratentorial Craniotomy and Its Management: Two Case Reports

( Seon-jin Yoon ),( Chang-ki Hong ) 대한뇌종양학회·대한신경종양학회 2015 Brain Tumor Research and Treatment Vol.3 No.2

The cerebellar infarction resulting from supratentorial craniotomy is uncommon event and its management has been controversial. After removal of space occupying lesion on right frontal area, two cases of remote cerebellar infarctions occurred. We reviewed each cases and the techniques to manage such complications are discussed. Early extraventricular catheter insertion and midline suboccipital craniectomy were effectively performed in obtunded patients from cerebellar infarction.

소양인(少陽人) 중풍환자(中風患者)에 병발된 Aspiration Pneumonia에 형방패독산(荊防敗毒散)을 투여한 증례(證例)

심규헌,김정렬,김달래,한동윤,Shim, Gyu-Heon,Kim, Jung-Ryul,Kim, Dal-Rae,Han, Dong-Youn 사상체질의학회 2003 사상체질의학회지 Vol.15 No.2

Aspiration pneumonia is common complication in Stroke patient. A 60-years-old man was admitted because of cerebrovascular infarction. This patient had problem of aspiration pneumonia. Without Western medical treatment(Antibiotics), patient's symptoms, sign and laboratory findings were improved through Soyangin Hyoungbangpaedoksan treatment. So, we report it for the better treatment.

경두개 도플러(TCD)를 이용한 정상군과 뇌경색군의 상호비교연구

최재영,이동원,정승현,이원철,Choi, Jae-Young,Lee, Dong-Won,Jeong, Sung-Hyun,Lee, Won-Chul 대한한방내과학회 1998 大韓韓方內科學會誌 Vol.19 No.1

Background and Purpose : Cerebrovascular reactivity(CVR) can be estimated by measuring the change of cerebral blood flow that occurs during vasostimulation. To estimate the cerebrovascular reactivity, we investigated the change of flow velocity of the middle cerebral artery(MCA) during hyperventilation and hypoventilation with the transcranial doppler. So we studied whether the CVR measured by this method could show a significant difference between the normal and the cerebral infarction subjects and whether the CVR may decrease with age in normal subjects. Methods : Using transcranial doppler, we measured the mean velocity(Vm), the pulsatility index(P.I.) at the resting state, the end of breath-holding and the end of hyperventilation in 36 normal and 10 cerebral infarction subjects, so we calculated the percentile change of mean velocity(%${\Delta}$Vm) and P.I.(%${\Delta}$P.I.) after the vasostimulation. We estimated the change of Vm, P.I., %${\Delta}$Vm and %${\Delta}$P.I. by the age group and compared those parameters between the age-matched normal control and cerebral infarction subjects. Results : The Vm in MCA significantly decreased with age(p<0.05), but there was no significant difference in Vm and P.I. between normal and cerebral infarction subjects. The %${\Delta}$Vm and %${\Delta}$P.I. in response to hyperventilation significantly decreased with age in MCA and there was significant difference in $%{\Delta}Vm$ of MCA after breath-holding between the normal and cerebral infarction subjects. Conclusion : The breath-holding and hyperventilation tests could be non-invasive and useful methods in estimation of the cerebrovascular reactivity and could be applied in the basal and follow-up evaluation of the cerebrovascular reserve of the ischemic stroke patients.

Five - year Trends of Cerebrovascular Surgery in a Neurosurgical Department with a Small Volume of Practice at a Single Institute with Reference to the Endovascular Treatment

변형수,전형준,이형중,이영준,김현영,김동원 대한뇌혈관외과학회 2010 Journal of Cerebrovascular and Endovascular Neuros Vol.12 No.2

Objective : In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. Method : We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008. Results : The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation. Conclusion : Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD. (Kor J Cerebrovascular Surgery 12(2):91-97, 2010)

급성 허혈성 뇌졸중과 동시에 발생한 급성 심근 경색 2예

박종규 ( Jong Kyu Park ),이상학 ( Sang Hak Lee ),최성훈 ( Seong Hoon Choi ),정재헌 ( Jae Hun Jung ),이남호 ( Nam Ho Lee ) 대한내과학회 2008 대한내과학회지 Vol.74 No.6

심근 경색과 허혈성 뇌졸중은 그 위험 요인과 병태 생리에 공통점이 있다. 간혹 이 두 질환이 한 환자에서 비슷한 시기에 일어날 수 있으나, 대개 수일에서 수주일의 간격을 두고 생긴다. 그러나 심근 경색과 뇌졸중이 동시에 생기는 경우는 드물며, 이런 경우 심근 경색에 대한 정확한 진단과 치료가 어려울 수 있다. 특히 급성 뇌졸중은 심근 경색의 전형적인 특징을 바꾸기도 하므로, 이 두 질환이 합병된 것을 발견하려면 진단에 대한 적극적인 의심이 필요하다. 저자들은 뇌졸중과 심근 경색이 동시에 발생한 두 환자를 보고하였다. 두 환자 모두에서 두 질환이 같은 날 발생하였다. 첫 환자에서는 의식 변화로 인해 흉부 증상에 대한 문진이 불가능하였고, 두번째 환자는 흉통을 호소하지 않는 환자였다. 두 증례 모두에서 임상 소견과 검사 소견을 통해 동시에 생긴 뇌졸중과 심근 경색을 진단하였으며, 응급으로 경피적 관동맥 중재술을 통하여 심근 경색을 치료하였다. Myocardial infarction (MI) and stroke often share the same risk factors and pathogenic mechanism. Sometimes they can occur in the same patient proximately, occurring days or weeks apart. However, the simultaneous occurrence of MI and stroke is rare and presents a diagnostic and therapeutic challenge. Specifically, an acute stroke can alter typical features of MI. Thus, recognition of the coexistence of these two events requires a high threshold of suspicion. The authors describe two patients who presented with simultaneous stroke and MI development. The two events developed on the same day in both patients. The second patient did not have chest pain, whereas chest symptoms could not be assessed in the first patient secondary to altered mental status. After the diagnoses were made using clinical and laboratory findings, urgent percutaneous coronary intervention was performed in both patients.(Korean J Med 74:672-675, 2008)