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남병극,이재홍,이순금,이명종 울산대학교 의과대학 1996 울산의대학술지 Vol.5 No.1
Background : There have been some reports of intracranial hemorrhage which were attributed to atherosclerotic occlusive disease of major intracranial arteries, mostly the carotid system. The vertebrobasilar system very rarely presents hemorrhage as a result of occlusion or stenosis. We report a case of cerebellar and subarachnoid hemorrhage with vertebrobasilar atherosclerotic occlusion. Case report : A patient with severe vertigo, diplopia and ataxia of sudden onset was managed with intraarterial thrombolytic therapy for the left vertebral artery occlusion. After that, the arterial occlusion and the neurologic deficits resolved rapidly. Four years later, he developed a sudden headache and vertigo. Brain CT revealed right cerebellar hemorrhage with adjacent subarachnoid hemorrhage. Follow-up angiography showed occlusion of the right vertebral artery with fine collateral vessels. Rupture of small collateral vessels secondary to the atherosclerotic occlusion of the distal vertebral artery was postulated as the underlying cause of hemorrhage. Conclusion : Atherosclerotic occlusive disease of the vertebrobasilar system may bring about intracranial hemorrhage just like moyamoya disease does in the carotid system. The same pathomecha-nism seems to play in these clinical situations.
최영희,남병극,김효경,박지강,홍은석,김양호,Choi, Young-Hee,Nam, Byung-Kuk,Kim, Hyo-Kyung,Park, Ji-Kang,Hong, Eun-Seog,Kim, Yang-Ho 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1
Three workers, field operators in lubricating oil processing of petroleum refinery industry were found unconscious by other worker. One of them who were exposed to an high concentration of H2S was presented with Glasgow Coma Score of 5, severe hypoxemia on arterial blood gas analysis, normal chest radiography, and normal blood pressure. On hospital day 7, his mental state became clear, and neurologic examination showed quadriparesis, profound spasticity, increased tendon reflexes, abnormal Babinski response, and bradykinesia. He was also found to have decreased memory, attention deficits and blunted affect which suggest general cognitive dysfunction, which improved soon. MRI scan showed abnormal signals in both basal ganglia and motor cortex, compatible with clinical findings of motor dysfunction. Neuropsychologic testing showed deficits of cognitive functions. SPECT showed markedly decreased cortical perfusion in frontotemporoparietal area with deep white matter. Another case was recovered completely, but the other expired the next day.