• Title/Summary/Keyword: Infarction

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Pituitary Apoplexy due to Pituitary Adenoma Infarction

  • Kim, Joo-Pyung;Park, Bong-Jin;Kim, Sung-Bum;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.246-249
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    • 2008
  • Cause of pituitary apoplexy has been known as hemorrhage, hemorrhagic infarction or infarction of pituitary adenoma or adjacent tissues of pituitary gland. However, pituitary apoplexy caused by pure infarction of pituitary adenoma has been rarely reported. Here, we present the two cases pituitary apoplexies caused by pituitary adenoma infarction that were confirmed by transsphenoidal approach (TSA) and pathologic reports. Pathologic report of first case revealed total tumor infarction of a nonfunctioning pituitary macroadenoma and second case partial tumor infarction of ACTH secreting pituitary macroadenoma. Patients with pituitary apoplexy which was caused by pituitary adenoma infarction unrelated to hemorrhage or hemorrhagic infarction showed good response to TSA treatment. Further study on the predisposing factors of pituitary apoplexy and the mechanism of infarction in pituitary adenoma is necessary.

MRI findings on lacunar infarction with no clinical symptoms (임상적 증상이 없는 열공성 뇌경색의 MRI 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.26 no.4
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    • pp.33-38
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    • 2003
  • The purpose of this study was to examine how lacunar infarction developed and what its characteristics were. As this disease had little noticeable clinical symptoms and is likely to draw less attention than other types of cerebrovascular diseases like panhemispheric infarction, it‘s difficult to make an early diagnosis of it or treat it successfully. The subjects in this study were 196 people who showed no clinical symptoms and took a MRI test. When the MRI test data were analyzed, signal intensity and the part where that disease was detected were primarily taken into account. As a result, it's found that 116 people had no lacunar infarction and 80 people suffered from that disease, including 13 with very mild lacunar infarction, 41 with mild lacunar infarction and 26 with lacunar infarction. However, very mild and mild lacunar infarction could not be viewed as clinically significant cases, and only 26 people, which accounted for 13 percent of the subjects, should be considered to be diagnosed with lacuanr infarction. The most common part where that disease was found was white matter and basal ganglia, regardless of gender. Accordingly, those who are exposed to health hazards such as hypertension or diabetes should take a MRI test to prevent cerebrovascular diseases that might be caused by those illnesses.

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The Effectiveness of Decompressive Craniectomy with Dural Augmentation in Malignant Cerebral Infarction (급성뇌경색증에 동반된 악성 뇌부종 환자에 있어서 뇌경막확장성형술을 통한 두개골 감압술의 효용성)

  • Son, Sung Ho;Kim, Soo Young;Jeong, Young Gyun;Cho, Bong Soo;Park, Hyuck;Rhee, Dong Youl
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1072-1078
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    • 2001
  • Objectives : There is continuing controversy about the benefits of decompressive craniectomy in massive cerebral edema following space occupying hemispheric cerebral infarction. The aims of this study are to determine the effectiveness and to confirm the life-saving nature of decompressive craniectomy with dural augmentation for massive cerebral infarction. Patients and Methods : We present twelve patients with medically uncontrollable hemispheric cerebral infarction. All were treated with extensive craniectomy and duroplasty without resection of necrotic tissue. We evaluated various characteristics(size of hemispheric infarction, Glasgow Coma Scale, volume of low density and midline shift in CT) at three different periods(preoperative, immediate postoperative and 3-4weeks after operation) and evaluated effectiveness of hemicraniectomy for massive cerebral edema after large hemispheric infarction. Results : All patients have survived from surgery. Nine patients with nondominant hemispheric infarction showed significant functional recovery with minimal assistance, and remaining two patients with dominant hemispheric infarction and one patient with nondominant hemispheric infarction have functionally dependent. The volume of low density and midline shift in CT were significantly reduced after decompressive craniectomy. Conclusions : Our results indicate that decompressive craniectomy with dural augmentation without resection of necrotic tissue for massive cerebral hemispheric infarction not only reduce the mortality and infarction size but also significantly improve the outcome, especially for nondominant hemispheric infarction.

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Clinical Observation for Prognosis Utilizing Brain Computerized Tomography Findings and Barthel Index In Acute Cerebral Infarction (급성 뇌경색 환자의 Brain-CT 소견과 Barthel ADL을 이용한 예후에 관한 고찰)

  • Lee, Won-Chul
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.316-325
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    • 1997
  • In a 36-month period, 23 selected Patients with Acute Cerebral Infarction were studied utilizing Computerized Tomography, Barthel Index in an attempt to correlate Brain Computerized Tomography findings with 1week, 4weeks rehabilitation and evaluate the influences of the size and location of the lesion. The study suggested that the size of the lesion had impact on 4 weeks rehabilitation. There was significant different between the patients with Middle Cerebral Artery Pial Territory Infarction(I.P.B.M.C.A.) lesion and the patients with Lacunar Infarction(L.I.), Striatocapsular Infarction(S.C.I.), Internal Watershed Infarction(I.W.I.) lesion, but there was no significant difference between the patients with L.I. lesion and the patients with S.C.I. lesion and the patients with I.W.I. lesion. The size and location of the lesion should be considered together in predicting the functional outcomes of Acute Cerebral Infarction.

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Analysis of Ventricular Electromechanical Characteristics by Lesions in Sudden Myocardial Infraction: Computer Simulation Study (급성 심근경색 병변에 따른 심실의 전기 역학적 특성 분석: 컴퓨터 시뮬레이션 연구)

  • Baek, Dong Geun;Jeong, Da Un;Lim, Ki Moo
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.313-320
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    • 2017
  • Myocardial infarction is a disease caused by stenosis of the coronary arteries. The high risk of sudden cardiac death due to myocardial infarction has triggered related researches that have been actively studied so far. However, these studies focused on the clinical results, which are mainly based on observations of symptoms due to infarction through electrocardiograms. Therefore, in this study, we tried to analyze the behavior of heart according to the position and volume of infarction lesion through the computer simulation study using three dimensional ventricular models. In order to implement infarction, commercial software was used to simulate cell necrosis due to blockage of a specific coronary. In addition, the conduction block due to infarction was mimicked by reducing the electrical conduction in the infarcted area, which was 100 times less than the electrical conduction of the whole ventricular lattice implemented by the finite element analysis method. Thus, this study classified the infarcted cases into the upper, middle, lower, and apex according to lattice data of eight different infraction areas. In other words, we assumed that myocardial infarction would have inherent electro-dynamic characteristics depending on the location and extent, and analyzed the ventricular electromechanical responses for infarction lesions using a three dimensional cardiac physiome model. The results showed that the volume of infarction did not directly affect the cardiac responses, but the location of the infarction lesions could influence the ventricular pumping efficiency. These suggest that the occlusion of specific coronary arteries may have a fatal effect on the decline in ventricular performance. In conclusion, although location of myocardial infarction lesions is considered to be an important variable to be considered clinically rather than lesion size, quantitative predictions should be made more in the future considering physiological factors such as lesion location and direction of myocardial fiber at that location.

A Clinical Study on Stroke patients(CVA) in Seosan province (서산 지역에서의 중풍에 대한 임상적 고찰)

  • Lee, Geun-Dong;Seo, Jong-Eun;Han, Sung-Soo
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.715-721
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    • 2000
  • Objective : The purpose of this study is about stroke patients in Seosan. Method : The subjects of this study were 45 patients who were admitted to Hanseo University Oriental Hospital because of stroke. Each patients was diagnosed with Brain CT, sasang constitutional analysis. Results : 1. The rates in CVA was 58% on cerebral infarction, and 42% on cerebral hemorrhage. 2. The sites of cerebral infarction were Basal ganglia, MCA, Internal. External capsule. Thalamus, ect. Sites of cerebral hemorrhage were Thalamus, Basal ganglia, Cerebellum. 3. The ratio of left and right hemiplegia in cerebral infarction was 1:1.6, and in cerebral hemorrhage it was 1:2. 4. The most chief complaints in cerebral infarction, were hemiplegia, dysarthria, facial palsy, headache. In cerebral hemorrhage, their were hemiplegia, dysarthria, headache, dizziness, and facial palsy. 5. Classification of human corporal constitution in cerebral hemorrhage, the most was Taeumin, Soyangin, Soeumin. And in cerebral infarction, the most was Soyangin, Taeumin, Soyumin. 6. The ratio between male and female was 1.25:2 in cerebral hemorrhage, 2.5:5 in cerebral infarction. 7. The most prevalent age groups in cerebral hemorrhage was fifties to sixties. and in cerebral infarction was fifties to sixties. 8. The most common preceding disease in cerebral hemorrhage was HTN, DM. 9. The recurrence rate of cerebral hemorrhage was 16%, and cerebral infarction was 8%. 10. The ratio of recovery in cerebral hemorrhage was 84%, in cerebral infarction 58%. Conclusion : From this study, in cerebral hemorrhage most patients were Taeumin, in their fifties to sixties. And in cerebral infarction most patients were Soyangin, in their sixties to eighties. In both stroke patients, there were more female than male patients.

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Case Report of Cerebellar Artery Infarction Patients Treated by Traditional Korean Medicine (소뇌혈관별 경색에 따른 환자 증례보고)

  • Heo, Jong-won;Cha, Ji-yoon;Jo, Hyun-kyung
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.143-155
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    • 2016
  • Objective: This study reports on three cases of cerebellar artery infarction patients treated by traditional Korean medicine.Method: Three patients with cerebellar artery infarction according to cerebellar artery were treated by traditional Korean medicine at the traditional Korean medicine hospital of Daejeon University. The posterior cerebral artery (PCA) infarction patient had ataxia, dysarthria, gait disturbance, and dizziness; the anterior inferior cerebellar artery (AICA) infarction patient had facial palsy, dizziness, and hearing loss; and the posterior inferior cerebellar artery (PICA) infarction patient had gait disturbance and dizziness. Acupuncture, herbal medicine, and pharmacopuncture were used as traditional Korean medicine treatments during hospitalization. We then observed any improvement in the symptoms.Results: The scale for the assessment and rating of ataxia (SARA) score (gait, stance) of the PCA infarction patient was reduced from 8.6 to 2.2, while the dizziness numerical rating scale (NRS) score was reduced from 10 to 2 after treatment. The Yanagihara score of the AICA infarction patient was reduced from 27 to 14, while the dizziness NRS score was reduced from 10 to 2 after treatment. The SARA score (gait, stance) of the PICA infarction patient was reduced from 7.4 to 1.0, and the dizziness NRS score was reduced from 10 to 1 after treatment.Conclusion: Traditional Korean medicine appears to be effective in treating cerebellar infarction symptoms.

Acute Cerebral Infarction after Head Injury

  • Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.393-395
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    • 2005
  • Cerebral infarction rarely occur following head injury. The authors present the case of a 39-year-old man with complete infarction in the middle cerebral artery[MCA] and anterior cerebral artery[ACA] territories ccurred immediately after head injury. He had compound depressed fracture in right frontal bone with no neurological deficit. After the depressed bone elevation, postoperative computed tomography scan showed the right MCA and ACA territory infarction with midline shift. Cerebral angiography obtained on the day after emergent decompressive craneictomy showed the complete occlusion of the internal carotid artery[ICA] at the level of lacerum ICA segment. There was no evidence of neck vessel dissection and basal skull fracture. Cerebral infarction can occur in an ultraearly period after head injury without neck vessel dissection or basal skull fracture. We stress the need for attention to the cerebral infarction as the cause of a rare neurological deterioration of the head trauma.

Effects of Coptidis Rhizoma on the Anti-inflammation and Motor Recovery in Photothrombotic Brain Infarction Model in Rats (광화학적 뇌경색 백서 모델에서 황련의 항염증 및 운동기능 회복에 미치는 효과)

  • Lee, Su-Kyung;Lee, In;Shin, Sun-Ho;Kim, Eun-Young;Shin, Byung-Cheul
    • The Korea Journal of Herbology
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    • v.24 no.1
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    • pp.179-189
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    • 2009
  • Objectives : Coptidis Rhizoma (Coptis japonica MAKINO; CR) is a well known crude drug as antimicrobial, antibacterial, anti-inflammatory, antioxidant activity. However, there is no study of the effect of CR on brain infarction and it's mechanism. The aim of this study was to investigate the effects on ischemic stroke induced by photothrombotic infarction by evaluating the functional & neuronal recovery after brain infarction. Materials & Methods : Male Sprague-Dawley rats (250-300 g) were induced photothrombotic brain infarction on sensorimotor cortex, and brain infarction volume by image J software (NIH, USA) after Nissl stain, also single pellet reaching task as a functional motor recovery were observed. After orally pretreated by CR (500 mg/kg) or normal saline as a sham control before 7 days from the time of photothrombotic infarction, rats were sacrificed. After then we analysed anti-inflammatory cytokines (TNF-$\alpha$, IL-6, IL-1$\beta$), by RT-PCR and ELISA method, and immunohistochemistry (GFAP, connexin-43) as a marker of neural plasticity. Results : CR (100, 250, 500 mg/kg) decreased the infarction volume dose-dependently, however the effect of 500mg/kg of CR (CR 500) showed the best (P=0.051). Also, CR 500 decreased the infarction volume time-dependently, the most effective time was 3-7 days after stroke. Photothrombosis increased inflammatory cytokines after infarction, CR 500 suppressed significantly mRNA expression of IL-1$\beta$, IL-6 and TNF-$\alpha$. In serum, CR 500 decreased the amount of IL-1$\beta$, 12h, 24h and 48h respectively (p < 0.05), also decreased that of IL-6 and TNF-$\alpha$, 12h respectively (p < 0.05) after infarction. The more astrocytes were observed and neural plasticity was facilitated in the rat brain of CR 500 than that of sham control in immunohistochemistry. Conclusions : This results suggest that CR decrease infarction volume and improve functional motor recovery in acute stage in photothrombotic ischemic infarction model in the mechanism of anti-inflammation and promoting neural plasticity.