• Journal of Korean Neurosurgical Society
• /
• v.50 no.4
• /
• pp.322-326
• /
• 2011

Objective : Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. Methods : Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. Results : Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). Conclusion : Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ${\geq}$ 70%.

• Annals of Clinical Neurophysiology
• /
• v.2 no.2
• /
• pp.101-106
• /
• 2000

Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.

• Journal of the Korean neurological association
• /
• v.36 no.4
• /
• pp.314-317
• /
• 2018

Focal subarachnoid hemorrhage occasionally presents as transient focal neurologic episodes mimicking transient ischemic attack (TIA). Unless properly diagnosed, it may aggravate cerebral hemorrhage by administering antithrombotic agents. Therefore, clinicians need to be aware that such focal subarachnoid hemorrhage sometimes cannot be detected on noncontrast computed tomography and blood-sensitive magnetic resonance imaging can detect even a small amount of hemorrhage. We describe an 85-year-old woman with focal subarachnoid hemorrhage and possible cerebral amyloid angiopathy who presented transient left arm weakness recurrently, which mimicked TIA.

• Journal of Korean Neurosurgical Society
• /
• v.41 no.4
• /
• pp.224-229
• /
• 2007

Objective : Despite improvement of therapeutic regimen, incidence of stroke increases and it remains a leading cause of death. Our study aims at offering variable data on recurrent strokes. Methods : There were 59 patients who admitted from Jan. 2002 to Dec. 2004 due to recurrent strokes. A retrospective longitudinal cohort study was done. Results : Four-hundred-seventy five patients, diagnosed with acute stroke, experienced 491 strokes in 3 years, and there were 75 recurrent strokes [15.3%] in 59 patients. These 59 patients were included in the study. First hemorrhagic cases [H] were 19 [32%], and the first infarction cases [I] were 40 [68%]. Subsequent strokes after first stroke were as follows : $H{\to}H$ 14 [23.7%] cases, $H{\to}I$ 5 [8.5%], $I{\to}H$ 8 [13.6%], $I{\to}I$ 32 (54.2%]. A Cox regression analyses showed that the first type of stroke was a significant factor to the second stroke as follows : if one has had a hemorrhagic stroke, the possibility of second hemorrhagic attack ($H{\to}H$ attack) increase 3.2 times than ischemic type and in ischemic stroke [$I{\to}I$ attack] 3.6 times increased incidence of second ischemic attack. Conclusion : The recurrence rate of stroke was 12.4% [59 of 475 patients]. If the first stroke is hemorrhage or infarction, the next stroke would have high potentiality of hemorrhage, or infarction. The possibility of same type in second stroke Increase over 3 times. In $H{\to}H$ group, the time interval between first and second stroke was shorter and the age of onset was earlier than in $I{\to}I$ group. Moreover, the infarction was more frequent than hemorrhage in multiple strokes. There was a correlation in lacunar type infarction between first and second attack.

• Journal of Biomedical and Translational Research
• /
• v.19 no.4
• /
• pp.110-115
• /
• 2018

Transient ischemic attack (TIA) indicates high risk for major stroke and is considered a medical emergency. Diffusion-weighted imaging (DWI) enables detection of acute ischemic lesions. The clinical significance of DWI positive lesions in TIA is obscure and its prevalence, clinical features are not established. Therefore, we performed a clinical, etiological and prognostic analysis through a cross-sectional analysis of 235 TIA patients, grouped according to presence of DWI lesion. Clinical features, underlying risk factors for stroke, outcome and rate of recurrence were analyzed. 3 months follow-up of modified Rankin Scales (mRS) were done with telephone survey. DWI positive lesions were present in 14.0% of patients. Etiological factors significantly associated with DWI lesions in TIA patients were male sex (p = 0.038), stroke history (p = 0.012) and atrial fibrillation (p < 0.001). Presence of at least one medium or high risk of cardioembolism from TOAST classification were not associated with lesions when excluding association to atrial fibrillation (p = 0.108). Clinical features showed no significant difference. Whether the patients had lesion-positive DWI was not related to an increase in mRS score during the hospital stay or at the 3-month follow-up after discharge. Future studies should include multi-center samples with large numbers, considering each unique medical environment. Routine acquisition of follow-up DWI for proper evaluation of the tissue-based definition of TIA should also be considered.

• YAKHAK HOEJI
• /
• v.51 no.5
• /
• pp.336-342
• /
• 2007

Treatment of hypertension is important in reducing death and attack rates by Ischemic heart disease (IHD). The purposes of this study are to investigate recent prescriptions for patients with IHD and to evaluate antihypertensive drug use. On the basis of the guidelines proposed by Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure, we analyzed prescriptions of antihypertensive drugs for patients with IHD. It is necessary to set up new guideline for appropriate treatment to lower death and attack rates for patients with IHD.

• The Journal of the Society of Stroke on Korean Medicine
• /
• v.9 no.1
• /
• pp.54-58
• /
• 2008

Transient Ischemic Attack(TIA) is an important risk factor of stroke but often underestimated by clinicians. In this case, we administered oriental-western cooperative therapy to a 72 years old female TIA patient with severe MCA stenosis. After treatment, all symptoms were disappeared and has not reappeared until 1 year follow-up.

• Journal of Ginseng Research
• /
• v.46 no.4
• /
• pp.585-591
• /
• 2022

Background: Korean Red Ginseng (KRG) extract has been shown to have beneficial effects in patients with atherosclerosis, suggesting that KRG extract may be effective in preventing subsequent ischemic stroke in patients with severe atherosclerosis. Methods: This double-blind, placebo-controlled trial randomized patients with severe atherosclerosis in major intracranial arteries or extracranial carotid artery, to ginseng group and placebo group. They were given two 500-mg KRG tablets or identical placebo tablets twice daily for 12 months according to randomization. The primary endpoint was the composite of cerebral ischemic stroke and transient ischemic attack during 12 months after randomization. The secondary endpoints were change in volumetric blood flow of the intracranial vessels and the incidence of newly developed asymptomatic ischemic lesions. Any adverse events were monitored. Results: Fifty-eight patients were randomized from June 2016 to June 2017, 29 to ginseng and 29 to placebo, and 52 (28 and 24, respectively) completed the study. One patient in the placebo group, but none in the ginseng group, experienced ischemic symptoms (p = 0.46). Changes in volumetric blood flow and the presence of ischemic brain lesions did not differ significantly in the two groups, and none of these patients experienced adverse drug reactions. Conclusion: Ginseng was well tolerated by patients with severe atherosclerosis, with these patients showing good compliance with ginseng dosing. Ginseng did not show significant effects compared with placebo, although none of the ginseng-treated patients experienced ischemic events. Long-term studies in larger patient populations are required to test the effect of ginseng.

• The Journal of Korean Medicine
• /
• v.23 no.3
• /
• pp.119-133
• /
• 2002

Objectives : This study was designed to investigate significant differences between the first attack and reattack groups to form fundamental data for decreasing recurrence and secondary prevention of stroke. Methods : I studied 204 patients admitted within 7 days of onset, after the diagnosis of stroke, in the Oriental Medical Hospital of Dongeui University from February to July in 2001.compared the reattack group with the first attack group for risk factors, clinical symptoms and progress, average mark and degree of improvement in Activity Index. Results : 1. Meaningful risk factors associated with the reattack group were male sex, a past history of hypertension and transient ischemic attack, and a family history of stroke. 2. The reattack group had conscious or cognitive disorder in early stage of onset, dysphagia, constipation, urinary incontinence, visual field defect in acute stage, high blood pressure and tachycardia in abnormalvital sign in acute stage, neuropsychosis, shoulder pain and rigidity, and pneumonia in complications more than the first attack group. 3. In Activity Index, the average mark of reattack group was lower than that of the first stroke group and improvement of the reattack group was delayed compared with the first attack group. Conclusions : The reattack group had more severe symptoms and clinical progress than the first attack group.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.3
• /
• pp.257-260
• /
• 2009

Intraventricular hemorrhage long after successful encephaloduroarterio synangiosis (EDAS) is very rare. The effect of revascularization surgery for preventing hemorrhagic event of moyamoya disease remains controversial. We report a 17-year-old female with intracerebral hemorrhage and intraventricular hemorrahge 10 years after successful EDAS. Even though cerebral vessels angiography showed good collateral circulations without specific weak points, a cerebral hemorrhage could occur in patient with ischemic type of moyamoya disease long after successful indirect bypass operations. Good collateralization of cerebral angiography or magnetic resonance perfusion image after indirect bypass surgery would ensure against ischemic symptoms, not a hemorrhage. And, thus a life-time follow-up strategy might be necessary even if a good collateral circulation has been established.