• Title/Summary/Keyword: acute stroke

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Factors Affecting Delayed Hospital Arrival Times in Acute Ischemic Stroke Patients

  • Lim, Yong-Deok;Choi, Sung-Soo
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.7
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    • pp.53-59
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    • 2016
  • The purpose of this study was to investigate the factors of hospital arrival delays of acute ischemic stroke patients. The study subjects were 126 cerebral infarction patients G Metropolitan City university hospital emergency center. General characteristics, disease-related characteristics and stroke-related were collected by self-reported questionnaires. Hospital arrival times by subjects' characteristics were tested by $x^2$ test and logistic regression analysis. Of 126 cerebral infarction patients, Their average hours taken to move to a hospital was 12.7 hours with the fastest case being 0.5 hour and the most delayed case being 127.8 hours. 61.1%(77 persons) of the stroke patients under this experiment said to have taken 3 hours or less. In logistic regression analyses, Coming to the hospital directly without passing through other hospitals was found to have higher probability of arriving less than 3 hours(${\beta}$=2.960, p=.009), And if LAPSS was tested positive, such cases are more likely to arrive within 3 hours(${\beta}$=2.219, p=.049). For acute ischemic stroke and caregivers need training to be conducted promptly admitted to hospitals for education and treatment hospital stroke screening will help to improve the treatment of stroke patients

A Case report of acute stroke patients treated with Chungyoung-tang (청영탕(淸營湯)으로 신진장애를 가진 중풍 초기 환자 치험례)

  • Cho, Yoon-Seong;Jung, Eun-Woo;Kim, So-Yeon;Kim, Hyun-Sik;Lee, Sang-Kwan
    • Herbal Formula Science
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    • v.15 no.2
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    • pp.171-178
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    • 2007
  • This study is clinical report for a acute stroke patient who was improved by treatment of a herbal medication. Stroke patients often shows spirit disorder in early stage. However, the cases which applied Onbyung theory are rare. This paper aims to show that Onbyung theory can be effective to acute stroke. We diagnosed the patient as invasion of the yong system by heat(熱入營分), which showed confusion, insomnia, delirium, anxiety, reddened tongue and dry mouth with cracked lip. After administration of Chungyung-tang(淸營湯) in Wen bing Tiao (溫病條辨), the patient showed those symptoms were highly improved. Thus, we concluded that Onbyung Theory can the patient be adapted to improve the symptom of acute stroke.

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Investigation on Warning Signs of the patients with Acute Ischemic Stroke (급성기 뇌경색 환자의 전조증상 유무에 따른 특성 비교)

  • Jung, Jae-han;Sun, Jong-joo;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Ko, Seong-gyu;Chen, Chan-yong;Han, Chang-ho
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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    • pp.59-64
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    • 2006
  • Objective : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : Three-hundred sixty three acute stroke patients were recuited in the oriental medical hospitals of 3 universities located in metropolitan region from October in 2005 to October in 2006. We evaluated their stroke type with brain MRI, their waring signs, and general characteristics such as age, sex, past history, risk factor, etc. Result : Of the 363 patient, 138(38%) patients were experience of warning signs. The frequency of Stress were found more in experience of warning signs than none of them. Warning signs were more common in Large Artery Atherosclerosis than in the other etiology. Conclusion : Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which their patients appeal. For the further investigation, it seems to be necessary to construct fundamental databases for stroke by increasing the number of patients and by examination into the etiology and location.

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Paradigm Shift in Intra-Arterial Mechanical Thrombectomy for Acute Ischemic Stroke : A Review of Randomized Controlled Trials after 2015

  • Sheen, Jae Jon;Kim, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.427-432
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    • 2020
  • Three randomized control trials (RCTs), published in 2013, investigated efficacy of mechanical thrombectomy in large vessel occlusions and did not show better results compared to intravenous (IV) recombinant tissue-type plasminogen activator (tPA) alone. However, most clinicians treating stroke consider mechanical thrombectomy as the standard treatment rather than using IV tPA alone. This paradigm shift was based on five RCTs investigating efficacy of mechanical thrombectomy in acute ischemic stroke conducted from 2010 to 2015. They demonstrated that mechanical thrombectomy was effective and safe in acute ischemic stroke with anterior circulation occlusion when performed within 6 hours of stroke onset. There are four reasons underlying the different results observed between the trials conducted in 2013 and 2015. First, the three RCTs of 2013 used low-efficiency thrombectomy devices. Second, the three RCTs used insufficient image selection criteria. Third, following the initial presentation at the hospital, reperfusion treatment required a long time. Fourth, the three RCTs showed a low rate of successful recanalization. Time is the most important factor in the treatment of acute ischemic stroke. However, current trends utilize advanced imaging techniques, such as diffusion-weighted imaging and multi-channel computer tomographic perfusion, to facilitate the detection of core infarction, penumbra, and collateral flows. These efforts demonstrate that patient selection may overcome the barriers of time in specific cases.

The Effects of Repetitive Transcranial Magnetic Stimulation on the Gait of Acute Stroke Patients

  • Ji, Sang-Goo;Kim, Myoung-Kwon
    • Journal of Magnetics
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    • v.20 no.2
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    • pp.129-132
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    • 2015
  • The aim of the present study was to examine whether repetitive transcranial magnetic stimulation (rTMS) can improve gait ability of acute stage stroke patients. This study was conducted with 39 subjects who were diagnosed as having a hemiparesis due to stroke. The experimental group included 20 subjects who underwent repetitive transcranial magnetic stimulation and the control group included 19 subjects who underwent sham therapy. The stroke patients in the experimental group underwent conventional rehabilitation therapy and rTMS was applied daily to the hotspot of the lesional hemisphere. The stroke patients in the control group underwent sham rTMS and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for four weeks. Temporospatial gait characteristics, such as stance phase, swing phase, step length in affected side, velocity, and cadence, were assessed before and after the four week therapy period. A significant difference was observed in post-treatment gains for the step length in the affected side, velocity, and cadence between the experimental group and control group ( p < 0.05). However, no significant differences were observed between the two groups on stance phase and swing phase ( p > 0.05). We conclude that rTMS may be beneficial in improving the effects of acute stage stroke on gait ability.

The Effectiveness of Combination Therapy of Oriental Medicine and Western Medicine on Acute Stroke: a controlled study (급성기 뇌졸중에 대한 한양방 병용치료의 효과)

  • Park, Jung-Mi;Choi, Byung-Ok;Jung, Woo-Sang
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.393-396
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    • 2001
  • Objectives: We were to assess the effectiveness of combined therapy of Oriental Medicine and Western Medicine on acute stroke. Methods: We selected acute middle cerebral artery territory infarction subjects, within 3 days after stroke onset, who had never have any type of stroke history before. The subjects, admitted to department of Oriental Medicine, received combination therapy of western medical treatment including thrombolytic, anticoagulant, or antiplatelet agents and oriental medical treatment including acupuncture and herbs medication. The other subjects, admitted to department of Neurology, received only modern western medical treatment. The National Institute of Health Stroke Scale (NIHSS) was checked at admission, 1 week and 2 weeks later to assess neurologic improvement. The Modified Barthel Index (MBI) was checked 1 week and 2 weeks after admission to motor function recovery. Results: Comparing the NIHSS between baseline and 1 week later, the combination therapy group showed more improvement than the single-treated with anticoagulants group. However, there was no significant difference between the two groups, comparing 1 week and 2 weeks later with the NIHSS and the MBI. Conclusions: Combination therapy have more beneficial effect on acute stage of stroke.

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Seasonal Variation of Acute Stroke;Hospital Based Study

  • Yun, Sang-Pil;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.29 no.2
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    • pp.1-6
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    • 2008
  • Objectives: This study aimed to investigate the seasonal variation in stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions. Methods: 226 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from November 2005 to October 2006. The year was subdivided into four parts: spring (March-May); summer (June-August); fall (September-November); and winter (December-February). Stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions in the four groups were examined. Results: Ischemic stroke was most frequent in summer, whereas hemorrhagic stroke was most frequent in winter. There was no significant difference in seasonal variation of stroke. The frequency of ischemic heart disease among stroke risk factors was significantly high in spring (p=0.031). The frequency of hypertension, diabetes mellitus, atrial fibrillation, and hyperlipidemia did not differ among seasons. There was no significant difference in Sasang constitution among seasons. Frequency of small vessel occlusion was highest in summer. Large artery atherosclerosis was frequent in spring and summer,but seasonal variation of ischemic stroke subtypes did not show statistical difference. Conclusion: Acute stroke demonstrates seasonal characteristics according to stroke types, ischemic stroke subtypes, risk factors for stroke, and Sasang constitutions. These results have important clinical implications in stroke prevention.

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Acute Ischemic Stroke Involving Both Anterior and Posterior Circulation Treated by Endovascular Revascularization for Acute Basilar Artery Occlusion via Persistent Primitive Trigeminal Artery

  • Imahori, Taichiro;Fujita, Atsushi;Hosoda, Kohkichi;Kohmura, Eiji
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.400-404
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    • 2016
  • We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke.

A Correlation Research of Diet and Lifestyle According to Sasang Constitution in Acute Stroke Patients (급성기 중풍 환자의 사상체질별 분포와 식생활습관 간의 상관성에 대한 연구)

  • Kim, Yong-Hyung;Choi, In-Young;Ma, Mi-Jin;Gang, A-My;Choi, Dong-Jun;Han, Chang-Ho;Lee, Won-Chul;Jun, Chan-Yong;Cho, Ki-Ho;Choi, Sun-Mi
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.741-750
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    • 2007
  • Objective : This study investigated the relationship between diet and lifestyle and Sasang constitution (SC) in acute stroke patients. Methods : From October 2005 to March 2007, 379 acute stroke patients were included. Patients were hospitalized within 14 days after the onset of stroke at DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital or Department Cardiovascular and Neurologic Diseases (stroke center), Kyung Hee University Oriental hospital. We assessed the type of SC of acute stroke patients by Questionnaire for Sasang Constitution Classification II (QSCC II). We investigated general characteristics, stroke types, dietary preferences (meat, sea food, fast food, alcohol drinking, coffee and green tea drinking) and lifestyle (smoking, exercise) according to SC. Results : This study showed that out of the total patients, the proportion of So-yang to Tae-eum to So-eumwas equal to 2.6 to 2 to 1. Of note, this study showed a higher proportion in age of So-eum & weight of Tae-eum. The ratio of cerebral hemorrhage to cerebral infarction was 1 to 9. SVO, LAA, SUE are the 3 types of cerebral infarction classified by TOAST; SVO ranked the highest while SUE ranked the lowest in all constitutions. There were no significant differences between So-yang and Tae-eum in the aspect of the preference for meat, but the majority of So-eum displayed high preferences for seafood. In the aspect of alcohol drinking and smoking history, So-yang recorded significantly bigger proportion while So-eum & Tae-eum patients represented a bigger proportion than So-yangin the aspect of no exercise habits. Conclusion : According to the result above, we could observe the general disposition of various characteristic distributions according to SC of acute stroke patients. Also, we could observe a relationship between diet and lifestyle and Sasang constitution (SC) in acute stroke patients. Further studies will be needed to better understand the relationship between diet and lifestyle and Sasang constitution (SC) in acute stroke patients.

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Oleanolic Acid Provides Neuroprotection against Ischemic Stroke through the Inhibition of Microglial Activation and NLRP3 Inflammasome Activation

  • Sapkota, Arjun;Choi, Ji Woong
    • Biomolecules & Therapeutics
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    • v.30 no.1
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    • pp.55-63
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    • 2022
  • Oleanolic acid (OA), a natural pentacyclic triterpenoid, has been reported to exert protective effects against several neurological diseases through its anti-oxidative and anti-inflammatory activities. The goal of the present study was to evaluate the therapeutic potential of OA against acute and chronic brain injuries after ischemic stroke using a mouse model of transient middle cerebral artery occlusion (tMCAO, MCAO/reperfusion). OA administration immediately after reperfusion significantly attenuated acute brain injuries including brain infarction, functional neurological deficits, and neuronal apoptosis. Moreover, delayed administration of OA (at 3 h after reperfusion) attenuated brain infarction and improved functional neurological deficits during the acute phase. Such neuroprotective effects were associated with attenuation of microglial activation and lipid peroxidation in the injured brain after the tMCAO challenge. OA also attenuated NLRP3 inflammasome activation in activated microglia during the acute phase. In addition, daily administration of OA for 7 days starting from either immediately after reperfusion or 1 day after reperfusion significantly improved functional neurological deficits and attenuated brain tissue loss up to 21 days after the tMCAO challenge; these findings supported therapeutic effects of OA against ischemic stroke-induced chronic brain injury. Together, these findings showed that OA exerted neuroprotective effects against both acute and chronic brain injuries after tMCAO challenge, suggesting that OA is a potential therapeutic agent to treat ischemic stroke.