No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

BACKGROUND: Atrial fibrillation (AF), commonly considered as a cardiac embolic source, can itself be induced by stroke. We therefore tried to find and analyze this 'stroke-induced' AF. METHODS: From the Inha University Stroke Registry of the past 2 years, 143 middle cerebral artery (MCA) territorial infarct patients who had been admitted within 48 hours after stroke onset were recruited to participate in the study. Electrocardiograms (EKG) on admission and follow-up during hospitalization were analyzed. Also, MCA infarct was subdivided according to insular involvement by brain imaging. RESULTS: Among 143 MCA territorial infarcts, 38 patients had AF on admission (Rt:21; Lt:17). Of those, insular involvements of the MCA infarct was noted in 32 patients. All the patients had a follow-up EKG and AF disappeared in 3 patients (Rt:2; Lt:1). In the remaining 105 patients, 10 patients subsequently developed new AF within 1 week after hospitalization. All those 10 patients had right-sided MCA infarcts and insular involvements were present in 9 patients. In summary, among the 48 MCA infarct associated with AF, 13 AF (Rt:12; Lt:1) were presumed to be the consequence and not the cause of stroke. CONCLUSIONS: Though human insular stimulation and inactivation studies have suggested that AF would be more common in left insular destructive lesions, it was not always supported in clinical series. From our study, presumed 'stroke-induced' AF was highly associated with right insular lesions. The mechanism of arrhythmogenesis by ischemic stroke might be more complicated than previously expected and, not merely the simple inactivation of an anatomical substrate, the insular cortex.
Atrial Fibrillation* ; Electrocardiography ; Follow-Up Studies ; Hospitalization ; Humans ; Middle Cerebral Artery* ; Neuroimaging ; Stroke

Intracerebral hemorrhage is the most serious complication of cerebral arteriovenous malformations (AVM). To identify angiographic characteristics of AVM which correlate with a history of hemorrhage, we retrospectively analyzed angiographic findings of 25 patients with AVM. Nine characteristics were evaluated; these include nidus size, location, arterial aneurysm, intranidal aneurysm, angiomatous change, venous drainage pattern, venous stenosis, delayed drainage and venous ectasia. These characteristics were correlated with hemorrhage, which was seen in 18 (72%) patients of CT or MR images. Venous stenosis (P<.05) and delaved venous drainage (P<.05) well correlated with a history of hemorrhage. Arterial aneurysm and intranidal aneurysm also had a tendency hemorrhage although they did not prove to be statistically significant. Detailed analysis of angiographic finding of AVM is important for recognition of characteristics which are related to hemorrhage and may contribute to establishing a prognosis and treatment planning.
Aneurysm ; Cerebral Hemorrhage ; Constriction, Pathologic ; Dilatation, Pathologic ; Drainage ; Hemorrhage* ; Humans ; Intracranial Arteriovenous Malformations* ; Prognosis ; Retrospective Studies

No abstract available.
Cleft Lip*

PURPOSE: Most of recent MR imagings of cerebral cortex activation have been performed by using high field magnet above 2-T or echo-planar imaging technique. We report our experience on imaging of cerebral cortex activation with a widely available standard 1.5-T MR. MATERIALS AND METHODS: Series of gradient-echo images (TR/TE/flip angle :80/60/40 degrees64 x 128 matrix) were acquired alternatively during the periods of rest and task in five normal volunteers. Finger movement (n=10 ;5 right, 5 left) and flashing photic stimulation (n=l) were used as a motor task and a visual task to activate the motor cortex and visual cortex, respectively. Activation images were obtained by subtracting sum of rest images from that of task images. Changes of signal intensity were analyzed over the periods of rest and task. RESULTS: Activation images were obtained in all cases. Changes of signal intensity between rest and task periods were 6.5-14.6%(mean, 10.5%) in the motor cortex and 4.2% in the visual cortex. CONCLUSION: Functional imaging of cerebral cortex activation could be performed with a widely available 1.5-T MR. Widespread applications of this technique to basic and clinical neuroscience are expected.
Cerebral Cortex* ; Echo-Planar Imaging ; Fingers ; Healthy Volunteers ; Motor Cortex ; Neurosciences ; Photic Stimulation ; Visual Cortex

An 18-year-old left-handed male harbored intractable medial temporal lobe epilepsy (MTLE) underwent fractionated gamma knife surgery (GKS) instead of open surgery, considering the mental retardation and diffuse cerebral dysfunction. GKS treatment parameters were: target volume, 8.8 cm3; total marginal dose, 24 Gy in 3 fractionations at the 50% isodose line. The patient has been free from seizures since 9 months after GKS, with notable improvement in cognitive outcome. Fractionated GKS could be considered as a safe tool for seizure control and neuropsychological improvement in patients with MTLE.
Adolescent ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Intellectual Disability ; Male ; Radiosurgery* ; Seizures ; Stereotaxic Techniques ; Temporal Lobe*

An 18-year-old left-handed male harbored intractable medial temporal lobe epilepsy (MTLE) underwent fractionated gamma knife surgery (GKS) instead of open surgery, considering the mental retardation and diffuse cerebral dysfunction. GKS treatment parameters were: target volume, 8.8 cm3; total marginal dose, 24 Gy in 3 fractionations at the 50% isodose line. The patient has been free from seizures since 9 months after GKS, with notable improvement in cognitive outcome. Fractionated GKS could be considered as a safe tool for seizure control and neuropsychological improvement in patients with MTLE.
Adolescent ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Intellectual Disability ; Male ; Radiosurgery* ; Seizures ; Stereotaxic Techniques ; Temporal Lobe*

This article report the case of a woman who developed an anterior spinal cord syndrome following epidural block. 10ml of 0.125% bupivacaine and 40mg of triamcinolone were injected epidurally for relief of back pain and radiating pain along the posterolateral aspect of right leg. Within 2 hours, the patient complained of weakness and severe pain in both lower extremities and rapidly became paraplegia. Myelography showed no obstruction and compression. Gd-enhanced sagittal and axial image of thoracic spine shows somewhat inhimogenous at the level of T9 on MRI. The paraplegia was permanent in the left leg and the right leg was slightly improved but grade I. We note a number of potential etiologies and analyze their possible mechanism of action.
Back Pain ; Bupivacaine ; Female ; Humans ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Myelography ; Paraplegia ; Spinal Cord* ; Spine ; Triamcinolone

In 1976 Ramanathan et al introduced a unilimb circle circuit connecting the CO2, absorber and dome valve. A coaxial breathing circuit, Mera F Type breathing circuit, is very light in weight, compact and it can be made any length. This circuit can be used as a circle system, rebreathing or non-rebreathing system and it can be applicable to both pediatric and adult anesthesia. This circuit is easily adaptable to humidification and pollution control devices. It is especially suitable for any kind of surgical procedures including head, neck and others requiring any awkward positions. A clinical study of this circuit was done in 30 cases and compaired with 18 cases using the coventional circuit. Fresh gas flow, tidal volume and respiratory rate were 4 L/min(02:2 L/min., N2O:2L/min.),10 ml/kg and 12-14/min respectively. Controlled ventilation using a volume preset ventilator was used in all cases. After induction, radial artery cannulation with a 20 G angiocatheter was done and blood gas analysis was performed at 30, 60 and 90 minutes respectively. The blood gas analysis was found satisfactory in either the conventional or the Mera F circuit system.
Adult ; Anesthesia* ; Blood Gas Analysis ; Catheterization ; Head ; Humans ; Neck ; Radial Artery ; Respiration* ; Respiratory Rate ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

Cerebral infarction is a known complication of temporal lobe herniation caused by a traumatic intracranial lesion. To ascertain the frequency, time of recognition, and influence on mortality of posttraumatioc cerebral infarction secondary to temporal lobe herniation, we retrospectively reviewed brain CT scans and clinical records of 55 patients who had CT and clinical signs of temporal lobe herniation on admission date. Cerbral infarctions were recognized in seven (12.7%) patients on CT scans taken within two days after admission (mean: 1.3 days). Cerbral infarctions were in the terrtiories of the posterior cerbral artery in all seven patients, two of whom had infarctions of the anterior choroidal artery as well. Mortality (71.4%) for these seven patients was not statistically significant from that (50%) of patients without cerebral infarction admitted with the same range of Glasgow Coma Scale score. The result suggests that such cerebral infarction does not greatly influence atient's mortality.
Arteries ; Brain ; Cerebral Infarction* ; Choroid ; Craniocerebral Trauma* ; Glasgow Coma Scale ; Head* ; Humans ; Infarction ; Mortality ; Retrospective Studies ; Temporal Lobe* ; Tomography, X-Ray Computed