Spontaneous spinal subarachnoid hemorrhage is unusual, accounting for less than 1% of all cases of subarachnoid hemorrhge. Very rare cases have been reported that they had no definitive etiology of spontaneuos spinal subarachnoid hemorrhage. One patient with spontaneous spinal subarachnoid hemorrhage is presented to emphasize the clinical and radiological features of this uncommon illness. The patient had severe back pain at the onset and was unable to walk. The s!mtoms improved slowly with conservative treatments. Complete blood work up CSF culture and spinal angiogrphy failed to reveal a cause for the hemorrhage. This is believed to be the first case report of spontaneous spinal subarachnoid hemorrhage of unknown cause in Korea.
Back Pain ; Hemorrhage ; Humans ; Korea ; Subarachnoid Hemorrhage*

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Audiometry ; Carpal Tunnel Syndrome* ; Condoms* ; Diagnosis ; Hand ; Mass Screening ; Median Nerve ; Neural Conduction ; Occupations ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Ulnar Nerve ; Vibration ; Wrist

Acute infarcts of the anterior inferior cerebellar artery (AICA) territory are unusual. Furthermore incomplete AICA infarcts are perplexing because of its variations of vascular anatomy and inconsistent clinical features. We present a case with clinical features of AICA infarction, which consist of ipsilateral peripheral-type facial palsy, vertigo, and contralateral facial and upper limb sensory changes without motor weakness. The patient had hypertension and was a current smoker. The high signal intensity on inferior pontine tegmental area was found on MRI and the R2 interneuronal dysfunction was note on Blink reflex. The angiographic findings didn't show any focal vascular lesions, which is contrary to the pathogenesis of AICA infarction published previously. On the clinical ground, the present case reserves to attention in that patients with peripheral-type facial palsy should be properly evaluated and with thorough neurological examination and we could differentiate between the incomplete AICA infarcts such as Gasperini syndrome and Bell's palsy.
Arteries ; Bell Palsy ; Blinking ; Facial Paralysis* ; Humans ; Hypertension ; Infarction ; Interneurons ; Magnetic Resonance Imaging ; Neurologic Examination ; Upper Extremity ; Vertigo

BACKGROUND & OBJECTIVES: Severe hemispheric infarction(SHI) reportedly has various range of high mortality. Recently it has been reported that more aggressive therapeutic intervention, such as decompressive hemicraniectomy or mild hypothermia might has potential benefits in the management of SHI. However, the mortality and the prognosis of Sill under the conservative treatment were rarely studied yet in Korea. METHODS: Sixty-six patients with CT proven SHI were subjected among 1649 acute stroke patients registered at the Hallym Stroke Data Bank since Jan. 1993. We analyzed the computerized databases for the mortality and compared inclusively demographic features, clinical characteristics, etiology, therapy modalities and CT findings of fatal group with those of survivors. RESULTS: Twenty-five patients were expired among 66 SI-il patients(mean age: 64.9+/-11.5, male to female ratio;37:29). The mean time to expire was 160.4 hours. The fatal group had a significantly higher incidence of cardioembolism. uncontrolled BP during the acute stage, and extensive infarction territory(MCA+ACA). Risk factors for ischemic stroke such as hypertension, hyperlipidemia. smoking, previous stroke history, diabetes mellitus. and old age were not related to mortality low densities and hyperdense MCA signs on brain imaging were not different between two groups. CONCLUSIONS: The early mortality rate of Sill under the conservative care was 38% in a referral hospital of Korea. intractable hypertension in the acute stage, cardioembolism and extent of infarct area may have predictable values of early mortality of SHI.
Diabetes Mellitus ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Hypothermia ; Incidence ; Infarction ; Korea ; Male ; Mortality* ; Neuroimaging ; Prognosis ; Referral and Consultation ; Risk Factors ; Smoke ; Smoking ; Stroke ; Survivors

OBJECTIVE: The aim of this study was to investigate frontal N30 status in Parkinson's disease (PD) and to examine the correlation between the amplitude of frontal N30 and the severity of motor deficits. METHODS: The frontal N30 was compared between 17 PD patients and 18 healthy volunteers. Correlations between the amplitude of frontal N30 and the Unified Parkinson's Disease Rating Scale (UPDRS) motor score of the more severely affected side was examined. RESULTS: The mean latency of the N30 was not significantly different between patients and healthy volunteers (p = 0.981), but the mean amplitude was lower in PD patients (p < 0.025). There was a significant negative correlation between the amplitude of N30 and the UPDRS motor score (r = -0.715, p = 0.013). CONCLUSIONS: The frontal N30 status indicates the motor severity of PD. It can be a useful biomarker reflecting dopaminergic deficits and an objective measurement for monitoring the clinical severity of PD.
Evoked Potentials ; Evoked Potentials, Somatosensory* ; Healthy Volunteers ; Humans ; Parkinson Disease*

A 57-year-old female was hospitalized for visual disturbance and right hemiparesis. MRI revealed cortical and sub-cortical infarcts in the left occipito-parietal area. One week later, she experienced paroxysmal electric shock like pain on the dorsum of her right hand. All analgesics failed to relieve her pain, but an antiepileptic drug eradicated the pain completely. This unusual seizure could have been misdiagnosed as a thalamic or pseudothalamic pain syndrome had an ictal EEG not been performed. We report the post-stroke somatosensory seizure, only with unilateral ictal pain. (J Korean Neurol Assoc 19(1):49~51, 2001
Analgesics ; Electroencephalography ; Female ; Hand ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Paresis ; Seizures* ; Shock ; Stroke

The habituation of early (R1) and late response (R2) of blink reflex was investigated in 44 patients with Parkinson's disease (PD) and 19 control subjects. The latency, duration and area of R1 and R2 components of blink reflex in single stimulation, and the percentage recovery of R1 in paired stimulation were not different between patients and control subjects. However, in PD patients, the latency of R2 evoked by test stimuli was shorter than that of conditioning stimuli, and the percentage recovery of R2 habituation was increased as compared to that of control subjects. The degree of early recovery of R2 habituation was slightly more evident in advanced PD patients and nonmedicated patients than that of control subjects. In addition, the early recovery of R2 was present in the test of asymptomatic side of PD patients. Our results suggests that blink reflex may be used as a method of evaluating the clinical status of PD patients.
Blinking* ; Humans ; Parkinson Disease*

Venous angioma and cavernous angioma have its own distinctive characteristics in the pathological, radiological, and clinical points of view. However, the chances of coexistence of two disease entities as the neuroimaging techniques developed, and highlight the possibility made us suspect that they might share the same pathogenesis. When they coexist, the clinical symptoms are almost always caused by cavernous angioma. Here, we report 2 cases of cavernous angioma coexisting with a venous angioma in the posterior fossa presenting acute brainstem dysfunction.
Brain Stem ; Hemangioma* ; Hemangioma, Cavernous* ; Neuroimaging

Since the development of magnetic stimulation as a way of assessing the functions of corticospinal pathways, diseases involving central motor pathways have been investigated by motor evoked potentials(@). However, studies correlating MEP findings and the neurological deficits were rarely carried out in patients with stroke. In this study, transcranial magnetic stimulation of the motor cortex and lower cervical area was performed in 50 patients with acute stroke and 23 healthy volunteers. Follow-up tests were performed in 22 patients about I month@ later. The amplitudes of @ were significantly reduced (P=0.0001), and central motor conduction time (CMCT) was significantly delayed (P=0.0004) in stroke patients compared to the normal controls. The abnormalities of MEP were closely related to the initial motor deficits. The cortical MEP findings in patients with cortical infarction and pontine infarction were more severe than those obtained in patients with subcortical I lesion. Initial MEP findings showed good correlation with the final functional outcome of the patients. The shortened latencies of follow-up MEP were significantly (P=0.0266) related to the improvement of the patients' motor deficit. These results illustrate that the results of magnetic stimulations are related to the prognosis of patients with stroke, and suggest that MEP may be I used in the monitoring their neurological or functional progress.
Efferent Pathways ; Evoked Potentials, Motor* ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Infarction ; Motor Cortex ; Prognosis ; Stroke* ; Transcranial Magnetic Stimulation

The porphyrias are inherited or acquired disorders of specific enzymes in the heme biosynthetic pathway. Porphyrias have diverse neurologic manifestations with unknown mechanism. Some authors have proposed ischemic vasculopathy as a cause of neurologic deficits, which was supported by reversible MRI lesions in porphyrias. We report a rare case with reversible MRI findings in porphyria. A 27-year-old woman was presented with seizures and hallucinations. MRI revealed multiple lesions of both hemispheres. After treatment, MRI lesions showed marked resolution of signal abnormalities.
Adult ; Biosynthetic Pathways ; Female ; Hallucinations ; Heme ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Porphyrias* ; Seizures