A 50-year-old woman with thunderclap headache and transient neurologic symptoms was diagnosed with reversible cerebral vasoconstriction syndrome. Serial angiography showed multifocal arterial vasoconstrictions, and MRI revealed multiple scattered cerebral infarctions. New neurologic symptoms and vasoconstriction in other arteries occurred repeatedly despite the on-going administration of traditional treatments. However, the symptoms reduced dramatically after administering intravenous steroid pulse therapy. This case suggests that steroid therapy can be considered as an alternative treatment when reversible cerebral vasoconstriction syndrome is intractable to traditional treatment.
Angiography ; Arteries ; Cerebral Infarction ; Female ; Headache Disorders, Primary ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Steroids ; Vasoconstriction*

A 64-year-old woman presented with headache and visual disturbance which occurred 10 minutes after bee venom acupuncture. She was normotensive. Her pupils were isocoric and normally reflexive but she could precept only lights just in front of her eyes. The brain MRI showed vasogenic edema in the cerebellum and occipitotemporoparietal areas. She fully recovered 2 days later. The brain MRI taken after 7 days revealed remarkable improvement. This case suggests that bee venom might cause posterior reversible encephalopathy syndrome.
Acupuncture* ; Bee Venoms* ; Brain ; Cerebellum ; Edema ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Posterior Leukoencephalopathy Syndrome* ; Pupil ; Reflex

BACKGROUND AND PURPOSE: To study the significance of intracranial artery calcification as a prognostic marker for acute ischemic stroke patients undergoing revascularization treatment after middle cerebral artery (MCA) trunk occlusion. METHODS: Patients with acute MCA trunk occlusion, who underwent intravenous and/or intra-arterial revascularization treatment, were enrolled. Intracranial artery calcification scores were calculated by counting calcified intracranial arteries among major seven arteries on computed tomographic angiography. Patients were divided into high (HCB; score > or =3) or low calcification burden (LCB; score <3) groups. Demographic, imaging, and outcome data were compared, and whether HCB is a prognostic factor was evaluated. Grave prognosis was defined as modified Rankin Scale 5-6 for this study. RESULTS: Of 80 enrolled patients, the HCB group comprised 15 patients, who were older, and more commonly had diabetes than patients in the LCB group. Initial National Institutes of Health Stroke Scale (NIHSS) scores did not differ (HCB 13.3+/-2.7 vs. LCB 14.6+/-3.8) between groups. The final good reperfusion after revascularization treatment (thrombolysis in cerebral infarction score 2b-3, HCB 66.7% vs. LCB 69.2%) was similarly achieved in both groups. However, the HCB group had significantly higher NIHSS scores at discharge (16.0+/-12.3 vs. 7.9+/-8.3), and more frequent grave outcome at 3 months (57.1% vs. 22.0%) than the LCB group. HCB was proven as an independent predictor for grave outcome at 3 months when several confounding factors were adjusted (odds ratio 4.135, 95% confidence interval, 1.045-16.359, P=0.043). CONCLUSIONS: Intracranial HCB was associated with grave prognosis in patients who have undergone revascularization for acute MCA trunk occlusion.
Angiography ; Arteries ; Cerebral Infarction ; Hexachlorobenzene ; Humans ; Infarction, Middle Cerebral Artery ; Intracranial Embolism ; Intracranial Thrombosis ; Middle Cerebral Artery ; National Institutes of Health (U.S.) ; Prognosis ; Reperfusion ; Risk Factors ; Stroke ; Thrombolytic Therapy ; Vascular Calcification

To investigate the prevalence of asthma, allergic rhinitis, and eczema, we did a cross-sectional survey of 4,003 children aged 6-7 years (students in the 1st year of elementary school) and 4,112 students aged 13-14 years (students in the 1st year of middle school), chosen from a random sample of 45 primary and 40 middle schools across the nation. The Korean-translated modified version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used in this survey. The weighted 12-month prevalence of asthma symptoms from the questionnaires was 10.3% (95% confidence interval [CI], 9.2 to 11.4) for children aged 6-7 years and 8.3% (95% CI, 7.4 to 9.2) for children aged 13-14 years. The weighted 12-month prevalence of allergic rhinoconjuctivitis symptoms was 18.9% (95% CI, 17.5 to 20.4) for children aged 6-7 years and 19.2% (95% CI, 17.9 to 20.6) for children aged 13-14 years. The weighted 12-month prevalence of eczema symptoms was 17.9% (95% CI, 16.6 to 19.3) for children aged 6-7 years and 11.2% (95% CI, 10.1 to 12.3) for children aged 13-14 years. Compared with results from a 2000 ISAAC study, the 12-month prevalence of asthma increased from 5.8% to 10.3% in children aged 6-7 years, but there was little change (from 8.7% to 8.3%) in children aged 13-14 years. The prevalence of allergic rhinoconjunctivitis and eczema has increased considerably in both age groups.
Aged ; Asthma ; Child ; Cross-Sectional Studies ; Eczema ; Humans ; Hypersensitivity ; Prevalence ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial