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Intracerebral Hemorrhage in Geriatric Patients.

Gook Ki KIM ; Eun Seok CHOI ; Young Jin LIM ; Won LEEM

Korean Journal of Cerebrovascular Disease.2002;4(1):27-30.

There are so many differences between the elderly patients and the younger patients in the aspects of a causes and the clinical course of spontaneous intracerebral hemorrage (ICH). As the mean life-time of a general population goes longer, the incidence of spontaneous ICH increases but the aggressive support in ICH is withdrawn more commonly and a prognosis of ICH becomes poor. Therefore, a prevention of ICH and a strict control of hypertension is very very important.
Aged ; Cerebral Hemorrhage* ; Humans ; Hypertension ; Incidence ; Mortality ; Prognosis

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Incidence and Pathophysiology of Cerebral Hemorrhagic Stroke in the Elderly.

Bum Tae KIM ; Ra Seon KIM ; Il Young SHIN ; Su Bin IM ; Won Han SHIN

Korean Journal of Cerebrovascular Disease.2002;4(1):23-26.

As the number of elderly people increases, the incidence of stroke, especially the hemorrhagic stroke, is increasing. A large-scale survey of the entire country pertaining to the incidence and demographic characteristics of hemorrhagic stroke in elderly is necessary. Through information garnered from a basic survey and clinical study, we must design a treatment program to reduce the mortality of elderly people through elucidating the specific properties of stroke pathophysiology.
Aged* ; Humans ; Incidence* ; Mortality ; Stroke*

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Management of Hypertension in Geriatrics.

Tai Ho RHO

Korean Journal of Cerebrovascular Disease.2002;4(1):17-22.

Hypertension is a very common disorder in the aged persons. There exist several hemodynamic characteristics associated with hypertension in the geriatric population, - decreased elasticity of arterioles due to fibrosis, decreased renin activity, and decreased cardiac output and renal blood flow. Clinically, isolated systolic hypertension, blood pressure variation within a day, and white coat hypertension, are more common in the aged population. Furthermore, aged persons have more chances to suffer other diseases, diabetes, COPD, and renal dysfunction, for example. These characteristics need tailored approaches in diagnosing and managing hypertension in the aged. In the current literature, detailed characteristics of 'geriatric hypertension', are described, including definition, grade of hypertension, importance of treatment of hypertension, complications of hypertension, drug or non-drug treatment, and principles of drug treatment especially in the specific age group.
Arterioles ; Blood Pressure ; Cardiac Output ; Elasticity ; Fibrosis ; Geriatrics* ; Hemodynamics ; Humans ; Hypertension* ; Pulmonary Disease, Chronic Obstructive ; Renal Circulation ; Renin ; White Coat Hypertension

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Radiosurgery for Cerebrovascular Disease.

Young Jin LIM ; Kwan Soo KANG

Korean Journal of Cerebrovascular Disease.2002;4(1):9-16.

The stereotactic radiosurgery for arteriovenous malformation (AVM) began in the early 1970s. Nowadays, by 2000 world-wide, more than 27,500 patients have undergone Gamma Knife radiosurgery for cerebrovascular disease (CVD). New concepts, consisting of obliteration rate, postradiosurgical hemorrhagic risk, dose selection for treatment, and radiosurgery for pediatric AVM, medium-to-large sized AVM, cavernous malformation, venous angioma, so on, have been established. Gamma Knife radiosurgery has been considered as an effective management stratege with relatively few side effects for AVM. However, recently delayed radiation-induced complications were reported in 3.2 to 12.5% in range. Therefore, the long-term follow-up is thought to be mandatory even after treatment goal, complete obliteration, is confirmed.
Arteriovenous Malformations ; Follow-Up Studies ; Hemangioma ; Humans ; Patient Selection ; Radiosurgery*

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What is a True Less Invasiveness for a Patient?.

Tsuneyoshi EGUCHI

Korean Journal of Cerebrovascular Disease.2002;4(1):5-8.

These days, a less invasive surgery is stressed. One current thought is that the endovascular surgery itself is the less invasive and safer surgery for a cerebral aneurysm, and not the microsurgery. Is this true? We have evaluated the merits and demerits of each method. Our conclusion is as follows. Endovascular Surgery should be considered as an alternative, only for the specific patients. Microsurgery itself retains its position of the first treatment of choice for a cerebral aneurysm. "Less invasive" cannot be equated with "less dangerous". We will show the above reasons using slides and videotapes of several patients.
Humans ; Intracranial Aneurysm ; Microsurgery ; Videotape Recording

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Surgical Management of Multiple Aneurysms Including Distal Anterior Cerebral Artery Aneurysms.

Jong Moo LEE ; Jae Sung AHN ; Young Il CHUN ; Yang KWON ; Byung Duk KWUN

Korean Journal of Cerebrovascular Disease.2001;3(2):191-195.

OBJECTIVE: The goal of this study is to evaluate the surgical outcome of multiple aneurysms including distal anterior cerebral artery (DACA) aneurysms. MATERIAL AND METHOD: From May 1989 to March 2000, 12 patients with multiple aneurysms including DACA aneurysms, presented with subarachnoid hemorrhage, had been surgically treated. Their medial record and radiological studies were studied retrospectively. Of 12 patients, in 5 patients, all of the aneurysms were clipped through a single craniotomy extended from midline to pterion in one stage, in 5 patients, multiple aneurysms were treated through separate craniotomies in one stage and 2 patients were treated in staged operation. RESULTS: Two patients showed Glasgow Outcome Scale (GOS) 5-4, 2 patients showed GOS 3-2 and 1 patient showed GOS 1 in 5 patients treated through a single craniotomy in one stage, 2 patients showed GOS 5-4 and 3 patients showed GOS 3-2. All patients treated in staged operation showed favorable outcome. CONCLUSION: In surgical management of multiple aneurysms including DACA aneurysms surgery through separate bony windows in two stages seemed to show more favorable outcome.
Aneurysm* ; Anterior Cerebral Artery* ; Craniotomy ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm* ; Retrospective Studies ; Subarachnoid Hemorrhage

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The Operative Treatment of Distal Middle Cerebral Artery Aneurysm Using Viewing Wand Navigator190.

Yun Sok KIM ; Jae Sung AHN ; Sang Ryong JEON ; Jeong Hoon KIM ; Young Shin RA ; Yang KWON ; Byung Duk KWUN

Korean Journal of Cerebrovascular Disease.2001;3(2):188-190.

The authors present use of Viewing wand navigator for localization and clipping of an aneurysm of distal middle cerebral artery. This method significantly decreased the operative time and minimized unnecessary dissection for localization of distally located aneurysms in selected cases.
Aneurysm ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Operative Time

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Takayasus Arteritis with Pregnancy Induced Eclampsia.

Kook Jin AHN ; Seong Tai HAHN ; Dong Won YANG ; Sang Hoon LEE ; Beum Saeng KIM ; Kyu Ho CHOI

Korean Journal of Cerebrovascular Disease.2001;3(2):184-187.

We experienced a case of Takayasus arteritis with eclampsia in a 43-year-old woman. The patient had angiographically definite Takayasus arteritis with the involvement of right common and internal carotid arteries. On MR images performed at clinical manifestations of eclampsia, unilateral involvement of T2 high signal intensities were demonstrated in right cerebral hemisphere. We report this case with a literature review.
Adult ; Carotid Artery, Internal ; Cerebrum ; Eclampsia* ; Female ; Humans ; Magnetic Resonance Imaging ; Pregnancy* ; Takayasu Arteritis*

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Mirror-Image Intracerebral Hemorrhage in Basal Ganglia: Case Report.

Nok Young LEE ; Jae Min KIM ; Koang Hum BAK ; Choong Hyun KIM ; Suck Jun OH

Korean Journal of Cerebrovascular Disease.2001;3(2):178-183.

Intracerebral hemorrhage in the brain is the most common complication of hypertension, aneurysmal rupture, or vascular malformation. The occurrence of symmetrically bilateral intracerebral hemorrhage is an unusual clinical event that develops in only a small percentage of all patients who have intracerebral hemorrhage. Even though, the size of contralateral hemorrhage is not too large, majority of patients with bilateral intracerebral hemorrhage in basal ganglia or thalamus have generally a poor outcome. In all cases of this report, the contralateral intracerebral hemorrhage was resulted from an inadequate control of hypertension. Therefore, optimal control of blood pressure must be considered as the most important treatment option to prevent recurrence. Authors report the characteristic clinical and radiologic features of four cases in which mirror-image bilateral intracerebral hemorrhage occurred.
Aneurysm ; Basal Ganglia* ; Blood Pressure ; Brain ; Cerebral Hemorrhage* ; Hemorrhage ; Humans ; Hypertension ; Recurrence ; Rupture ; Thalamus ; Vascular Malformations

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Thrombosed Cerebral Arteriovenous Malformation (AVM): Operative Case Report.

Yu Sik CHAE ; Hyeong Joong YI ; Kwang Myung KIM ; Young Soo KIM ; Yong KO ; Suck Jun OH

Korean Journal of Cerebrovascular Disease.2001;3(2):173-177.

Spontaneously thrombosed cerebral arteriovenous malformations (AVM) are infrequently reported. Its pathophysiology, and natural course, however, are still not clarified yet. Authors report a case of symptomatic, spontaneously thrombosed cerebral AVM in a 34-year-old male with a follow-up of 16-year duration, which was surgically extirpated due to repeated bleeding and intractable seizure disorder, and histopathologically confirmed. Relevant literatures are reviewed and discussed.
Adult ; Epilepsy ; Follow-Up Studies ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations* ; Male ; Seizures

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