• The Korean Journal of Pain
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• v.10 no.2
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• pp.291-295
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• 1997

Technique of epidural analgesia is generally regarded a safe procedures which is widely applied in postoperative and chronic pain control. Incidence of neurologic complications following epidural analgesia are rare; however, increasing number of published reports describing transient or permanent neurologic complications following such procedures have been appearing more frequently. We report two cases of neurologic complications following epidural analgesia as we believe it is important to draw the attention of other anesthesiologist to the possibility of existence of other complications of significant medicolegal consequences.

• The Journal of Korean Medicine
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• v.28 no.2 s.70
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• pp.241-246
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• 2007

Objectives : This study investigated stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in two groups divided by age according to the weakness of shingi (shenqi): younger (40 to 63 years) and older (= 64 years). Methods : 165 male patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. Stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in two age groups were examined. Results : Mean ages were $53.01{\pm}6.16$ and $70.95{\pm}6.37$ years for the younger 77 patients and older 88 subjects, respectively. There were no significant differences in stroke type, ischemic stroke subtypes, stroke complications and Sasang constitutions. Current smoking was more frequent in the younger age group (P= 0.005). Conclusion : Age does not seem to influence stroke types, ischemic stroke subtypes, stroke risk factors (except current smoking), stroke complications or Sasang constitutions.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.90-96
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• 2009

Purpose: This study explored and evaluated the systemic complications resulting from the bite of Korean venomous snake, focussing on hematologic and neurologic features. Methods: Medical records (demographic data, clinical measurements including laboratory results, severity score, and amount of antidote administration, and hospitalization course) of consecutive patients who presented with snakebites to two university teaching hospital during a 10-year period were retrospectively reviewed. Subgroup analysis was conducted for evaluations of anti-acetylcholine esterase administration in complicated victims. Results: The 170 patients displayed occurrence rates of hematologic and neurologic complications of 12.9% and 20.6%, respectively. Among 22 patients with hematologic complications, isolated thrombocytopenia was evident in eight patients (36.4%), prothrombin time (PT) / activated partial thromboplastin time (aPTT) prolongation in 11 patients (50.0%), and both in three patients (13.6%). The mean time to recovery was $4.5{\pm}1.8$ days for isolated thrombocytopenia, and $5.1{\pm}1.8$ days for PT and aPTT prolongation. Hematologic complications could occur suddenly 1?4 days after hospitalization. Among 35 patients with neurologic complications, dizziness was evident in 16 patients (45.7%), and diplopia / blurred vision in 19 patients (54.3%). The mean time to recovery was $3.4{\pm}0.6$ days in patients receiving anti-acetylcholine esterase and $6.9{\pm}1.8$ days in those not receiving anti-acetylcholine esterase (p=0.00). Conclusion: Occurrence rates of hematologic and neurologic complications following venomous snake bite differed as compared to other studies conducted in Korea. Onset of hematologic complications can occur rapidly days after admittance. Anti-acetylcholine esterase administration may be effective in treating neurologic complications.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.

• Clinical and Experimental Pediatrics
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• v.56 no.12
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• pp.540-544
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• 2013

Down syndrome, the most common chromosomal abnormality, may be associated with various neurologic complications such as moyamoya syndrome, cervical spinal cord compression due to atlantoaxial subluxation, and basal ganglia damage, as well as epileptic seizures and stroke. Many cases of Down syndrome accompanied by isolated neurologic manifestations have been reported in children; however, Down syndrome with multiple neurologic conditions is rare. Here, we have reported a case of Down syndrome in a 10-year-old girl who presented with asymptomatic moyamoya syndrome, atlantoaxial subluxation with spinal cord compression, and basal ganglia calcification. To the best of our knowledge, this is the first report of Down syndrome, in a child, which was accompanied by these 3 neurologic complications simultaneously. As seen in this case, patients with Down syndrome may have neurologic conditions without any obvious neurologic symptoms; hence, patients with Down syndrome should be carefully examined for the presence of neurologic conditions.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.42-52
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• 2021

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

• The Journal of Korean Medicine
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• v.28 no.4
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• pp.1-7
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• 2007

Objectives : This study investigated stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in both sexes. Methods : 307 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from October 2005 to May 2007. Stroke types, ischemic stroke subtypes, risk factors for stroke, stroke complications and Sasang constitutions in both sexes were examined. Results : Mean age was higher among women than men (64.82${\pm}$10.21 years versus 62.18${\pm}$11.52 years for the 137 female and 170 male patients, respectively, p=0.037). There were no significant differences in stroke type, ischemic stroke subtypes, or stroke risk factors except smoking and Sasang constitutions. Current smoking was more frequent in male patients (p<0.001). Stroke complications, especially urinary tract infection (UTI), were significantly more common in women (p=0.002). Conclusion : Sex does not seem to influence stroke types, ischemic stroke subtypes, or stroke risk factors except current smoking and Sasang constitutions. UTI should be taken into consideration to manage female stroke patients. Smoking cessation is indicated to prevent stroke in men.

• The Journal of Korean Medicine
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• v.28 no.3 s.71
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• pp.207-215
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• 2007

Objectives : The objective of this study was to assess whether there were sex differences in stroke types, risk factors, warning signs, and stroke complications among patients with first-ever stroke. Methods : Six-hundred seventy six patients with first-ever stroke were recruited at the Department Cardiovascular and Neurologic Diseases (Stroke center) of KyungHee University Oriental Hospital, DongGuk University International Hospital, and Kyungwon University In-cheon Oriental Medical Hospital from September 2005 to June 2007. Patients were hospitalized within 28 days after the onset of stroke. We investigated their stroke types, ischemic stroke subtypes by TOAST classification, risk factors, warning signs, stroke complications, general characteristics such as age, sex, etc. Results : Overall, 347 patients were male and 279 female. Compared with males, female patients were significantly older (mean age 67.3${\pm}$1.1 versus 62.4${\pm}$1.6 years) (P=0.000). We did not find significant sex differences in stroke types or ischemic stroke subtypes by TOAST classification. History of hypertension was significantly more frequent in female than male patients (P=0.000). Among stroke complications, urinary tract infection was significantly more frequent in female than male patients (P=0.003). Among warning signs, blepharospasm was significantly more frequent in female than male patients (P=0.006). Conclusions : Knowledge of sex differences of stroke patients can help us gain better insights on the characteristics of stroke patients. We need further and larger scale research to acquire more concrete conclusions on this theme.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.510-516
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• 2014

Background: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI. Methods: We retrospectively studied 32 patients with preoperative ASCI detected by DWI. None of the patients had preoperative neurologic symptoms. The mean age at operation was $68.8{\pm}9.5$ years. Five patients had previous histories of stroke. Four patients had been diagnosed with infective endocarditis. Single cerebral infarct lesions were detected in 16 patients, double lesions in 13, and multiple lesions (>5) in three. The median size of the infarct lesions was 4 mm (range, 2 to 25 mm). The operations of three of the 32 patients were delayed pending follow-up DWI studies. Results: There were two in-hospital mortalities. Neurologic complications also occurred in two patients. One patient developed extensive cerebral infarction unrelated to preoperative infarct lesions. One patient showed sustained delirium over one week but recovered completely without any neurologic deficits. In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions. Conclusion: Patients with preoperative ASCI showed excellent postoperative neurologic outcomes. Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.76-79
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• 2013

During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.