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5 "Jung Hyun Park"
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Original articles
Intracranial aneurysms in autosomal dominant polycystic kidney disease
Jung Hyun Park
Kosin Med J. 2024;39(4):281-289.   Published online December 6, 2024
DOI: https://doi.org/10.7180/kmj.24.138
  • 1,223 View
  • 17 Download
Abstract PDFPubReader   ePub   
Background
The incidence of intracranial aneurysms (ICA) is high in patients with autosomal dominant polycystic kidney disease (ADPKD). However, little is known regarding the optimal screening and treatment methods for ICA.
Methods
This study investigated the characteristics of ADPKD patients with ICA, analyzing each variable according to whether the ICA ruptured, and examined the outcomes according to the treatment method. Specifically, a retrospective study was conducted on the treatment of ICA patients with ADPKD at a single institution for 10 years, from 2013 to 2022.
Results
The mean age of the 17 enrolled ADPKD patients with ICA was 57.4 years. Surgical and endovascular treatment methods were used in four and 13 patients. Eleven patients had unruptured ICAs, and the remaining six patients had suffered subarachnoid hemorrhage (SAH). Two patients experienced neurological deficits after discharge. All patients with unruptured ICAs were discharged without any complications, although one of them underwent additional treatment 5 years later. Four patients with SAH had known ADPKD at the time of diagnosis (67%). As for the treatment method, 13 patients were treated with coiling. In a comparison of variables between unruptured ICA and SAH patients, the location of the ICA showed a statistically significant difference (p<0.05).
Conclusions
In ADPKD patients, diagnostic screening for the detection of ICA is essential, and with appropriate management, interventional endovascular treatment may be a good treatment option.
Diagnostic significance of transcranial Doppler ultrasonography in patients with subarachnoid hemorrhage and cerebral vasospasm
Jung Hyun Park
Kosin Med J. 2024;39(4):265-271.   Published online December 2, 2024
DOI: https://doi.org/10.7180/kmj.24.139
  • 1,085 View
  • 27 Download
Abstract PDFPubReader   ePub   
Background
This study investigated the accuracy and usefulness of transcranial Doppler (TCD) ultrasonography as a diagnostic method in patients with subarachnoid hemorrhage (SAH) and cerebral vasospasm.
Methods
This retrospective study collected data from January 2022 to December 2023 at our institution, targeting patients with SAH caused by rupture of a cerebral aneurysm. TCD and brain computed tomographic angiography (CTA) were performed to diagnose cerebral vasospasm. The vessel diameters on CTA at the time of SAH occurrence and CTA 1 to 2 weeks after the occurrence were compared, and TCD was performed on a daily basis from 3 to 14 days after the occurrence of ictus.
Results
Among 152 patients with non-traumatic SAH over a 2-year period, 143 patients with SAH caused by ruptured cerebral aneurysms were enrolled. The mean age was 59.28±13.27 years. The modified Fisher grade was a statistically significant predictor of cerebral vasospasm (p<0.05). In addition, the Hunt-Hess grade also showed statistical significance (p<0.05). TCD showed high accuracy in predicting vasospasm. The sensitivity was 0.93 (95% confidence interval [CI], 0.87–0.97), specificity was 0.89 (95% CI, 0.81–0.96), positive predictive value was 0.92 (95% CI, 0.85–0.96), and negative predictive value was 0.92 (95% CI, 0.84–0.95).
Conclusions
TCD showed high accuracy in predicting the diagnosis of cerebral vasospasm. TCD is considered an essential diagnostic tool in the neurological management of cerebral vasospasm, which is a potentially fatal complication in SAH patients.
Case reports
A Ruptured Vertebral Artery Dissecting Aneurysm that Grew Immediately: Case Report
Jung Hyun Park
Kosin Med J. 2021;36(2):211-216.   Published online December 31, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.2.211
  • 2,365 View
  • 22 Download
Abstract PDFPubReader   ePub   

The etiology of the vertebral artery dissecting aneurysm (VADA) is unknown and they frequently occur in relatively healthy young men. Therefore, the pathological mechanism by which VADAs occur has not been accurately identified. In this paper, we will examine a case in which a young man complaining of a simple headache became unconscious due to the rupture of a VADA in grew immediately.

A Ruptured Blood Blister-Like Aneurysm that Experienced Regrowth with Coil Compaction Twice in a Month : Case Report
Jung Hyun Park
Kosin Med J. 2021;36(2):200-205.   Published online December 31, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.2.200
  • 2,462 View
  • 23 Download
Abstract PDFPubReader   ePub   

Unlike other aneurysms, blood blister-like aneurysms(BBA) occur at non-branching sites, are commonly located at the dorsal wall of the supraclinoid internal carotid artery (ICA), and are suspected to arise from dissecting aneurysms. They are typically diagnosed after a bleed because of their small size and unusual site. Therefore, lesions exist after brain computed tomography or magnetic resonance imaging, but they are often not found. In the case of BBA, which have a high risk of recurrence, the treatment is difficult, and selecting the treatment method is also challenging. This paper describes the treatment of a BBA with internal trapping of the ICA that eventually recurred despite performing coil embolization twice.

Flow Diverter Device for Treatment of Cerebral Aneurysm with Short-Term Follow Up: Two Case Reports
Jung Hyun Park
Kosin Med J. 2021;36(2):193-199.   Published online December 31, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.2.193
  • 2,052 View
  • 9 Download
Abstract PDFPubReader   ePub   

The flow diverter device (FDD) is an important treatment method for cerebral aneurysms, especially for intracranial dissecting aneurysms. This paper is the result of FDD treatment for two cases of vertebral dissecting aneurysm (VADA) patients and short-term follow-up at 3 months. All two cases were targeted for unruptured cerebral aneurysm, and 4-vessel angiography was performed as a follow-up examination for 3 months after receiving the procedure. As result, it was possible to shorten the period of use of antiplatelet drugs.

In the case of VADA, there are limitations in general coiling procedures or conventional surgical treatment methods. In that sense, the FDD treatment method can be a very effective alternative treatment of VADA


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