Annals of Rehabilitation Medicine

The Estimation of the Probable Cause and the Time of Cerebral Insult in Cerebral Palsy.: Moon, Jeong Lim , Moon, Young Wan , Whang, In Sik , Yeo, Joon Ho , Shin, Hyeon Bo , Lim, Gye Yeon; J Korean Acad Rehabil Med 2002;26(5):508-513.

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Objective: To estimate the probable cause and the time of cerebral insult in cerebral palsy (CP) based on MRI findings and risk factors.

Method: The subjects comprised all sixty-seven patients with CP showing abnormal MRI findings between March 1999 and September 2001 at the Catholic University of Korea, St. Mary's Hospital. A detailed medical history was available for all patients including those not born in our hospital. They ranged in age from two months to five years. We analyzed the brain magnetic resonance (MR) findings of patients with CP to correlate the probable cause and the time of cerebral insult through the consideration of medical histories including prenatal, perinatal and postnatal histories.

Results: Of the 67 MRIs, abnormalities were the followings; periventricular leukomalacias (PVLs) in 49 cases, cortical or subcortical infarction in 4 cases, brain atrophy in 7 cases, neuronal migration disorder in 4 cases, and delayed myelination in 3 cases. Among the patients with PVL, perinatal risk factors were responsible for cerebral insult in preterm, but pre- and perinatal contribution were similar in patients born at full term. Among the patients with cerebral infarction, only one case with meningitis at 11 months was suspected for cerebral insult. These patients had no risk factor as a peri- or post-natal etiology. Four patients with neuronal migration disorder had no risk factor for peri- or postnatal etiology except for the one who was a twin.

Conclusion: Review of brain MRI findings such as PVL, infarct, neuronal migration disorder and a detailed medical history including prenatal and perinatal etiology would be a useful method to estimate the probable cause and the time of cerebral insult in CP. (Korean Acad Rehab Med 2002; 26: 508-513)

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Causes of the Hemiplegic Shoulder Pain.: Yoon, Tea Sang , Kim, Dae Hwan , Park, Jin Woo , Kwon, Bum Sun , Ryu, Ki Hyung , Lee, Ho Jun , Park, Nyo Kung , Shim, Jae Hoon; J Korean Acad Rehabil Med 2010;34(2):158-162.

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Objective
To find out how many causes constitute hemiplegic shoulder pain (HSP) and how they distribute in an individual patient. Method: Twenty-three consecutive patients with HSP which had newly developed within 3 months after stroke were enrolled from January 2008 till July, 2008. They all performed a passive range of motion test for adhesive capsulitis, modified Ashworth test for spasticity, simple x-ray for subluxation, ultrasonography for rotator cuff problems and three- phase bone scintigraphy for complex regional pain syndrome (CRPS). The causes of HSP were analyzed in number and distribution. Results: Average 2.26 causes constituted with HSP in an individual patient. Most common causes were adhesive capsulitis and CRPS (respectively 14 patients). Two patients had 4 and eight patients had 3 types of shoulder pathology. Conclusion: More than two types of shoulder pathology existed in a patient with HSP. These findings shoulde be carefully considered when treating the patients with HSP. (J Korean Acad Rehab Med 2010; 34: 158-162)

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Timing and Causes of Death of Stroke Patients Died in Hospitalization.: Kim, Kyeong Tae , Lee, Kyoung Min , Kim, Koo , Lee, Hyeong Il , Bae, Boung Cheul , Joo, Jae Hyung; J Korean Acad Rehabil Med 2003;27(4):494-499.

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Objective
To evaluate the frequency distribution and causes of death according to number of days after stroke.

Method: We reviewed in 158 cases of the stroke patients who had died in hospitalization from January 2000 to June 2002 by medical records retrospectively. We evaluated the correlations between the frequency of death and causes of death by frequency analysis.

Results: Mean age was 65.8⁑11.5 years old and average survival days after stroke were 16.2⁑24.1 days. The proportion of stroke subtypes were infarct (51.3%), intracranial hemorrhage (36.7%), and subarachnoid hemorrhage (12.0%). The frequency of death at 7 days and 30 days after stroke onset were 52.5% and 89.2%, respectively. The most frequent cause of death was respiratory arrest due to transtentorial herniation or brain stem lesion (48.1%), followed in frequency by pneumonia (22.2%), cardiac origin (10.8%), and vasospasm (6.3%). Within the first 30 days, the leading cause of death was respiratory arrest due to transtentorial herniation or brain stem lesion. After the first 30 days, the most frequent cause of death was pneumonia.

Conclusion: The results of this study are valuable as basic data of mortality and causes of death after stroke during an acute stroke management and early rehabilitation. (J Korean Acad Rehab Med 2003; 27: 494-499)

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Acute Paraplegia Secondary to Spontaneous Hematomyelia: A case report.: Lee, Eunsinn; J Korean Acad Rehabil Med 2000;24(1):162-166.

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Spontaneous hematomyelia (intramedullary spinal hematoma) is an uncommon event of an unknown cause. A 35-year-old man experienced sudden paresthesia over the chest, radiating pain, and motor weakness followed by complete paraplegia appeared after 1 hour. The preoperative diagnosis was made by magnetic resonance imaging which revealed hemorrhages from T4 to T9 cord segments. The selective spinal angiography, CSF study, blood laboratory, and pathology revealed no apparent cause for the hemorrhages.

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Musculoskeletal Causes of Anterior Chest Wall Pain.: Sung, Duck Hyun , Ra, Yun Ju , Jung, June Yong , Jeong, Soon Tak , Jung, Seung Hyun , Park, Seung Woo , Lee, Joo Heung; J Korean Acad Rehabil Med 2003;27(1):96-101.

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Objective
To investigate the musculoskeletal causes of anterior chest pain and know the prevalencies of the diseases.

Method: During 4-year periods (1997∼2001), 37 patients with anterior chest wall pain was analyzed with regard to the causes of pain and the frequencies of the diseases.

Results: 17 patients (45.9%) had systemic diseases and 20 patients (54.1%) had focal joint problems. Systemic disease included the undifferentiated spondyloarthropathy (18.9%), ankylosing spondylitis (13.5%), psoriatic arthritis (2.7%), SAPHO (Synovitis, Acne, Psoriasis, Hyperostosis, Osteitis) syndrome (8.1%), and rheumatoid arthritis (2.7%). Focal joint diseases included costochondritis (10.8%), sternoclavicular inflammatory arthropahty (5.4%), sternoclavicular hyperostosis (2.7%) and infective arthritis (2.7%). Other focal joint problems were pain in sternoclavicular joint with the tenderness and swelling (2.7%), pain in costochondral joint (13.6%), sternoclavicular joint (5.4%), xyphoid process (2.7%) with only focal tenderness. 3 (8.1%) patients had pain in chest wall which had no focal tenderness and swellings on the joint.

Conclusion: Diverse systemic diseases were identified as causes of the anterior chest wall pain. So physiatrist keep in mind this result and make use of them in diagnostic approaching of the anterior chest pain due to chest wall skeletal involvement. (J Korean Acad Rehab Med 2003; 27: 96-101)