Educational Needs for Psychiatric Nursing Competencies among Non-Psychiatric Nurses / 정신간호학회지

Purpose@#The purpose of this study is to identify and prioritize educational needs for psychiatric nursing competencies among 142 non-psychiatric nurses from general hospitals. @*Methods@#Data were collected from November 13 to 19 2022 through self-administered questionnaires consisting of measures of psychiatric nursing competencies. Data were analyzed using descriptive statistics, paired t-test, Borich's needs assessment model, and the Locus for Focus model to determine the priority of educational needs. @*Results@#Non-psychiatric nurses reported that enhancing skills in psychiatric nursing were more significant than improving knowledge and attitude using Borich’s Needs Assessment Model and the Locus for Focus Model. The highest priority educational needs were ‘Skill to distinguish whether symptoms in psychiatric patients are symptoms of mental illness or side effects of psychiatric drugs’, ‘Skill to calm and supportive communication in psychiatric emergency when psychiatric patients are at risk of harm’, ‘Attitude to remain calm about the psychotic behaviors of psychiatric patients’, and ‘Knowledge of non-therapeutic communication that interferes with effective communication with psychiatric patients’. These items should be considered as priorities among the 39 items to improve psychiatric nursing competencies. @*Conclusion@#Results of this study suggest that developing intervention programs to enhance psychiatric nursing competencies are needed among non-psychiatric Nurses.

Vertebrobasilar Occlusion Presenting as Sudden Isolated Bilateral Sensorineural Hearing Loss: Case Report

Isolated bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia, primarily due to occlusion of the anterior inferior cerebellar arteries or their branch, the internal auditory artery. We reported on uncommon case of sudden bilateral sensorineural hearing loss without typical neurological symptoms resulting from vertebrobasilar ischemia. We performed the available examinations, including otoscopy, laboratory tests, and pure tone audiogram, however we were not able to identify the cause of bilateral sensorineural hearing loss. Brain magnetic resonance image showed the cerebellar infarction of the posterior inferior cerebellar artery territory. Brain magnetic resonance angiography showed bilateral vertebral and basilar artery occlusion. We suggest vertebrobasilar ischemia as a cause of sudden isolated deafness.

Vertebrobasilar Occlusion Presenting as Sudden Isolated Bilateral Sensorineural Hearing Loss: Case Report

Isolated bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia, primarily due to occlusion of the anterior inferior cerebellar arteries or their branch, the internal auditory artery. We reported on uncommon case of sudden bilateral sensorineural hearing loss without typical neurological symptoms resulting from vertebrobasilar ischemia. We performed the available examinations, including otoscopy, laboratory tests, and pure tone audiogram, however we were not able to identify the cause of bilateral sensorineural hearing loss. Brain magnetic resonance image showed the cerebellar infarction of the posterior inferior cerebellar artery territory. Brain magnetic resonance angiography showed bilateral vertebral and basilar artery occlusion. We suggest vertebrobasilar ischemia as a cause of sudden isolated deafness.

Patterns of Collateral Pathway on Transfemoral Cerebral Angiography in Patients with Internal Carotid Artery Stenosis / 대한뇌졸중학회지

BACKGROUND: In recent studies, by utilizing single photon emission computed tomography (SPECT) and magnetic resonance angiography (MRA), anatomical and functional evaluation became possible. Although MRA is increasingly being used to evaluate vascular status, conventional angiography is still gold standard for investigating anatomical structures. We studied the correlation between internal carotid artery (ICA) stenosis, patterns of collateral pathway, and cerebrovascular reserve using transfemoral cerebral angiography (TFCA) and SPECT. METHODS: We studied 54 patients with symptomatic ICA stenosis who were visit to our hospital between Sep 2009 and May 2011. Forms of collateral pathway were classified into primary and secondary pathway group. Severity of ICA stenosis was divided into 4 stages. Vascular reserve on SPECT was classified into favorable and poor groups. RESULTS: As a result of TFCA, collateral pathways were observed in 44 of 54 patients. Collateral flow via anterior communicating artery (AcoA) pattern occupied the highest proportion and other major patterns were collaterals via posterior cerebral artery-middle cerebral artery (PCA-MCA) and via posterior communicating artery (PCoA) pattern. Twenty-eight patients were primary pathway group and 16 patients were secondary pathway group. In both groups, most patients had moderate or severe ICA stenosis. As a result of SPECT, favorable vascular reserves were observed in 17 of 54 patients. Most of them had mild ICA stenosis and/or primary collateral pathway. Contrarily, most of secondary pathway group had poor vascular reserve even if their ICA stenosis severity was mild. CONCLUSION: In patients with symptomatic ICA stenosis with collateral pathways, rate of primary collateral pathways was higher than secondary collateral pathways. Secondary collateral pathways had insufficient compensatory effect about reduced cerebral blood perfusion.

A Case of Leg Monoparesis with Sensory Deficit Due to Cerebral Infarction / 대한뇌졸중학회지

A male patient aged 54 came to the neurology department complaining of weakness and tingling sensation in the left lower extremity during squatting exercises for the previous four days. A neurological examination revealed left proximal leg weakness and hypesthesia on the medial side of the left lower leg. In eight hours after onset, he took brain and lumbar MRIs at a local clinic and the results were normal. In order to identify possible causes, we performed a follow-up lumbar MRI, femoral angiography, electromyography, and nerve conduction study but failed to obtain any abnormal findings. Finally, a recent infarction of right corona radiata was observed by a follow-up brain MRI which was taken 16 days after onset of the symptom. Leg monoparesis caused by cerebral infarction is known to be rare and in particular combines motor and sensory deficits limited to one extremity.

Cerebral Toxocariasis Presented With Seizure and Memory Disturbance

Toxocariasis has a broad clinical spectrum, from asymptomatic to systemic illness. However, cerebral toxocariasis has rarely been reported. We experienced a patient who presented with seizure and memory disturbance after treatment for visceral larva migrans of toxocariasis. Laboratory findings included eosinophilia, cerebrospinal fluid (CSF) pleocytosis, and positive results for toxocariasis in the serum and CSF. The patient showed marked improvement after combined albendazole and steroid treatment. This case indicates that cerebral toxocariasis is an unusual cause of cognitive dysfunction and seizure.