Korean Clinical Imaging Guidelines for Diagnosis of Headache Based on the 2017 Evidence-Based Clinical Imaging Guidelines

Headache is the most common cause of neurological disorders. The usefulness of imaging tests may vary depending on the patient's clinical situation. The Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency have decided to develop evidence-based guidelines for the imaging tests necessary for diagnosing patients with selected, frequently encountered types of headache. Development, working, and advisory committees were formed. Recommendation statements were derived from the adaptive development methods provided by the existing guidelines. Non-contrast head CT is recommended in patients with acute thunderclap headache due to possible subarachnoid hemorrhage (SAH), and CT angiography is recommended to confirm aneurysmal SAH. In patients with non-acute headache and normal neurological findings, radiological examination is not recommended, but head MRI is recommended to investigate the cause of secondary headache. Non-contrast head MRI is recommended for new-onset headache with neurologic abnormalities in pregnant women.

Ischemic Stroke after Use of Cannabis: a Case Report and Review of Literature

Cannabis or marijuana is the most commonly used recreational drug after alcohol in the world, and usage is generally recognized as having few serious adverse effects. However, usage is restricted in South Korea. The report of ischemic stroke associated with cannabis is rare in literature. We present a case of a 47-year-old female patient with no underlying disease presenting with acute ischemic stroke after smoking cannabis in South Korea. The result for synthetic cannabinoid metabolites (delta-9 tetrahydrocannabinol) screening was positive. Absence of other vascular risk factors and drug screening results suggest a causal role of cannabis in this ischemic stroke case. The patient eventually progressed to brain death. The underlying mechanism, clinical manifestation, and imaging findings of cannabis-related stroke will be reviewed.

Recurrent Rhabdomyolysis after Cerivastatin-Gemfibrozil Combination Therapy / 대한신장학회잡지

A 64-year-old woman with ischemic heart disease was admitted to our hospital because of both leg pain and difficulty to walk for 5 days. She had taken cerivastatin and gemfibrozil for atherosclerosis and ischemic heart disease. One year ago, she had been admitted to our hospital because of acute renal failure due to rhabdomyolysis of unknown origin and was improved after conservative therapy. Laboratory studies revealed serum creatinine 1.2 mg/dL, creatine kinase 23,700 IU/L, serum myoglobin >500 ng/mL, urine myoglobin >3,000 ng/mL. (99m)Tc-HDP whole body Bone scan showed multiple increased uptakes of the soft tissue, especially both calf. With supportive care, she was recovered and discharged with normal creatinine(0.8 mg/dL) and creatine kinase(260 IU/L).