Recurrent cerebellar hemorrhage: case report and review of the literature.

We report a case of cerebellar hemorrhage (CH) that recurred in other hemisphere after 4 months of the first attack. A 58-year-old man presented with general weakness and computerized tomography (CT) of the brain showed a 41 mm hematoma in the right cerebellum with intraventricular extension. The satisfactory outcome was obtained after emergency surgical intervention and intensive rehabilitation. However, the patient irregularly took the prescribed anti-hypertensive medication. Four months after first attack, the recurrent CH in left side showed by brain CT. Only 2 cases of recurrent CH have been published thus far. The patient is the third reported case of recurrent CH and the second case in which CH recurred in the other hemisphere. Further, no patient has been reported to develop recurrence of CH in such a short period after the first onset. We discuss the possible pathophysiology, clinical course, treatment outcome, risk factors associated with such events and the importance of blood pressure control for preventing recurrence.

Contribution of the multifidus muscle for control of upright posture in subjects with spina bifida occulta.

CONTEXT: The multifidus muscle plays a role in controlling lumbosacral position and postural sway. One of its attachment sites is the exact site of spina bifida occulta (SBO). OBJECTIVE: To investigate the role of the muscle for postural control in SBO. DESIGN: Cross-sectional cohort. PARTICIPANTS: Eighty subjects with SBO (38 in minor; 42 in major) and controls. INTERVENTIONS: N/A. MAIN OUTCOME MEASURES: Subjects stood upright on a platform at 0 degrees and on an inclined surface (10 degrees and 20 degrees) with feet in plantarflexion/dorsiflexion, together with eyes open and closed. The platform system measured posture to obtain sway area and sway mean for statistics. RESULTS: Upon sway area/mean, the group differences of major/minor SBO vs. control were all significant. Sway means of minor SBO were lower than those of major SBO at corresponding inclined degrees. CONCLUSIONS: Subjects with SBO demonstrated increased sway as compared to controls.

Efficacy of near-infrared irradiation on intractable hiccup in custom-set acupoints: evidence-based analysis of treatment outcome and associated factors.

OBJECTIVE: The condition intractable hiccup (IH) is generally an incapacitating disorder indicating neurologic or non-neurologic disorders. Linearly polarized, near-infrared irradiation (SL) is shown to be effective in the treatment of IH where it is applied on custom-set acupoints. The aim of this study was to investigate the treatment efficacy of IH by SL on the acupoints and to survey the relationship between IH and comorbid-related factors. MATERIAL AND METHODS. A total of 35 patients with IH were enrolled prospectively and divided into central and non-central groups. All patients received SL using an SG-type lens unit on the relevant acupoints and were followed-up for up to 6 months for efficacy of the novel therapy. RESULTS: There was no significant difference between patients with IH produced by central or non-central origins (p=0.7105) regarding the therapeutic effect of SL; however, the effects of age, bed-shaking, gun-waving motion and nasogastric (NG)-tube placement were significant. The severity index of IH was analyzed and found to be associated with the seasons. For those patients with elevated levels of aspartate aminotransferase (ASAT) after therapy, it took a significantly shorter (p=0.0029) period of time to treat IH with this novel therapy (p=0.0029). Thirty-four patients had complete resolution of IH within a few days of beginning SL, with partial resolution in 1 patient only. CONCLUSIONS: Without potential side effects, SL on custom-set acupoints could be a complementary therapy for patients with IH regardless of central or non-central origins.