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Self-Knotting of Nasogastric Tube in a Stroke Patient with Dysphagia: A Case Report
강인현,배민준,Yangrok Hur,황기훈 대한연하장애학회 2020 대한연하장애학회지 Vol.10 No.2
In cases of inadequate nutrition among individuals with dysphagia, nasogastric tube insertion is considered for nutritional supplementation. Typically, the complications of nasogastric tube insertion are not severe. In rare cases, however, nasal or nasopharyngeal injury caused by the self-knotting of nasogastric tubes can occur. This paper presents a case of spontaneous knotting of a nasogastric tube and its removal in a patient with aspiration pneumonia caused by dysphagia. This case shows that self-knotting must be considered when there is strong resistance during the removal of a nasogastric tube.
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A Case Report of Iatrogenic Hematoma on Anterior Tibialis Muscle after Electromyography
문원식,강인현,최종경,황기훈 대한근전도전기진단의학회 2018 대한근전도 전기진단의학회지 Vol.20 No.1
Needle electromyography (EMG) is valid investigation routinely performed by physiatrists and neurologists, and quite safe when performed by an experienced examiner. Needle EMG is generally well tolerated and rarely thought to be associated with any significant side effects, other than mild pain, so practitioners usually overlook any potential complications. However, needle EMG is an invasive procedure and under certain situations has the potential to be associated with bleeding complications such as hematoma or acute compartment syndrome (ACS). We report a case of ACS after EMG in the left lower extremity that led to a lawsuit. To prevent complications such as hematoma and ACS resulting from needle EMG, we should be familiar with the clinical features of ACS and perform immediate evaluation and treatment to improve patient prognosis.
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Dysphagia due to Physiological Constriction after Stroke: A Case Report
배민준,강인현,Yangrok Hur,황기훈 대한연하장애학회 2021 대한연하장애학회지 Vol.11 No.2
The aortic arch normally causes no symptomatic physiological constriction of the esophagus. Symptoms of dysphagia are generally observed in the presence of specific conditions, such as an aortic aneurysm. In the present case, during a videofluoroscopic swallowing study (VFSS), the authors incidentally found that despite the absence of an aortic lesion, the dysphagia observed in a stroke patient was caused by compression from the aortic arch. The patient complained of discomfort when swallowing, similar to a bolus lodged in the chest, which was consistent with compression by the aortic arch found on the VFSS and chest computed tomography (CT). After undergoing dysphagia therapy, the VFSS after 52 days revealed improved swallowing function; however, the sensation of food lodging in the chest due to compression by the aortic arch persisted. We conclude that although the physiological constriction of the esophagus by the aortic arch is usually asymptomatic, the constriction can be a factor that exacerbates the swallowing function in patients with dysphagia, and should therefore be considered during the differential diagnosis.
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Sporadic Creutzfeldt-Jakob Syndrome Misdiagnosed as Recurrent Stroke: A Case Report
배민준,강인현,Yangrok Hur,Ki Hun Hwang 대한노인병학회 2021 Annals of geriatric medicine and research Vol.25 No.2
While sporadic Creutzfeldt-Jakob disease (sCJD) typically presents with neurological symptoms such as cognitive impairment, ataxia, and myoclonus, its clinical manifestations can be diverse. We report about a 70-year-old woman with sCJD who was misdiagnosed with recurrent stroke. She initially showed hemiplegia and high-intensity signals on brain diffusion-weighted magnetic resonance imaging (DWI), which corresponded to the symptoms of a stroke. She was diagnosed with recurrent stroke as her muscle weakness showed stepwise deterioration, with the appearance of additional high-intensity signals on brain DWI. Several days later, she developed Broca’s aphasia, cognitive impairment, and myoclonus in the right upper and left lower extremities. Brain DWI showed high-intensity signals in the cortex, caudate nucleus, and putamen. Therefore, sCJD was suspected; she subsequently underwent further evaluation and was diagnosed with sCJD. The findings of this case indicate that sCJD can have a clinical course similar to that of recurrent stroke.
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