Clinical Analysis of Prognostic Factors for Hypertensive Intracerebral Hemorrhage

The authors reviewed medical records of 219 patients who were admitted due to the hypertensive intracerebral hemorrhage(HICH) between January 1993 and December 1994. The relationship between the patient's age and sex, Glasgow Coma Scale(GCS) on the admission, location and volume of intracerebral hematoma, Graeb score, ventriculocranial ratio(VCR) and the maximum transverse diameter of fourth ventricle were analyzed. The neurological outcome for survivors was determined two years after admission. Forty normal brain scans were obtained to determine the normal range of VCR and the maximum transverse diameter of fourth ventricle. From reviewing the cases, the authors found; the most common age group of HICH was 7th and 8th decades with slight male preponderance(1:0.75); VCR of the lateral ventricle and maximum transverse diameter of the 4th ventricle were 0.16 and 1.14 cm in 40 normal brain scans, respectively; basal ganglia(42%) and thalamus(29.2%) were the most common sites of HICH hemorrhage in 219 patients followed by subcortex(13.7%), pons(7.3%) and cerebellum(4.6%); the fourth ventricular dilation(>1.35cm in diameter) and increased VCR(>0.24) were the most significant predictors for poor outcome.

Multiple Intracranial Meningiomas: Case Report

Meningioma is the third most common intracranial tumor and different from meningiomatosis and multiple meningiomas. Multiple meningiomas without the stigma of Von Recklinghausen's disease are rare. The incidence of multiple meningiomas has been reported in 1-8.9% of all intracranial meningiomas. Although the pathogenic factors related to the multiple meningiomas are unknown, various theories have been studied and reported. The authors report two cases with multiple meningiomas without evidence of the Von Recklinghausen's diseases treated successfully by staged operation. The clinical, radiological and histopathological features of these lesions are discussed.

Solitary Cerebellar Metastasis from Primary Uterine Cervical Carcinoma: A Case Report

Brain metastasis from primary uterine cervical carcinoma have been described but are extremely rare and usually occur in the presence of widely disseminated diseases. The authors report a case of solitary cerebellar metastasis from uterine cervical carcinoma, which was confirmed by histopathological examination. The patient has shown no evidence of metastatic lesions elsewhere, thus far, but had undergone a radical hysterectomy under the diagnosis of uterine cervical carcinoma 52 months prior to the surgical excision of the cerebellar metastasis.

Fahr's Disease(=Idiopathic Strio-Pallido-Dentate Calcinosis): A Case Report

The authors present a case of Fahr's disease which is characterized by idiopathic symmetrical calcifications in the basal ganglia and the dentate nuclei. Computerized tomographic scans of the brain demonstrated bilateral calcified lesions recognized in the region of the dentate nuclei of both cerebellar hemispheres and the basal ganglia. A review of the literature on several cases of intracranial ferrocalcinosis is presented.

Microsurgical Study on the Circle of Willis in Korean Adults

Anatomical information of the circle of Willis is important in evaluating the various cerebrovascular diseases and surgical procedures. In this study, we present the anatomical structures of the circle of Willis in 54 Korean adults. The authors observed the morphological characteristics of the vasculature, the incidence of deficiency or incompleteness in the circle and clinical considerations. Measurements of the outer diameter and the length of each arterial segments were performed. Number and the origin of perforators from individual arteries were also oserved. Results of this study were as followings. Normal circles of Willis was oserved in 35 cases(64.81%) and abnormal circles in 19 cases(35.9%). 2) Incidental detection of aneurysms occurred in 5 cases(9.26%). 3) Frequency of anomalies were most commonly observed in the anterior communicating arteries(N=16, 20.37%). 4) A string-like artery was most frequently observed in te post-erior communicating artery(N=11, 20.37%). 5) Anomalous origin of the P1 segment of the posterior cerebral artery was observed, fetal type was in 12 cases(22.2%) and transitional typ was in 3 cases(5.55%) respectively. 6) The longest artery was the A1 segmnt of the anterior cerebral artery;the second, posterior communicating artery;the third, P1 segment of the posterior cerebral artery;and the shortest, anterior communicating artery. 7) The outer diameters of the basilar artery and internal carotid artery were almost, equal, A1 segment was half of ICA, AcoA was two thirds of A1 segment, PcoA was half of P1 segment and P1 segment was two thirds of the basilar artery. There were difference the anterior and posterior portion of the circle Willis. In the anterior communicating arteries, duplicated structure were frequently found. And also, inequality in the outer diameter of both A1 segmnts was observed. String-like arteries were often revealed in the posterior communicating arteries. Anomalous origin of P1 segments that may be persistant embryonic derivatives were frequently demonstrated in posterior cerebral arteries.

Mucopyocele Involving Sphenoid Sinus: Case Report

A rare case of sphenoid sinus mucopyocele with visual impairment and opthalmoplegia is presented. Clinical presentations including headache, opthalmoplegia, visual disturbance and ptosis are caused by local extension of the mucopyocele of the sphenoid sinus. The authors report a mucrpyocele involving the sphenoid sinus with a brief review of the literature.

Two Cases of Intracerebral Tuberculoma

It is believed that differentiating tuberculoma, abscess, metastatic tumor and glioma is often difficult without exisional biopsy. The authers report two cases of tuberculoma in the cerebral hemisphere which were treated surgically. Differentiating characteristics of intracerebral tuberculoma in MR imaging and CT scans are also discussed. With the references reviewed, the MR imaging features of the tuberculoma were found to be distinct from those of abscess, metastatic tumor, glioma and cysticercus granuloma.