Extraordinarily Long-Term Posttraumatic Cerebrospinal Fluid Fistula

Most posttraumatic cerebrospinal fluid (CSF) leakage is noticed by the patients with the first symptom, rhinorrhea. A 38-year-old woman presented with frequent clear continuous rhinorrhea and otorrhea for 5 years after basilar skull fracture. After this, meningitis was developed with subsequent CSF fistula. Her clinical symptom was improved by medical treatment. The dural defect and CSF leakage were not detected by computerized tomography (CT) cisternography. We report a rare case of persistent posttraumatic CSF fistula that continued for five years.

Hepatic Hemangioma with Atypical Sonographic Features: Value of Two-Phase Spiral CT

PURPOSE: The purpose of this study was to evaluate enhancement patterns, as seen on two-phase spiral CT, of hepatic hemangiomas in which atypical features had been seen on sonography (US) MATERIALS AND METHODS: Two-phase spiral CT scanning was performed in 18 patients in whom 24 atypical hemangiomas had been seen on US. Two-phase images were obtained at 25-45 seconds (arterial dominant phase) and 2-5 minutes (equilibrium phase) after the initiation of a bolus injection of contrast material (150 ml, 5 ml/sec). Enhancement patterns of hemangiomas during each phase were classified as homogeneous high, peripheral high, or low attenuation, and were retrospectively analyzed. RESULTS: In the arterial dominant phase of spiral CT, low attenuation was seen in nine hemangiomas (38%), globular or spotty peripheral high attenuation in 14 (58%), and homogeneous high attenuation in one (4%). In the equilibrium phase, enhancement patterns were peripheral high attenuation (partial fill-in) in 18 lesions (75%), and homogeneous high attenuation (complete fill-in) in three (12.5%), In the other three (12.5%) enhancement showed no significant change; in one of these, density was slightly less than in the arterial phase, and two showed subtle peripheral high attenuation. Fourteen hemangiomas (58%) showed globular or spotty peripheral high attenuation in the arterial dominant phase and peripheral or homogeneous high attenuation with progressive centripetal enhancement in the equilibrium phase. CONCLUSION: Our results suggest that two-phase spiral CT during the arterial dominant and equilibrium phase is useful in differentiating hepatic hemangiomas with atypical features seen on US from malignant hepatic tumors.

MR Measurement of the Normal Corpus Callosum in Children

PURPOSE: To measure the mean size of the various portions of the corpus callosum in normal Korean children, using MR imaging. MATERIALS AND METHODS: Our subjects were 166 children (male : female=100 : 66) aged under 15 whose findings on MR imaging and neurologic examination were normal. Using midsagittal T1-weighted imaging, we measured the length of the brain and corpus callosum, the height of the latter, and the thickness of its genu, body, transitional zone and splenium. The measurements were statistically analysed according to age and sex. RESULTS: Brain length and the size of the various portions of the corpus callosum tended to increase relatively rapidly during the first three years of life, but the rate of growth tended to decrease according to age. The mean length of the brain and corpus callosum and the mean thickness of the splenium of the corpus callosum did not differ according to sex. The mean thickness of the genu, body and transitional zone of the corpus callosum was greater in males than in females. The ratio of the length of the corpus callosum to the anteroposterior diameter of the brain was significantly greater in females than in males (alpha = 0.05). CONCLUSION: Using MR imaging, we measured the mean sizes of the various portions of the corpus callosum in normal children ; these values may provide a useful basis for determing changes occurring in its structure.

Analysis of Operative Treatment of 154 Herniated Intervertebral Disc in Lumbar Spine / 대한정형외과학회잡지

One hundred and fifty-four operative cases of herniated intervertebral disc were evaluated in department of Orthopedic Surgery, National Police Hospital from June 1973 to May 1979. The results were obtained as follows: 1. Out of the 154 patients, there were 137 male and 17 female cases. The ratio between male and female was 8:1. 2. The majority (72%) of the herniated intervertebral disc was found in the age group of 20 to 40 years. 3. The most common site of the lesion was between L4 and L5 vertebrae (70%). 4. About 90% of the patient showed significant sign in myelographic and clinical studies. 5. To prevent adhesion of sciatic nerve & dura after the operation, spraying the methyl-prednisolone over the operative site and covering dura with fat in spinal canal could be resulted in good method. 6. The dissecting type is considered to be what operators should observe attentively during the operation. 7. The result of treatment was excellent in 94 cases (61%) and good in 47 cases (30%).

Clinical Study of Meniscus Tear / 대한정형외과학회잡지

It is assumed that the frequency of the meniscus tear on the right and the left knee and the mechnism of injuries in westerners are different from those in easterners. The writer had experienced 32 cases of the meniscus tear in National Police Hospital, during the period from 1973 to 1977, and inquired into its frequency and cause based on appropriate references. This is the report on the result of our study. 1. Out of 32 cases, 21 cases were found in the group of 20 to 29 years of age. 2. Eleven years of age with a discoid type was noticed as the youngest. 3. Out of 32 cases, 20 cases were found on the lateral meniscus and 12 on the medial, showing every five lateral cases to every three medial cases. 4. Out of 32 cases, 17 cases were found on the right knee joint with 14 lateral and 15 on the left knee joint with 9 medial. 5. Out of 32 cases, 27 cases were found on the male and 5 on the female, showing 5. 4 male cases to every one female case. 6. Out of 32 cases, 29 cases had the apparent history of trauma. 7. Transverse tear was found more frequent on the lateral meniscus and longitudinal or bucket handle tear was found more frequent on the medial meniscus.