Clinical Analysis of Metastatic Brain Tumors

The author analyzed 153 cases of metastatic brain tumors, including diagnostic and therapeutic aspects, who had been admitted to Yonsei University College of Medicine and Jeonju Presbyterian Medical Center from January, 1976 to August, 1983. Results obtained are as follows: 1) Metastatic brain tumors constituted 16.5% of all brain tumors. 2) The majority of patients was in the age range of 41 to 60 years. 3) The most common primary tumor with brain metastasis was lung carcinoma(45.1%). 4) Headache was the single most common presenting symptom of cerebral metastasis. 5) The most frequent intracranial locations of metastatic brain tumors were parietal and frontal lobe. 6) The computed tomographic scan has become the single most valuable and accurate diagnostic tool for investigation of metastatic brain tumor. It was also important study in evaluating the effect of treatment. Multiplicity of lesions was an important diagnostic feature. Also densely enhancing, and homogeneous cortical mass surrounded by edema with finger-like projections was a common characteristic feature. 7) Combined therapy-surgical excision followed by whole brain radiotherapy and/or chemotherapy-had been shown to result in better prognosis than either modality alone. The 6 months survival rate of combined therapy was 66.7% and it was more efficient in prolonging the patient's quality of life than the other methods currently available. In some instances, admittedly rare, long-term survival could be achieved. When the metastatic mass was producing wevere neurological disability because of its location, and the prognosis was otherwise reasonable, significant palliation and improvement in the patient's neurological status could be secured by surgical removal.

A Clinical Analysis of Occlussive Cerebrovascular Disease

The author analyzed 352 patients who had been admitted to P.M.C. with clinical signs and symptoms of occlussive stoke from 1973 to 1980. Cerebral angiography was performed on 250 patients and 126 patients of them were confirmed to have angiographical evidence of occlusion. We've analyzed these 126 patients in clinical point of view. As presented above, positive rate of angiography was 50%. The site of lesion was most common at MCA which was somewhat different from other reports, and the side of predelection was left. In majority of cases, the occlusive stroke was occurred in age group between 40 to 60, and man was about 3 times as common as woman. Risk factors, in our series, were hypertension, cardiac problems, diabetes and so on which were similar to other reports. Hypertension, the most common risk factor, correlated well to the peak age incidence but there was not any intimate relationship with the level of serum cholesterol. The outcome of medically treated group(112 patients) was somewhat better than surgery(14 patients). Among 12 of EIAB, TIA noted the best result compared to RIND and SIE. Meticulous selection of patient using CT scanning and measurement of rCBF would promote the benefit of surgery.

Delayed Traumatic Intracerebral Hemorrhage

The authors experienced a case of delayed traumatic intracerebral hemorrhage following a closed head injury. The patient had epidural hematoma at the right temporal area which was confirmed by the computed tomography. The hematoma was successfully evacuated and immediate postoperative course was uneventful. On the second day after operation the patient's condition deteriorated again and repeated computed tomography showed a large delayed intracerebral hematoma in the left occipital lobe. He was immediately treated surgically for the intracerebral hematoma with good result.