MRI of the Posttraumatic Cerebral Parenchymatous Injuries

The authors retrospecitviely analyzed the MRI findings of the 8 head-injured patiens who had showed persistent unconsciousness and severe neurologic deficite after trauma. T2-weighted MR images disclosed high signal intensity lesions of various size and shape at lobar white matter and corpus callosum, subcortical gray matter, brain stem, and cerebral cortex, and assisted greatly in understanding the neurologic deficits of the corresponding patients. The lesions were mostly multiple and involved multiple structures. CT's revealed in those patients only small hemorrhages, suspicious low densities, such nonspecific findings as slit ventricles and diffuse brain atrophy, or no abnormality at all. Post-traumatic parenchymatous lesions detected by MR images were either missed or quite underestimated on CT's. MRI was very supeior to CT in the detection and anatomic localization of nonhemorrhagic intraaxial cerebral injuries. especially in the cases of small corical contusions, brainstem and white matter injuries. For the evaluation of the acute posttraumatic patients, CT ios indicated in order to fastly detect intracranial hemagomas which may need emergent surgical evacuation. If CT findings does not explain the neurologic degicits of the patients, especially in the late stage. MRI is indicated. MRI is expected to play a major role in the diagnosis of shear injuries involoving white matter and brainstem where CT has been of little contribution or misleading.

Prolapse of Bladder through Vesico-Vaginal Fistula / 대한비뇨기과학회지

Prolapse of bladder through vesico-vaginal fistula is quite a rare urological problem. A 38-year-old woman was admitted to the Woo Sok University Hospital with a baby head sized round mass attached to the vagina. Patient had a prolapse of uterus after having her second child birth about 10 years ago and cauterization with corrosives for the treatment of prolapse of uterus was undergone for two times. About one year prior to the admission, the prolapse of uterus recurred and cauterization with corrosives was tried again, resulting vesico-vaginal fistula through which the bladder was everted and prolapsed. Under the general anesthesia, the everted and prolapsed bladder was reduced manually in normal position and vesico-vaginal fistulectomy was performed with good result.