The Status of Central Nervous System Tumors in Daegu City and Kyungbook Province

The authors analized statistically 403 cases of C.N.S. tumors confirmed by pathology in the boundary of Daegu city and Kyungbook province from January 1984 to December 1986. The results were as follows: 1) The each cases of male and female were 220(54.6%) and 183(45.4%). 2) Intracranial tumors were 288 cases(71.5%), spinal tumors 75(18.6%), and others 40(9.9%). 3) Numbers of C.N.S. tumors were 8.7/100,000 population in city and 6.3/100,000 in country. 4) Among the intracranial tumors, glioma(30.9%) was the most common and followed by meningioma(16.3%) and metastatic tumor(8.7%). Among the spinal tumors, metastatic tumors was 34.6%, neurofibroma 30.7%, and meningioma 5.3%. 5) The majority of intracranial tumors were found in supratentorial region(76.3%), in which area frequency of tumor incidence were as follows; glioma, meningioma, metastatic tumor. Among the infratentorial area(22.6%), the sequence of tumor incidence were glioma, medulloblastoma, and neurilemmoma, 6) Tumors predominantly in male were oligodendroglioma(2:1), metastatic tumor(1.8:1), and medulloblastoma(1.7:1), and in female were meningioma(1:2), neurilemmoma(1:1.7), and pituitary tumor(1:1.5). 7) Peak age incidence of glioma, meningioma, and neurilemmoma were from 40 to 60 years, pituitary tumor and oligodendroglioma were 30 to 50 years, craniopharyngioma and ependymoma were around 10 years old, and metastatic tumor was 50 to 70 years old. 8) In the spinal tumors, the most favorable site of longitudinal axis was thoracic area(62.7%) and transverse location was epidural space(45.3%). 9) The most common site of metastatic tumor were came from lung(29.1%) in brain metastasis and prostate(19.2%) in spine.

Spontaneous Intracerebral Hemorrhage due to Small Vascular Malformations and Unknown Causes

Twenty-two patients who had evidence of spontaneous intracerebral hemorrhage in brain computerized tomographic(CT) scan specially with small vascular malformations who were angiographically verified and unknown causes, were reviewed. The majority of patients were in first and second decades of life. The duration of symptoms from onset to admission showed relatively short in verified cases and even distributed from 1 day to 1 month in unknown cases. The most common presenting symptoms and signs were headache and papilledema in unknown cases. In brain CT scan, variable findings were seen as hematoma with surrounding eidence of vascular anomaly, hematoma only and blood-fluid level in verified cases, and tumor-like findings in unknown cases. The most common site of hematoma were parietal and occipital lobes in verified cases and were parietal and infratentorial area in unknown cases. The results achieved with excision of these cases were good. These small vascular malformations require special attention because of following view-points: 1) their relative frequent cause of intracerebral hematoma; 2) their variable findings in CT scan ; 3) more careful serial angiographical identification of anomalous vessel with subtraction and magnification; 4) their careful histopathological observation of operative specimen.

Clinical Observation, of Chronic Subdural Hematomas (Burr hole, Drainage and Craniotomy, Membranectomy)

The authors have presented 44 cases of chronic subdural hematoma which were diagnosed by brain computerized tomographic (CT) scan at the Department of Neurosugery, Keimyung University, School of Medicine from May 1980 to July 1982. There were 42 men and 2 women. The common incidence of age was between fourth and fifth decade. Most of the cases(80%) had a history of head injury and nearly all cases complained headache(93%). The most common sign was papilledema(71%) in relatively young age patients and mental change(62%) in old age patients. All cases performed brain CT scan, which showed hypodense(41%), isodense(21%), hyperdense(21%) and mixed dense(18%) lesion. The thickness of hematoma which was measured by brain CT scan revealed 10 mm-30mm in most cases and showed the tendency of increase in old age patients. Of 44 cases, 23 cases were treated with craniotomy and membranectomy, 18 cases with burr hole and drainage, and 3 cases which were bilateral lesion with both methods. There was not any different result in both methods and most of all cases showed good postoperative course except 3 cases of poor preoperative state.

Diagnostic Value of Computed Tomography for Intracranial Suppuration

The authors report their experience with 22 cases of intracranial suppuration : 18 with brain abscess and four with subdural empyema. A small series of nine consecutive cases of intracranial suppuraion with one death is presented since Computed Tomographic brain scanning become a routine diagnostic procedure. These patient have been compared to 13 consecutive cases treated without benefit of CT analysis in order to determine the factors responsible for the recently improved prognosis. The mortality rate was 30.8% for al operated patients treated before availability of CT and 22.7% for the patient since advent of CT scan. Among the factors that may have contributed to the improved results for patients diagnosed with CT are : fewer patients with poor preperative clinical status, and a great incidence of total abscess removal. In addition, CT scanning provided more accurate diagnosis and localization of abscess and aided in the rapid detection of postoperative complication.

An Oligodendroglioma in a Child

Oligodendroglioma is said to account for between 3% and 12% of all intracranial glioma and usually occur in adult, constituting only 1% of primary intracranial neoplasm in children. The authors experienced a case of oligodendroglioma involving right lateral ventricle in a child and reviewed the literatures.