An Experiments Study for Usage of Urokinase in Treatment of Intracerebral Hematoma

Thrombolysis using urokinase solution is one of the effective methods in treatment of intracerebral hematoma. The present study was undertaken in order to 1) determine the most effective concentration of urokinase solution, 2) determine the most suitable time interval of irrigation of urokinase solution through the measurement of hemoglobin and FDP(Fibrin / Fibrinogen Degradation Product) of drained solution, 3) estimate the size of unresolved hematoma without taking brain CT. The results are summarized as follows : 1) The most effective and economic concentration of urokinase solution was 1000 u/ml. 2) The most preferable time interval of irrigation of urokinase solution was about one hour. 3) It was possible to estimate the size of unresolving hematoma by means of measurement of hemoglobin and hematocrit of patient, hemoglobin and volume of the thrombolysed solution, so that it was unnecessary to take brain CT for measurement of remaining hematoma.

A Case of Epidermoid Cyst in the Fourth Ventricle

Epidermoid cyst is a congenital tumor and it's incidence is relatively rare in all intracranial tumors. Preference site is the basal surface of the brain, particularly the cerebellopontine angle and parasellar region. We report a epidermoid cyst in the fourth ventricle of 37 years old femals with signs of cerebellar dysfunctions. The literature on the incidence, diagnosis, surgical technoque and complications are reviewed.

Epidural Morphine for Control of Pain after Lumbar Laminectomy

Epidural morphine has been used successfully for the relief of acute or chronic pain by direct injection or catheter method. We report the use of morphine for postoperative pain control in 18 herniated lumbar disc patients. These patients were compaired with 25 others who were not received epidural morphine. Without using of epidural catheter, single small dose morphine(3~5mg) in 1.5ml normal saline was administered under the direct infution into the epidural space just before closure of the lumbar operative wound. Epidural morphine group required only 2 times of parenteral narcotics injections within the first 24 hours after lumbar laminectomy, whereas nonmorphine group required 48 injections. The average narcotics injection frequencies were statistically significant(p<0.01). Hypotension were occured in three cases and pruritus in two cases. But more investication and study were needed for hypotension which was true side effect or not. Respiratory depression was not occured.