ABSTRACT
Two Cases of ruptured bacterial aneurysms involving the distal branches of the middle cerebral artery associated with an intracerebral hematoma are reported. Both patients presented with a medical history of valvular heart disease and subacute bacterial endocarditis. The mortality of ruptured intracranial bacterial aneurysms has been reported to be very. High and a proper treatment strategy for such aneurysms still remains controversial. Most authors have recommended aggressive antimicrobial therapy, serial antiographic follow-up studies, and surgery for aneurysm's that do not resolve or enlarge even after medical treatment. Both of the reported patients were treated with antibiotics and underwent surgical evacuation for huge-sized intracerebral hematomas, and in one patient, the aneurysm was completely resected.
Subject(s)
Humans , Aneurysm , Aneurysm, Infected , Anti-Bacterial Agents , Endocarditis, Subacute Bacterial , Follow-Up Studies , Heart Valve Diseases , Hematoma , Middle Cerebral Artery , MortalityABSTRACT
The authors present three cases of intracranial aneurysm associated with brain tumors. Two cases were unruptured intracranial aneurysms(one was located at the origin of anterior choroidal artery of right internal carotid artery and the other at the bifurcation of right middle cerebral artery). Which were found incidentally during the transcranial approaches to pituitary adenoma and right frontal glioblastoma multiforme respectively. As preoperative angiography was not performed in those cases, there was some difficulty in clipping the neck of the aneurysms. The third case presented with sudden headache and vomiting, and her brain computed tomography, magnetic resonance imaging and cerebral angiography showed subarachnoid hemorrhage, five anterior and one posterior circulation aneurysms as well as a pituitary adenoma. The patient refused the operation. It is well known that some brain tumors, such as pituitary adenoma, glioma, meningioma, are often associated with intracranial aneurysms. In planning the treatment of those brain tumors, preoperative angiography seems essential to know the status of the vessels adjacent to the tumors and to rule out incidental aneurysms.
Subject(s)
Humans , Aneurysm , Angiography , Arteries , Brain Neoplasms , Brain , Carotid Artery, Internal , Cerebral Angiography , Choroid , Glioblastoma , Glioma , Headache , Intracranial Aneurysm , Magnetic Resonance Imaging , Meningioma , Neck , Pituitary Neoplasms , Subarachnoid Hemorrhage , VomitingABSTRACT
The authors analysed 39 cases chronic subdural hematoma admitted to the Department of Neurosurgery, Seoul Red Cross Hospital from January 1990 to June 1993. The results were as follows : 1) The ratio of male versus female was 6.8 : 1 and the incidence was predominant in patients whose ages were over 50. 2) Past history of head trauma was found in 28 cases(72%) and head trauma with habitual alcoholism was found in 6 cases(15%). 3) Symptoms and signs at admission were headache(90%), hemiparesis(62%), mental change(46%) and vomiting(36%). 4) The densities of hematoma shown in Brain CT scan were iso, hypo, mixed, and hyperdense and the shapes of hematoma were crescenteric, planoconvex, and biconvex in order of frequency. 5) We have found an association between the neurologic grade at admission and the prognosis, and noted full recovery in 33 cases(84%) and no death as a result of the 2-burr hole trephination.
Subject(s)
Female , Humans , Male , Alcoholism , Brain , Craniocerebral Trauma , Hematoma , Hematoma, Subdural, Chronic , Incidence , Neurosurgery , Prognosis , Red Cross , Seoul , Tomography, X-Ray Computed , TrephiningABSTRACT
A rare case of thoracic myelopathy caused by the ossification of hypertrophied ligamentum flavum is presented. A fourty-year old male complained of decreased pain, temperature, touch sense at right lower limb, weak urinary stream, poor penile erection, and constipation. CT revealed an ovoid, homogeneously high density at the site of left T10-11 ligamentum flavum, which compressed the spinal cord posterolaterally. MR imaging showed significant spinal cord compression on the left posterolateral aspect at T10-11 level by a well-defined purely low-intensity signal lesion. Simple spine X-rays did not show any abnormality. T10 total laminectomy and removal of the ossified ligamentum flavum resolved his neurological dysfunction. Clinical summary of the case is presented and the corresponding literature are reviewed.
Subject(s)
Humans , Male , Constipation , Laminectomy , Ligamentum Flavum , Lower Extremity , Magnetic Resonance Imaging , Penile Erection , Rivers , Spinal Cord , Spinal Cord Compression , Spinal Cord Diseases , SpineABSTRACT
Solitary chondroma is a benign tumor which rarely involves the intracranial cavity. Most of them are originated from and attached to the skull base. Very rarely they occur intradurally. The authors experienced a female case of a chondrome located at fromtal interhemispheric fissure and connected to the inferior margin of the falx by a thin pedicle. Her clinical , radiologic, operative, and pathologic findings are reported and the pertinent literatures are reviewed.