Clinical Observation of Medulloblastoma

The authors represented a clinical analysis on 31 patients with medulloblatoma who had been treated surgically at the Department of Neurosurgery, Yonsei Medical Center and Wonju Christian Hospital from Sept. 1967 to Aug. 1981. The results were summarized as follows ; 1) Among 31 patients, 19 were male and 12 were female. About 73% of cases were found under the age of 16 and male was predominant in this age group. 2) The most common clinical symptom was that of increased intracranial pressure(84%). Gait disturbance, generalized seizure and mental change were also found and duration of symptom of symptom was average 2.2 month. Neurological signs showed papilledema, cerebellar signs and lower cranial palsies. 3) Plain skull X-rays, carotid and vertebral angiography and conray ventriculography were useful diagnostic methods but brain CT scan was thought to be the most accurate, noninvasive and helpful method which showed size and location of tumor and relationship with surrounding structures. In brain CT scan hydrocephalus and compression 4th ventricle were found in 94%, and 88% revealed contrast enhancement. 4) Considering 1 year survival rate which was possible follow up in this study, microsugical total excision of tumor followed by radiation therapy disclosed the best result for reducing recurrence and seeding of tumor among the current therapeutic methods.

Clinical Observation of Intracranial Abscesses

Sixty five intracranial abscesses were experienced from December , 1970 to August, 1981, of which fifty seven cases were operated. The clinical analysis and surgical experiences were summarized as follows. 1) The patients consisted of 45 male and 12 female and 31 patients(54.4%) were under 20 years of age. 2) Of the 57 patients, 45 patients(79%) had a demonstrable infectious source leading to the intracranial infection. There were 15 patients with ear infection and 13 patients with trauma. 3) Staphylococcus and streptococcus were the most common pathogens in this study. 4) Common symptoms of the patients were headache and fever, which were followed by mental disturbance and focal neurologic disturbance. 5) Brain CT scan offered accurate, non-invasive, rapid and easily repeatable means of diagnosis and following of lesions. After contrast infusion, ring enhancement had mostly thin and regular wall(88%). 6) The best operative methods of the brain abscess were aspiration and resection, or drainage and resection. The deep seated brain abscess, subdural abscess and epidural abscess could be treated using only drainage method with good results.