A Case of Pituitary Tuberculoma

A case of pituitary tuberculoma in a 53-year-old male is reported. His clinical complaints included headache and right ptosis. Endocrinological studies showed hypopituitarism. Radiologic studies showed enlargement of the sellar turcica. Removal of the tumor resulted in resolution of his neurological symptoms and signs.

Extracranial Metastasis of Supratentorial Ependymoma without Recurrence of Primary Focus

A case of supratentorial ependymoma in a 48-year-old man. After operation and radiological treatment, metastasis to scalp and cervical lymph node occurred, without recurrence of primary focus. 11 cases of intracranial ependymoma with extracranial metastasis were reviewed. Metastasizing intracranial ependymomas are 3 times as frequent in males and originate above tentorium. The most effective transmission of metastasis of ependymoma is through the blood stream and the frequent sites of metastasis are lungs, pulmonary hilus, mediatinum, liver, scalp, vertebra, femoral bone and cervical lymph nodes. Our case is the oldest among reported cases and metastasized to relatively rare site.

Epidermoid Cyst in the Cerebello-Pontine Angle Associated with Trigeminal Neuralgia

A case of epidermoid cyst in the cerebello-pontine angle, resulting in trigeminal neuralgia, is presented. There were no abnormal findings in the clinical and radiologic examination except the typical neuralgic pain. The tumor was found incidentally during posterior fossa exploration for neurovascular decom pression of the trigeminal nerve under diagnosis of primary trigeminal neuralgia. The patient was treated with only removal of the tumor.

Clinical Features of Craniopharyngioma

The present study involves 30 craniopharyngioma patients who were admitted to the Department of Neurosurgery, Yonsei Medical college from April, 1965 to December, 1978. All 30 patients received surgery, the results of which were analyzed and evaluated as follows. 1. They consisted of 22 male and 8 female patients. Sixty percent of all patients were under 20 years of age. 2. Chief complaints were as follows:headache(80.0%), decreased visual acuity(80.0%), visual field cut(46.3%), nausea and vomiting(40.3%), papilledema(40.0%), optic atrophy(33.3%), diabetes insipidus(27.0%), and mental disturbance(27.0%). 3. They were diagnosed mainly by cerebral angiography until 1977, at times combined with pneumoencephalography, isotope brain scan, and Conray ventriculography. Since 1978 using the CT brain scan we have been able to reduce risk during and after neuroradiological study, and accurately determine location, size, shape and invasiveness of the tumor. 4. Surgical procedures were performed in 32 cases of craniopharyngioma using several approaches;transfrotal approaches;transfrontal approach:29 cases, transsphenoidal approach:2 cases, and sterotaxic cyst puncture:1 cases. In 8 cases(27.0%) total resection of the tumor was performed, subtotal resection in 23 cases(71.9%), and aspiration of the cyst in one case(3.1%). 5. In the above 32 surgeries, 24 cases(75.0%) of craniopharyngioma were performed by microsurgery, 8 cases involved total resection and 16 cases subtotal removal. As a result of microsurgery, it was possible to remove the tumor from the surrounding structures with less damage. 6. To manage hydrocephalus during the operation, extraventricular drainage was applied in 8 cases(27%) and in 7 cases(23.3%) ventriculoatrial or ventriculoperitoneal shunts were employed pre-or postoperatively. 7. Postsurgical radiation therapy was given to 8 patients in the dosage of 5000-7000 rad during 6 to 8 week period following surgery.