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1.
Journal of Cerebrovascular and Endovascular Neurosurgery ; : 20-25, 2020.
Artículo | WPRIM | ID: wpr-835649

RESUMEN

Progressive epidural hematoma is a form of acute epidural hematoma that graduallyexpands from a small initial hematoma; in cases that are clinically aggravated dueto the presence of a mental illness or neurological condition, patients should be surgicallytreated for evacuation of the hematoma, but poorer outcomes are expected ifthe patient has several medical co-morbidities for surgery. We experienced two casesof progressive epidural hematoma which were successfully managed by endovasculartreatment: an 85-year-old male with medical co-morbidities and a 51-year-oldfemale with a poor-grade subarachnoid hemorrhage resulting from the rupture of adissecting aneurysm of the vertebral artery. In both cases, a middle meningeal arteryembolization was performed and contrast leakage was observed and controlled usingcerebral angiography, halting the progression of their epidural hematomas. Thus,endovascular embolization of a middle meningeal artery may play a useful role in salvagetherapy in certain complicated situations that limit treatment of the hematomaby surgical evacuation.

2.
Korean Journal of Neurotrauma ; : 128-134, 2016.
Artículo en Inglés | WPRIM | ID: wpr-122142

RESUMEN

OBJECTIVE: The optimal threshold of the infusion volume of cement has been a continuous subject in percutaneous vertebroplasty (PVP). This study verifies a causal relationship between the cement volume and the clinical outcome, and suggests the parameters of the appropriate volume of cement in PVP. METHODS: This is a retrospective study. One hundred nine patients, who underwent PVP between 2012 and 2015, were included in the study. Various factors such as patients' fracture levels, fracture types, fracture body volumes, fracture rates, bone mineral densities, and infused cement volumes were analyzed. Cement infusion ratios were calculated, using total amount of infused cement and fractured body volume. Follow up was done after one-week, one-month and three-months, postoperatively. Changes in the middle body height and the cement leakage levels were monitored and clinical outcomes were evaluated using a visual analogue scale. RESULTS: Among the variables, the infusion ratio (r=-0.320, p=0.003, Pearson's correlation) was the only index that showed a significant cause and effect relationship with favorable clinical outcome, except the group with a T-score of higher than -2.5, and the group with a upper thoracic vertebral level. The patients with a cement infusion ratio of 27.8% or more of the fractured body volume had favorable results. CONCLUSION: This study showed that high cement infusion ratio revealed favorable outcome in the vertebroplasty of the osteoporotic compression fractures. Infusion ratio of more than 27.8% to osteoporotic compressed vertebrae is optimal for rapid recovery after PVP.


Asunto(s)
Humanos , Estatura , Cementos para Huesos , Densidad Ósea , Estudios de Seguimiento , Fracturas por Compresión , Análisis Multivariante , Estudios Retrospectivos , Columna Vertebral , Vertebroplastia
3.
Korean Journal of Neurotrauma ; : 156-158, 2016.
Artículo en Inglés | WPRIM | ID: wpr-122136

RESUMEN

The management guideline for traumatic brain injury (TBI) recommends high-dose barbiturate therapy to control increased intracranial pressure refractory to other therapeutic options. High-dose barbiturate therapy, however, may cause many severe side effects; the commonly recognized ones include hypotension, immunosuppression, hepatic dysfunction, renal dysfunction, and prolonged decrease of cortical activity. Meanwhile, dyskalemia remains relatively uncommon. In this study, we report the case of a hypokalemic patient with severe rebound hyperkalemia, which occurred as a result of barbiturate coma therapy administered for TBI treatment.


Asunto(s)
Humanos , Lesiones Encefálicas , Coma , Hiperpotasemia , Hipopotasemia , Hipotensión , Terapia de Inmunosupresión , Presión Intracraneal
4.
Journal of Korean Neurosurgical Society ; : 79-82, 2015.
Artículo en Inglés | WPRIM | ID: wpr-83148

RESUMEN

Cleidocranial dysplasia is a well-documented rare autosomal dominant skeletal dysplasia characterized by hypoplastic/aplastic clavicles, brachycephalic skull, patent sutures and fontanelles, midface hypoplasia, and abnormalities of dentition. Patients with cleidocranial dysplasia often complain about undesirable esthetic appearance of their forehead and skull. Notwithstanding many studies of molecular, genetics and skeletal abnormalities of this congenial disorder, there have been very few written reports of cranioplasty involving cleidocranial dysplasia. Thus, we report a rare case of successful cranioplasty using a modified split calvarial graft technique in patient with cleidocranial dysplasia.


Asunto(s)
Humanos , Clavícula , Displasia Cleidocraneal , Dentición , Frente , Genética , Cráneo , Suturas , Trasplantes
5.
Korean Journal of Neurotrauma ; : 93-99, 2015.
Artículo en Inglés | WPRIM | ID: wpr-205826

RESUMEN

OBJECTIVE: The risk of complications is high for patients with a large cranial defect and hydrocephalus, undergoing cranioplasty and ventriculoperitoneal (VP) shunt operation. The purpose of this study is to examine retrospectively such cases with complications and contrive an operative technique to reduce complications. METHODS: Nineteen patients underwent cranioplasty and VP shunt operation due to large cranial defects and hydrocephalus. These patients were divided into two groups: Group A with 10 patients who underwent staged-operations, and Group B with 9 patients who underwent one-stage operation. Their complications in each group were retrospectively reviewed. Another five patients underwent a one-stage operation with temporary occlusion of the distal shunt catheter to improve on the technique and were categorized as Group C. Complications in these groups were compared and analyzed. RESULTS: The results of the data analysis revealed that complications related to anesthesia (40%) and those related to antibiotic prophylaxis (30%) were high in Group A, while non-infectious delayed complications (45%) and perioperative complications such as intracranial hematoma (33%) were high in Group B. However, for patients in Group C, it showed less complication with the operative technique devised by these authors, as opposed to two previous procedures. CONCLUSION: In patients with hydrocephalus and a large cranial defect, complications arising from existing one-stage operation or staged-operations can be reduced by implementing the technique of "one-stage operation with temporary occlusion of the distal shunt catheter."


Asunto(s)
Humanos , Anestesia , Profilaxis Antibiótica , Catéteres , Craniectomía Descompresiva , Hematoma , Hidrocefalia , Estudios Retrospectivos , Estadística como Asunto , Derivación Ventriculoperitoneal
6.
Journal of Korean Neurosurgical Society ; : 365-369, 2014.
Artículo en Inglés | WPRIM | ID: wpr-212038

RESUMEN

Spinal epidural lipomatosis (SEL) is a rare disorder, regarded in literature as a consequence of administration of exogenous steroids, associated with a variety of systemic diseases, endocrinopathies and the Cushing's syndrome. Occasionally, SEL may occur in patients not exposed to steroids or suffering from endocrinopathies, namely, idiopathic SEL. Thus far, case studies of SEL among Korean have been published rather sporadically. We reviewed the clinical features of SEL cases, among Koreans with journal review, including this report of three operated cases. According to this study, there were some differences between Korean and western cases. Koreans had higher incidences of idiopathic SEL, predominant involvement in the lumbar segments, very few thoracic involvement and lower MBI, as opposed to westerners.


Asunto(s)
Humanos , Síndrome de Cushing , Incidencia , Lipomatosis , Esteroides
7.
Journal of Korean Medical Science ; : 772-776, 2004.
Artículo en Inglés | WPRIM | ID: wpr-123111

RESUMEN

Astroblastoma is one of the very unusual type of tumors, whose histogenesis has not been clarified. It occurs mainly among children or young adults. Astroblastoma is grossly well-demarcated, and shows histologically characteristic perivascular pseudorosettes with frequent vascular hyalinization. Perivascular pseudorosettes in astroblastoma have short and thick cytoplasmic processes and blunt-ended foot plates. A 15-yr-old girl presented with headache and diplopia for one and a half year. A welldemarcated mass, 9.7 cm in diameter, was found in the right frontal lobe in brain MRI, and it was a well-enhanced inhomogenous mass. Cystic changes of various sizes were observed inside the tumor mass as well as in the posterior part of the mass, but no peritumoral edema was found. Histologically, this mass belongs to a typical astroblastoma, and no sign of anaplastic astrocytoma, gemistocytic astrocytoma or glioblastoma was found in any part of the tumor. Immunohistochemically, the tumor cells showed diffuse strong positivity for glial fibrillary acidic protein, S-100 protein, vimentin and neuron specific enolase, and focal positivity for epithelial membrane antigen and CAM 5.2, while showing negativity for synaptophysin, neurofilament protein, pan-cytokeratin and high molecular weight keratin.


Asunto(s)
Adolescente , Femenino , Humanos , Neoplasias Encefálicas/metabolismo , Diagnóstico Diferencial , Proteína Ácida Fibrilar de la Glía/metabolismo , Queratinas/metabolismo , Imagen por Resonancia Magnética , Neoplasias Neuroepiteliales/metabolismo , Fosfopiruvato Hidratasa/metabolismo , Proteínas S100/metabolismo , Vimentina/metabolismo
8.
Journal of Korean Neurosurgical Society ; : 71-73, 2002.
Artículo en Coreano | WPRIM | ID: wpr-146645

RESUMEN

In angiographic examinations, abnormalities of vertebral arteries are incidental findings because they are, in most of cases, clinically asymptomatic. We report a case of young woman with a fenestrated anomaly of the left vertebral artery with ischemic strokes. The patient was suffered from repeated attacks of transient ishemic attack(TIA) and cerebral infarction. Vertebral angiography demonstrated a fenestrated anomaly of the left vertebral artery and a large intraluminal thrombus was detected at just proximal of the fenestration. Proximal balloon occlusion of the involved vertebral artery was done and the patient became free from ischemic attack. Follow-up angiography showed well visualization of the posterior circulation through right vertebral artery and the ballooned vertebral artery was well occluded. The left posterior inferior cerebellar artery(PICA) was filled well via collateral circulation from the opposite side.


Asunto(s)
Femenino , Humanos , Angiografía , Oclusión con Balón , Infarto Cerebral , Circulación Colateral , Estudios de Seguimiento , Hallazgos Incidentales , Accidente Cerebrovascular , Trombosis , Arteria Vertebral
9.
Journal of Korean Neurosurgical Society ; : 89-94, 2002.
Artículo en Coreano | WPRIM | ID: wpr-146640

RESUMEN

Spontaneous spinal epidural hematoma is a rare entity. Various definitions for spontaneous epidural hematoma have been reported in the literature. The expression of nontraumatic spinal epidural hematoma seems to be less ambiguous and includes idiopathic hematomas and hematomas secondary to coagulopathy, vascular malformations, and tumors. We report three cases of nontraumatic spinal epidural hematomas observed from 1991 to 2000. The causes of the spinal epidural hematomas were not clear in two cases among them, but in the another one case, the cause was determined to be an acquired coagulopathy. We reviewed 24 cases reported in the Korean Journal of Neurosurgery and our three cases with particular emphasis on the various causes such as coagulopathy, vascular malformations and tumors. Among the 27 cases, numerous causes were detected such as three cases of vascular malformation, one case of anticoagulant treatment, five cases of combined lumbar disc herniation, two cases associated with pregnancy and postpartum, one case associated with hypertension, and one case associated with ossification of ligamentum flavum. No causes were detected in the ten cases. The authors reviewed the literature.


Asunto(s)
Embarazo , Hematoma , Hematoma Espinal Epidural , Hipertensión , Ligamento Amarillo , Neurocirugia , Periodo Posparto , Malformaciones Vasculares
10.
Journal of Korean Neurosurgical Society ; : 278-281, 2002.
Artículo en Coreano | WPRIM | ID: wpr-151899

RESUMEN

The authors present a case of unilateral agenesis of internal carotid artery associated with an aneurysm at the unusual site. A 22-years old female was admitted with sudden headache and nausea. She was alert on admission and no focal neurologic deficit was detected. Brain computed tomography(CT) scan showed subarachnoid hemorrhage. In the cerebral angiography, right internal carotid artery was absent and an aneurysm was arisen from the junction of the right middle cerebral artery and posterior communicating artery. The blood supply of the right anterior cerebral artery was maintained from the left internal carotid artery via the anterior commuicating artery. The territory of the right middle cerebral artery was supplied from the basilar artery through enlarged right posterior communicating artery. Direct clipping of the aneurismal neck was performed through right pterional approach. In the postoperative high resolution CT scan, there was no carotid canal in the right skull base suggesting agenesis of the right internal carotid artery.


Asunto(s)
Femenino , Humanos , Adulto Joven , Aneurisma , Arteria Cerebral Anterior , Arterias , Arteria Basilar , Encéfalo , Arteria Carótida Interna , Angiografía Cerebral , Cefalea , Aneurisma Intracraneal , Arteria Cerebral Media , Náusea , Cuello , Manifestaciones Neurológicas , Base del Cráneo , Hemorragia Subaracnoidea , Tomografía Computarizada por Rayos X
11.
Journal of Korean Neurosurgical Society ; : 1127-1129, 2001.
Artículo en Coreano | WPRIM | ID: wpr-200917

RESUMEN

The vast majority of schwannomas occur on cranial nerves, and rarely in the retroperitoneum. Solitary schwannoma in the psoas muscle is extremely rare. The authors present a case of retroperitoneal neoplasm in the psoas muscle identified as schwannoma which is not associated with von Recklinghausen's disease. A 68 years old female patient was admitted because of low back pain and weakness at the left leg. CT and MRI revealed a large cystic mass with well-defined margin and multiple internal septation within the left psoas muscle. The tumor was totally extirpated and histologically confirmed as a schwannoma.


Asunto(s)
Anciano , Femenino , Humanos , Nervios Craneales , Pierna , Dolor de la Región Lumbar , Imagen por Resonancia Magnética , Neurilemoma , Neurofibromatosis 1 , Músculos Psoas , Neoplasias Retroperitoneales
12.
Journal of Korean Neurosurgical Society ; : 644-649, 2000.
Artículo en Coreano | WPRIM | ID: wpr-107489

RESUMEN

No abstract available.


Asunto(s)
Humanos , Drenaje , Hidrocefalia
13.
Journal of Korean Neurosurgical Society ; : 680-683, 2000.
Artículo en Coreano | WPRIM | ID: wpr-107483

RESUMEN

No abstract available.


Asunto(s)
Osteosarcoma , Hueso Esfenoides
14.
Journal of Korean Neurosurgical Society ; : 1805-1809, 1999.
Artículo en Coreano | WPRIM | ID: wpr-10215

RESUMEN

The authors report a surgically treated patient with very unusual combination of a giant posterior fossa cyst in cerebellopontine area, Chiari I malformation and syringomyelia in cervico-thoracic area. Ventricles were not dilated. He complained weakness and clumsiness on the right upper extremity. His symptom was attributable to the syringomyelia of cervical spinal cord. The authors managed this patient by removing the arachnoid cyst and cystoperitoneal shunt on the assumption that this cyst has an influence on the formation of Chiari malformation and syringomyelia. After operation there was marked improvement in the motor power in the arm, and a follow-up MRI one month later showed a disappearance of syringomyelia. The authors believe that this very unusual condition is of interest in making the pathogenesis of syringomyelia clear.


Asunto(s)
Humanos , Aracnoides , Brazo , Estudios de Seguimiento , Imagen por Resonancia Magnética , Médula Espinal , Siringomielia , Extremidad Superior
15.
Journal of Korean Neurosurgical Society ; : 300-309, 1999.
Artículo en Coreano | WPRIM | ID: wpr-204461

RESUMEN

Astrocytes play important roles in normal brain development and the physiological processes. In particular, 30% of the brain volume consists of astrocytes, and they are the primary target cell in the brain for cellular injuries from chemical exposures. The present study attempts to establish an immortalized murine astrocyte cell line to study the mechanisms of chemical-induced carcinogenesis of astrocytes. Primary astrocytes isolated from mice were transfected with plasmid carrying the SV40 T antigen. Clonal cells obtained after G418 selection were continuously subcultured to establish an immortalized astrocyte cell line. The cell line was positive on GFAP expression and was sensitive to exposure to such chemicals as MNNG. Cells were treated with MNNG for 5 days, with doses ranging from 0.001ug/ml to 1ug/ml. Dose-dependent cellular transformations of astrocytes were observed. Treatments at 0.01ug/ml showed the most distinct characteristics of neoplastic transformation. Subsequent treatment with TPA produced higher levels of neoplastic cell transformation than MNNG treatment alone, as evidenced by increases of saturation density, soft-agar colony formation and cell aggregation. Promotional effects of TPA on cell transformation was further demonstrated by the shortening duration of foci appearance. Addition of hydrocortisone to the culture media resulted in further promotion of cell transformation in astrocytes treated with MNNG and TPA, suggesting that glucocortocoid also plays a role in the promotion of chemical-induced astrocyte transformation. The present study demonstrates that astrocytes are susceptible to chemical-induced carcinogenicity and subject to mechanisms of multistage carcinogenesis. Analysis of MNNG-transformed astrocytes showed that, while the expression of TGF-beta was decreased, expression of GFAP, IL-1betaand fibronectin were increased. The results suggest that these factors are associated with mechanisms of MNNG-induced astrocyte transformation and may be used as potential candidates for biomarkers representing astrocyte-related tumors and cell toxicities. The study showed scientific evidence that growth factors, cytokine and the extracellular matrix are involved in processes of chemical-induced transformation of astrocytes. In addition, the present work provided an excellent opportunity to develop an immortalized astrocyte cell line that can be used for studying mechanisms of astrocyte-related diseases.


Asunto(s)
Animales , Ratones , Antígenos Virales de Tumores , Astrocitos , Biomarcadores , Encéfalo , Carcinogénesis , Agregación Celular , Línea Celular , Transformación Celular Neoplásica , Medios de Cultivo , Matriz Extracelular , Fibronectinas , Hidrocortisona , Péptidos y Proteínas de Señalización Intercelular , Metilnitronitrosoguanidina , Fenómenos Fisiológicos , Plásmidos , Factor de Crecimiento Transformador beta
16.
Journal of Korean Neurosurgical Society ; : 5-14, 1998.
Artículo en Coreano | WPRIM | ID: wpr-121011

RESUMEN

To determine the spectral pattern of metabolites in 31 brain tumors in which the presence of lipids, lactate and additional intermediary metabolites had been detected, in vivo 1H-MR spectroscopy was performed. Metastasis (n=3), meningioma(n=7), astrocytic tumors of different grades(n=11), postop recurrent tumors(n=2) and other tumors(n=10) were examined using the stimulated echo(STEAM, TE=30ms) or double spin echo technique(PRESS, TE=272ms) with CHESS pulse for water suppression. The detection of lactate in astrocytic tumors correlated with a higher grade of malignancy, and lipid was observed in most glioblastomas. Elevated lactate levels in tumors do not simply originate in the necrotic region, but are related to the high glycolytic activity of adequately perfused, viable neoplastic cells. Lipid signals were detected in high grade, late stage brain tumors, indicating the need for enhanced phospholipid metabolism and membrane degradation, respectively. The absence of lactate and presence of alanine, glutamate/glutamine in most meningiomas distinguished them from schwannomas and other glial tumors. Observation of the spectral pattern of metabolites in brain tumors in which lipid and lactate has been detected might play an important prognostic role in the management and differentiation of metastasis, glial tumors, tumor recurrence, and other non-neoplastic diseases.


Asunto(s)
Alanina , Neoplasias Encefálicas , Encéfalo , Glioblastoma , Ácido Láctico , Espectroscopía de Resonancia Magnética , Membranas , Meningioma , Metabolismo , Metástasis de la Neoplasia , Neurilemoma , Protones , Recurrencia , Análisis Espectral , Agua
17.
Journal of Korean Neurosurgical Society ; : 648-654, 1998.
Artículo en Coreano | WPRIM | ID: wpr-147713

RESUMEN

Hypoglossal neurinomas are very rare and those which simultaneously involve the intracranial and extracranial portions are extremely unusual. Using the modified transcondylar approach, the authors successfully removed a dumbbell-shaped hypoglossal neurinoma at the intracranial portion and extending to the anterior upper portion of the axis through the hypoglossal canal. After dividing the cervical musculatures into layers, the vertebral artery was mobilized by opening the foramen transversarium and removing the postero-lateral part of the right occipital condyle, the lateral mass of the atlas and the mastoid tip by means of a small lateral suboccipital craniotomy. This approach offers a wide surgical field and a direct approach to the skull base and upper anterior cervical spine. After total removal of the hypoglossal neurinoma, a very simple supplementary autogenous bone graft was performed between the occipital bone and the lateral mass of the atlas, using the corticocancellous bone fixed with small screws. Postoperatively, the tumor was removed totally and there was no limitation on the cervical rotatory movement. A review of cases of hypoglossal neurinomas and the surgical approaches employed is included in this paper.


Asunto(s)
Vértebra Cervical Axis , Craneotomía , Apófisis Mastoides , Neurilemoma , Hueso Occipital , Base del Cráneo , Columna Vertebral , Trasplantes , Arteria Vertebral
18.
Journal of Korean Neurosurgical Society ; : 1312-1313, 1997.
Artículo en Coreano | WPRIM | ID: wpr-23701

RESUMEN

Since its earliest description in the 18th century, meningioma has been considered a relatively indolent benign tumor which can be completely removed. Some grow very quickly, however, recur more frequently and with each recurrence, may change their biology to a more malignant form. A meningioma rarely metastasizes to the extracranium; the most frequent extracranial metastatic sites include the lung, musculoskeletal system and lymph node. The authors report a rare case of meningotheliomatous meningioma which occurred in the left parasagittal area and invaded the superior sagittal sinus; after surgery, it showed multiple recurrences and regrowth, and finally metastasized to the left thoracic cage. The authors also reviw the literature.


Asunto(s)
Biología , Pulmón , Ganglios Linfáticos , Meningioma , Sistema Musculoesquelético , Metástasis de la Neoplasia , Recurrencia , Seno Sagital Superior
19.
Korean Journal of Anesthesiology ; : 778-783, 1997.
Artículo en Coreano | WPRIM | ID: wpr-108631

RESUMEN

Amniotic fluid embolism (AFE) is a rare but devasting obstetric emergency. We experienced a case of AFE during dilatation and curettage (D & C) in a 15 2/7 weeks pregnant woman, age 30, who was diagnosed as having a missed abortion. Sudden rapid hypoxemia, low SpO2, hypotension, low PETCO2, high CVP, and tachycardia, right axis deviation and right bundle branch block in 12 leads ECG were developed during D &C under general anesthesia, and signs of disseminated intravascular coagulation (DIC) followed after the operation, which are consistent with the findings of AFE. Even though there was no definite pathologic and radiologic confirmation of AFE, laboratory findings showed 100 times higher level of alpha-fetoprotein in her central venous blood than same weeks of missed abortion woman's blood. Though it is rare, the anesthesiologist should always suspect the possibility of AFE, when the patient shows an unexplained collapse, cyanosis, low PETCO2, high CVP, low SpO2, ECG change and DIC during any kind of obstetric procedure.


Asunto(s)
Femenino , Humanos , Embarazo , Aborto Retenido , alfa-Fetoproteínas , Líquido Amniótico , Anestesia General , Hipoxia , Vértebra Cervical Axis , Bloqueo de Rama , Cianosis , Dacarbazina , Dilatación y Legrado Uterino , Dilatación , Coagulación Intravascular Diseminada , Electrocardiografía , Embolia de Líquido Amniótico , Urgencias Médicas , Hipotensión , Segundo Trimestre del Embarazo , Mujeres Embarazadas , Taquicardia
20.
Journal of Korean Neurosurgical Society ; : 1063-1068, 1996.
Artículo en Coreano | WPRIM | ID: wpr-46029

RESUMEN

A rare case of intraventricular central neurocytoma in 17-year-old male is reported. The patient had diffuse headache and diplopia. Radiologic findings displayed obstructive hydrocephalus and a large, well-demarcated intraventricular mass lesion obstructing the foramen of Monroe. The tumor arouse from the splenium of corpus callosum. It was removed successfully using two different approaches after extraventricular drainage of the cerebrospinal fluid(CSF). Histologically, the tumor showed pathological features as that of oligodengroglioma on the light microscope. In immunohistochemical examination, glial fibrillary acidic protein(GFAP) was negative and synaptophysin, positive. Numerous neurosecretory granules were found and no typical synapsis was noticed on the electron microscope. No shunt operation was needed. Postoperative radiotherapy or chemotherapy was not performed and no tumor recurrence was detected during the one year follow-up period. We present the case together with a review of the literatures.


Asunto(s)
Adolescente , Humanos , Masculino , Ventrículos Cerebrales , Emparejamiento Cromosómico , Cuerpo Calloso , Diplopía , Drenaje , Quimioterapia , Estudios de Seguimiento , Cefalea , Hidrocefalia , Neurocitoma , Radioterapia , Recurrencia , Sinaptofisina
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