A Case of Chordoid Meningioma at Right Temporo-Parietal Lobe: Case Report

A large tumor located at right temporoparietal lobe was found in 25-years-old female. The brain CT scan and MR imaging revealed a large multi-lobulated mass which was composed of solid and cystic portions involving right temporoparietal lobe. Preoperative routine laboratory check showed microcytic hypochromic anemia and monoclonal gammopathy with bate-gamma bridging. The mass was removed totally by operation and histologic diagnosis resulted in chordoid meningioma surrounded by massive polyclonal lymphoplasmacellular infiltrates. After the mass was removed, the blood picture of the patient normalized and the patient discharged with neurologically free stage. We report this case with relative literatures.

Aneurysmal Bone Cyst of the Second Cervical Spine

Aneurysmal bone cysts are lytic lesions that have been described in virtually every portion of the skeleton but most commonly occur as solitary lesions in the metaphyseal portions of long bones. One fifth of aneurysmal bone cysts occur in the spine where they most frequently involve the posterior elements. In the spine, aneurysmal bone cyst have been reported to occur in the lower thoracic and lumbar regions, but their occurrence in the cervicodorsal area is uncommon. In this case, the second cervical vertebral body and posterior elements are affected. Fortunately, the lesion didn't invade into the spinal canal. The main symptom on admission was pressure pain, tenderness and motion limitation of the cervical spine. We removed the lesion involving posterior elements of second cervical spine and used horse-shoe shaped pediatric C-D device for occipito-cervical fixation. The clinical symptoms were resolved after operation. The clinical, radiologic, operative and pathological findings are reported and the corresponding literature are reviewed.

The Effects of Intravenous Administration of Nimodipine on Cerebral Pial Vessels Following the Injection of Autogenous Hemolytic Blood into Cisterna Magna in Rabbits

The reactions of cerebral pial vessels following the injection of normal saline(0.05cc, at 37 degrees C, pH7.4) and autogenous hemolytic blood(0.05cc, 0.1cc 0.2cc) into the cisterna magna of rabbits were tested in vivo. This experiment was performed in order to observe the effect of intravenous nimodipine(30 microgram/kg) injection at the maximally constricted time of the pial vessels, about 6 hours after intracisternal injection of autogenous hemolytic blood. The diameter changes of the pial vessels were measured under operating microscope through a cranial window on craniectomized area. Pial vessels were not significantly changed after an intracisternal injection of normal saline. But after intracisternal injection of autogenous hemolytic blood(0.05cc, 0.1cc, 0.2cc), pial vessels were maximally constricted at 6 hours and the constriction was continued during the experiments. Percentile constriction was increased as the amount of subarachnoid hemolytic blood increased. According to the results, pial vessels, especially small pial artery, were constricted by autogenous hemolytic blood containing oxyhemoglobin. Nimodipine, calcium antagonist, showed dilating effect on vasospasm after experimental subarachnoid hemorrhage with autogenous hemolytic blood in rabbits.

Clinical analysis of Stereotactic Aspiration in Basal Ganglia Hematoma

We analyzed 54 cases of spontaneous intracerebral hematoma in the basal ganglia who had been admitted to Pusan National Hospital from June, 1991 to December, 1992 and underwent CT-guided stereotactic aspiration. Fifity four cases had basal ganglia hematoma with or without ventricular rupture. In 12 cases out of them, the residual hematoma could be completely evacuated by urokinase irrigation through a catheter introduced into the cavity of hematoma. Patients with preoperatively poor neurologic condition, large or deep-seated hematoma, or the operation undergone before 6 hours from ictus, had worse outcome. In the case whose hematoma was removed more than 60%, Glasgow Outome Scales were not changed significantly. Patients of spontaneous intracerebral hematoma mostly are older age, so careful observation and medical treatment are required to prevent postoperative complications and improve general condition.

A Case of Suprasellar Immature Teratoma: Case Report

We report a case of immature teratoma arising at the suprasellar region in a 18 year-old-male who presented with bitemporal hemianopsia, nausea and polydipsia. The teratoma is a rare neoplasm consisting of 0.5% to 1.2% of all intracranial tumors. The clinical presentation, radiologic finding, pathology and treatment are briefly described with a review of other cases from the literature in view of clinical features and management.

A Case of Oligodendroglioma in the Lateral and Third Ventricles

Oligodendroglioma that occurs in the ventricle has been reported uncommonly. The case is reported of a 38-year-old man who presented with severe headache and vomiting and was discovered to have an oligodendroglioma in the lateral and third ventricles. The clinical presentation, radiological finding, pathology and response to radiation are described with brief review of general biology in oligodendroglioma.

Primary Lymphoma of the Cerebellum

Primary lymphoma is rare lesion of the intracranial neplasm. We have recently experienced a case of primary lymphoma invoving cerebellar vermis and hemisphere. The patient presented with headache, vomiting, ataxia and dysmetria. The brain CT scan and MR imaging revealed round mass lesion involving the left cerebellar hemisphere and vermis with minimal surrounding brain edema. On vertebral angiography, tumor stain appeared during the late arterial phase. Preoperative CSF analysis showed no specific abnormal findings. The CSF cytology was normal. The mass was surgically removed and the histological feature was diffuse histiocytic lymphoma. In the postperative and postradiation period, the metastasis occurred to the head of the caucate nucleus and cervical spinal cord. A case of primary lymphoma of the cerebellum is presented with review of literature.

Cervicothoracic Extradural Ganglionneuroblastoma Invaded from Mediastinum

Ganglionneuroblastoma is a rare neoplasm involving central nervous system. We have recently experienced a case of cervicothoracic extradural ganglionneuroblastoma invaded from upper posterior mediastinum. The patient presented with a progressive weakness of both lower extremities and had difficulty in voiding. The plain X-ray films, thoracic spine CT scan and myelography disclosed an extradural mass from C6 to T4 level. This extradural mass was communicated with upper posterior mediastinum. The mass was surgically removed and then the patient showed good recovery postoperatively.

A Case of Cervical Ganglioneuroma: Case Report

Ganglionneuroma is slow-growing benign neoplasm that orignates from the sympathetic nervous system. A case of dumb-bell shaped Ganglionneuroma at first and second cervical areas is presented on this paper with chief complaint of neck pain and quadriparesis. The tumor was totally removed under operating microscope and the diagnosis was pathohistologically confirmed. The postoperative result was good and relative literatures were reviewed.

Clinical Analysis or Primary Reconstruction to Compound Depressed Frontal Skull Fracture

The injured skull bone may be contaminated in compound frontal skull fracture, so definitely left out for the prevention of infectious complications in the classic concept. The efficacy of primary replacement and resection of the injured bony fragments in the treatment of compound depressed frontal skull fractures was studied in 33 patients who could be followed up over one year during a recent 5-year period. The patients was divided into a group I which took a primary replacement of injured bony fragments and group II which left out the injured bony fragments in immediate operation. The results are summarized as follows : 1) The age incidence was more frequent in the 3th and 4th decades. The sex distribution was more frequent in male(87%). 2) The motor vehicle accident was most frequent in the injury mechanism. 3) The conscious level on admission was 53% in 13~15 GCS group, 12% in 9~12 group, 26.6% in 6~8 group and 8.4% in 3~5 group. 4) The incidence of an extending fractures was 42% to orbital roof, 35% into frontal sinus, 25% into cribriform plate and 16% into nasal bone. 5) The incidence of intracranial injury was 65% in dural laceration and 51% in cerebral laceration. Of cases of dural laceration the cerebral laceration was associated in 78%. 6) The time duration from injury to operation was under 12 hours in most cases(84%). 7) The incidence of a complication was 36.1% in total group, 27.7% in group I and 47.2% in group II. The infectious complication was not a significant difference between group I(14.9%) and group II(16.7%). In conclusion the infectious morbidity of which were most dangerous complications due to compound depressed frontal skull fractures was not a significant difference in two compared group. The author believe that immediate bone replacement for compound depressed frontal fractures with or without extension to frontal sinus, orbit, or cribriform plate os both practical and safe procesures.

Malignant Histiocytic Lymphoma of Scalp

This paper reports a case of malignant histiocytic lymphoma mainly in the frontal region with intracranial extradural extension. Operation was performed to remove the mass but the tumor began to recur rapidly. And so under the condition that the operative wound was not fully healed, the patient received radiotheray and chemotherapy postoperatively, with remarkable regession of the tumor.

Teratoma in the Posterior Cranial Fossa

A rare case of teratoma occuring in the posterior cranial fossa is reported. The tumor was partially encapsulated, and a surgical removal was accomplished. Teratoma is defined as a true tumor, composed of several types of tissues representing more than one germinal layer, which are foreign to the part in which it arises. The literature on teratomas located in the posterior cranial fossa is reviewed.

A Case of Cavernous Angioma of the Cerebellar Vermis

A case of cavernous angioma of the cerebellar vermis is described. Cevernous angioma is rare vascular malformation of the central nervous system and the cerebellar vermis is very unusual site. Exact preoperative diagnosis of this lesion is difficult because cavernous angioma is angiographically silent and generally accepted to be very rare. The relevant literature is reviewed.

A Case of Penetrating Cranial Injury by a Wooden Foreign Body

Many objects create penetrating cranial injuries. Metallic objects and low velosity missiles are the most common offenders. Wood as wounding agent of the brain, has some characteristics. It has profound risk of infection, a significant propensity to fragmentation that is virtually undetechable on routine X-ray screening and very low atteunation value in CT scan. Because of its characteristics and rarity, we report a case of penetrating cranial injury by a wooden foreign body with review of literature.

Post-Traumatic Arachnoid Cyst by Delivery Forceps

The first report of growing skull fractures of children was in 1861 by John How ship who noted partial absorption of the right parietal bone, arising from a blow on the head in a child aged 9 months. The cases of cranial defects that develope from fractures of the skull in childhood are not common but post-traumatic arachnoid cyst by delivery forceps had rarely reported in world literature. Consequently the author had a case of post-traumatic arachnoid cyst by delivery forceps with its common features and evaluated on various aspects of this syndrome. This case had been treated by surgery with removal of cyst, cranioplasty and V-P shunt.

Kinetic Analysis of Na-K-ATPase Activity of Rabbit Cerebral Cortex by DDVP

The kinetics of inhibition of Na-K-ATPase activity by o, 0-dimethyl o-(2,2-dichlorovinyl) phosphate(DDVP) was investigated with homogenerate of rabbit cerebral cortex. The results were summarized as the follows : 1. Inhibition of Na-K-ATPase activity by DDVP showed a dose-dependent manner with an estimated I5.0 of 3.5x10(-4) M. 2. Altered pH and activity curves for Na-K-ATPase activity demonstrated comparable inhibition by DDVP in buffered acidic, neutral and alkaline pH renges. 3. Kinetic studies of cationic-substrate activation of Na-K-ATPase showed noncompetitive with respect to substrate and K+ and a mixed type inhibition with respect to Na+. These results suggest that DDVP appeared to exert its effects on Na-K-ATPase activity by interfering with the formation of Na-dependent phosphoenzyme.