A Case Report of Cerebral Infarction Following General Anesthesia / 대한마취과학회지

We experienced a case of aeute cerebral infaretion after operation. A 74 year old female patient slipped down and received left femoral neck fracture. Preoperatively, orthopedist, internist and anesthesiologist visited and evaluated her but could not find any suspicious symptoms related to cerebral infarction. She have suffered from hypertension and diabetes mellitus for 1Q yrs. She underwent bipolar endoprosthesis under general anesthesia. Postoperatively, she became deep drowsy and revealed respiratory depression, abnormal neurological sign and was diagnosed as acute cerebral infartion on cranial computed tomography and ultimately expired.

Delayed Traumatic Intracranial Lesion

A retrospective analysis of 33 cases with operated delayed intracranial lesion who were admitted to EU1 Ji General Hospital from January 1990 to December 1992 was made according to their age and sex, etiology, lesion site, time interval to finding delayed intracrainal lesion, brain CT findings, relationship of GCS in initial and delayed lesion, associated injuries, treatment and prognosis(GOS). The results were follows : 1) The young males on first to second decade were most frequently affected. 2) The most common caused was pedestrian accident by motor vehicle, followed by fall down. 3) The most common associated injury was skull fracture, followed by skeletal injury of extremity. 4) The most common delayed intracranial lesion was delayed epidural hematoma on youth. 5) The most frequent time interval when the delayed intracranial lesion may be occurred was from 12 hr to 24 hr after admission. 6) The most possible intial lesion which the delayed epidural hematoma may be occurred was scanty hematoma with pnumocephalus or CSF leakage. 7) The GOS(Glasgow Outcome Scale) of analysed 33cases were good in 60% and poor in 40%, i.e good recovery(42%), moderate disability(18%), severe disability(15 %), vegetative state(12%), death(12%).

Four Cases of Surgically Managed Distal Anterior Cerebral Artery Aneurysm

A series of 4 patients with aneurysm of distal anterior cerebral artery(DACA), operated with microtechniques, is reviewed. Because the incidence of aneurysms in this location was only 2 to 4% of that of total aneurysm, little expericences on surgical management of this aneurysm have been reported. An aneurysm in this location is difficult to approach surgically because of their multiplicity, characteristically broad and sclerotic base, with small subarachnoid space in the interhemispheric fissure. We surgically treated DACA aneurysms of 4 cases through the interhemispheric approach via the unilateral frontal paramedian craniotomy on the nondominant side.