Arteriovenous Malformations of the Brain Associated with Cerebral Aneurysms

No abstract available.

The Effects of Nimodipine and Intracisternal Urokinase on the Content of Leukotrience C4 in the Brain Tissue after Experimental Subarachnoid Hemorrhage in Rats

To find out whether early lysis of subarachnoid blood clot with intracisternal urokinase as well as intraperitoneal nimodipine prevents or decrease the breakdown of arachidonic acid(AA) of the brain after subarachnoid hemorrhage(SAH), we have investigated the levels of leukotrience(LT) C4, the metabolite of the lipooxygenase pathway of the AA metabolism, in the brain tissue after experimental SAH in rats. The experimental SAH was induced by an intracisternal autologous blood injection through the catheter which was inserted into the cisterna magna. Experimental animals were assigned to one of four groups as follows. The control group(I) was that intracisternal saline irrigation was done after SAH induction. The second group(II) was treated with an injection of nimodipine(4 times per a day of 1.2 mg/Kg until sacrificed) intraperitoneally after SAH induction, the third group(III) was tried with an intracisternal urokinase irrigation(3 times per a day of 0.1 ml, 1 ml : 20,000 unit urokinase, until sacrificed) and the fourth group(IV) was treated with intraperitoneal nimodipine and intracisternal urokinase(same regimen as above). Average levels of LT C4in each group was determined at 24 hours(subgroup a), 48 hours(subgroup b), 72 hours(subgroup c) after the induction of SAH by the radioimmunoassay method. The result showed that average levels of LT C4was significantly enhanced in the brain tissue at 48 hours after SAH induction in control group(group Ia vs. IB vs. Ic : 43.85+/-15.62 vs. 184.32+/-27.46 vs. 39.29+/-12.79 pg/ml, respectively. group Ia vs. Ib vs. Ic ; p<0.01) and was decreased by intraperitoneal nimodipine, intracisternal urokinase or combination of both at 48 hours after SAH induction (group Ib vs. IIb vs. IIIb vs. IVb : 184.32+/-27.46 vs. 41.99+/-5.94 vs. 37.68+/-10.4 vs.37.38+/-9.27 pg/ml, respectively group Ib vs. IIb vs. IIIb, and IVb ; p<0.05). However, there was no significant differences among the second, the third and the fourth group(group IIa vs. IIIa vs. IVa, group IIb vs. IIIb vs. IVb and group IIc vs. IIIc vs. IVc : 41.07+/-7.06 vs. 37.97+/-4.48 vs. 31.84+/-6.07 pg/ml, 41.99+/-5.94 vs. 37.68+/-10.43 vs. 37.38+/-9.27 pg/mi and 36.41+/-6.76 vs. 37.98+/-3.45 vs. 35.59+/-8.37 pg/ml, respectively). We concluded that the early lysis of subarachnoid blood clot with intracisternal urokinase had some benefits against the damage of neurons in the early period after SAH as much as intraperitoneal injection of nimodipine. However, the benefit of the combined treatment with intraperitoneal nimodipine and intracisternal urokinase, compared to intraperioneal nimodipine or intracisternal urokinase alone, has not been cleary established.

Aneurysms of the Nontraumatic Extracranial Carotid Artery and Vertebral Artery: Cases Report

No abstract available.

Surgical Treatment of Spontaneous and Traumatic Delayed Cerebrospinal Fluid(CSF) Rhinorrhea

The authors presented 9 cases of surgically treated CSF rhinorrhea, two of which were spontaneous and 7 were traumatic delayed. The duration of leakage was longer than 1 month in most cases and seven of the nine cases were complicated by meningitis. The leakage site was most accurately detected by metrizamide computed tomographic cisternography(MCTC) and the most frequent leakage site was the cribriform plate. Good surgical results were obtained by direct repair and/or shunt without recurrence during follow-up period from 7 months to 2 years.

Subtemporal Approach for Basilar Bifurcation and Basilar-Superior Cerebellar Artery Aneurysms

The pterional(Transsylvian) and subtemporal approaches are main surgical route for direct clipping of basilar bifurcation and basilar-superior cerebellar artery aneurysms. In general , the pterional approach has the advantage for high placed aneurysm and the subtemporal approach has the advantage for low placed and posterior directed aneurysm of basilar bifurcation. The authors has been performed surgery for 5 cases of basilar bifurcation and basilar-superior cerebellar artery aneurysms through subtemporal route during 1.5 years with good results in 3 cases, fair result in 1 case, and death in 1 case. We described about this 5 cases detaily and discussed the subtemporal approach for these lesions.

The Effect of Orthopaedic Operations upon Postoperative Arterial Oxygen Tension / 대한정형외과학회잡지

To 48 adult patients general and spinal anethesia was administered for elective orthopedic (intra-thoracic and extremity) and abdominal(general and gynecological) operations. Radial artery was cannulated and postoperative change of PaO2 was observed for 7days. The results are as follows: 1) General anesthesia administered for operations on the legs results in a reduction of PaO₂ which is maximal immediately after discontinuation of anesthesia, gradually returns toward normal in a 3-hour period, and becomes normal on the first postoperative day. 2) General anesthesia administered for thoracomy and laparotomy is followed by the same early changes, which do not return toward normal in the first 3 hours. Reduciton of PaO₂ persists, and PaO₂ continue to deteriorate for several days, not completely returning to normal even 7days post-operatively. 3) When spinal anesthesia is administered for laparotomy, PaO₂ does not begin to fall untill several hours after the end of operation. The subsequent course follows as that in 2, above. 4) When spinal anesthesia is administered for operation on the legs, PaO₂ does not change significantly throughout the postoperative period. 5) Thus, it is concluded that late forms of postoperative hypoxemia is influenced primarily not by the method of anesthesia, but by site of operation.