Intracranial Arachnoid Cyst: Case Report

Intracranial arachnoid cysts are uncommon congenital lesions of considerable interest and importance, the origins and exact nature of which remain uncertain. They account for about 1% of all intracranial space-occupying lesions4). Its predilection sites are in the sylvian fissure, the interhemispheral fissure, the cerebral convexity, the base of the brain, and over the midline of the cerebellum in the posterior fossa6)11). We are reporting a case of arachnoid cyst, developed in the left sylvian fissure in a ten years old male patient.

A Clinical Analysis of Spontaneous Intracerebral Hemorrhage

We have experienced 40 cases of spontaneous intracerebral hemorrhage admitted to the Chung Ang University Hospital. We analized the result of the treatment of spontaneous intracerebral hemorrhage and assessed prognostic factors affecting the result of treatment of intracerebral hemorrhage. 1) The age distribution was ranged from 26 to 69 and 67.5% of them were in fourth and fifth decade. The ratio of male to female was about 5:3 and the age of the patients did not significantly influence on the result of operative or non-operative cases(P:0.22 P>0.05). 2) The predilection sites of hemorrhage were basal ganglia(60%) and thalamus(15%). 3) There was a correlation between the conscious status on admission and that of two weeks after admission, not so strong, in the operated cases. I.e., the higher Glasgow Coma Score on admission, the better results two weeks after admission. But such a correlation was not found in the non-operated cases(P:0.5732 P0.05). The hemorrhage in the dominant hemisphere had little correlation with the outcome(P:0.5068 P<0.01). 4) The pre or post-operative conscious status appeared to have no correlation with the hematoma volume. The large hematoma not always lead to poor prognosis when it was removed in proper time unless the secondary change of the hematoma did not develop(P:0.4257 P<0.05, P:0.4644 P<0.05). 5) The blood pressure on admission, not his proper pressure, had no correlation with the result two weeks after admission in the operated or non-operated cases(P:4988 P<0.01, P:0.4120 P<0.05). 6) The midline shift on the carotid angiogram had a closed correlation with the conscious status of the operated or non-operated cases in spite of little influence of hematoma volume to the conscious state(2:0.7350 P<0.01, P:0.5377 P<0.01).

A Case of a Recurrent Postoperative Discitis

The etiology of the postoperative discitis is not fully known, but most likely, the cause seems to be of a low grade infection and chemical and mechanical injuries. The incidence of these complication is from 0.12% to 2.6% of all cases. The characteristics of this disease are recurrence of severe lower back and gluteal pain, spasm of lumbar paravertebral muscle and elevated E.S.R. following the asymptomatic post-operative period, a roentgenogram showed an early destructive change in the adjacent vertebra, the narrowing of the intervertebral disc space, sclerotic changes in the vertebral bone and occasional fusion of the spine, and relatively good prognosis. We present a case of recurrent postoperative discitis with E.S.R. change and roentgenographic change.

Histologic Study of the Autogenous Garfted Fascia Lata to Dural Defects in Rabbits

Defects in the dura mater can be result from craniocerebral trauma, neoplastic or inflammatory destruction surgical removal and congenital absence. Materials used for closure of dural defects were variable. Of these, autogenous fascia lata have been used for a long time. It seems interesting to study the histologic fate of the autogenous grafted fascia lata in the dural defects. After autogenous fascia lata graft to dural defect in 18 rabbits, the histologic fate of the autogenous grafted fascia lata was observed microscopically. The results are as follows: 1) The adhesions among the grafted fascia lata, arachnoid, pia mater and brain cortex were usually mild. This result may be due to either short period of observation or autogenous substitutional material. 2) The grafted autogenous fascia lata was revealed minimal inflammatory response and was ultimately reabsorbed. 3) The grafted autogenous fascia lata was replaced by granulation tissue and fibroblast originated from the host mesenchymal tissue.

Forestier's Disease(Ankylosing Hyperostosis of the Spine): Case Report

The characteristic features of the Forestier's disease, ankylosing hyperostosis of the spine, consist essentially in marginal proliferation at the vertebral edges which are apt to unit their homologues to form bridges and to extend as a bony layer which thickens the vertebral cortex with an overgrowth of bone spreading like a flow. The disease had been long looked upon as vertebral spondylosis or other spinal diseases such as ankylosing spondylitis before Forestier first defined it as a new disease entity. The bony changes could be occurred everywhere on the spinal column, but are mainly confined to the anterior part of the thoracic spine, especially in the right side. It clinically may be of little significance because of little symptoms. Forestier reported 88% of the patients was over 50 years old and 65% was male of 45 cases. Although the pathogenesis is uncertain, a spinal expression of more diffuse ossifying diathesis may be considered. We are reporting a case of the Forestier's disease which was incidentally found on a 55 years old paraplegic patient who had suffered from back trauma.

Primary Osteosarcoma of the Skull

Osteosarcoma is the most frequently encountered primary malignant tumor of the bone. But sarcoma of the skull are rare tumor to be observed even in an extensive neuropathological practice. We presents a case of skull neoplasm identified as osteosarcoma. A twelve year old male patient was admitted to our department because of the large palpable mass on the posterior parietal and occipital region with headache, nausea and vomiting. On admission moderate papilledema was noted in the both eyes. Other neurologic finding were within normal limits. Chest film and long bone series showed no evidence of abnormality. Skull films revealed a large round destructive area on the posterior parietal and occipital region and the right carotid angiogram revealed patch densities in the mass lesion which was supplied by the right occipital artery and possibly the right middle meningeal artery. Serum Alkaline Phosphatase was 14 BL Units. The findings on the pathology side was compatible with osteosarcoma.