• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.426-429
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• 2000

뇌 지주막하출혈에서 흔치않은 임상양상인 양측성 외전신경마비와 두통을 주소로 내원한 46세 여자환자에서 혈관조영술을 시행하여 좌측 후교통동맥 동맥류, 전맥락동맥 동맥류, 그리고 우측 후교통동맥 동맥류등 다발성 뇌동맥류가 발견되어 수술시행 하였다. 양측성 외전신경마비 이외에 시력 및 시야장애는 보이지 않았다. 수술시 상당한 뇌압증가의 양상을 보였고, 좌측 후교통동맥 동맥류 출혈흔적과 기저조에 소량의 혈종이 있었으며, 첫번의 좌측 수술 후 2주 정도에 안구운동장애가 서서히 회복되어 정상화되었다. 저자들은 뇌동맥류 출혈에서 드물게 보는 양측성 외전신경마비 환자를 경험하였기에 문헌고찰과 함께 증례보고 한다.

• Journal of Korean Neurosurgical Society
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• 제29권9호
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• pp.1248-1254
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• 2000

신경섬유종을 동반한 다발성외경동맥 동맥류는 아주 드물며, 외경동맥동맥류의 원인으로 외상이 대부분을 차지한다. 39세 여자가 좌측 측두두정후두부의 거대한 종괴로 인한 두통을 주소로 내원하였다. 이학적 검사 소견상 좌측 측두두정후두부의 $5{\times}15{\times}18cm$ 거대한 종괴가 인지되었고, 아래로 처진 좌측 귀, 체간 및 사지에 다발성 담갈색 색소침착을 보였다. 뇌혈관조영술상 표재성 측두동맥과 후두동맥에 뇌동맥류가 인지되었으며 두부 자기공명영상에서 좌측 측두두정후두부에 거대한 혈종과 피하 종양이 관찰되었다. 수술전 다발성 외경동맥동맥류에 대해 색전술을 시행하고 혈종제거술, 피하 신경섬유종 절제술 및 뇌동맥류 절제술을 시행하였다. 수술후 증상은 호전되어 환자는 신경학적 장애 없이 퇴원하였다.

• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1592-1599
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• 2000

Objective : Multiple cerebral aneurysms reportedly account for 14-33% of all cerebral aneurysms. However, multiple separate aneurysms on single parent artery are uncommon. The majority of these are found on middle cerebral artery(MCA). Multiple aneurysms arising from anterior communicating artery(ACoA) are rare. We report 5 cases of multiple aneurysms developed separately on single artery and describe angiographic and operative findings of these lesions. Materials and Methods : Among 127 patients of cerebral aneurysms operated in our hospital, only 5 had multiple aneurysms on single parent artery. Results : Among 5 cases, 4 were diagnosed preoperatively and the only one was found intraoperatively. Two were found on MCA bifurcation, one on M2 and two on ACoA. All separate aneurysms developed on single parent artery were treated successfully with multiple clipping. Conclusion : Multiple cerebral aneurysms, developed separately on single parent artery, are uncommon. Furthermore, those arising from ACoA are very rare. Despite the advanced technology in radiological examinations, multiple cerebral aneurysms may not be detected on preoperative study only. Close proximity or smaller size of the lesion may be responsible for the preoperative false negative angiographic findings.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1322-1327
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• 2000

Objectives : To assess the surgical results for patients with multiple intracranial aneurysms and factors related to prognosis of patients. Materials and Methods : We retrospectively analyzed the clinical characteristics of 47 patients with multiple intracranial aneurysms and assessed the types of surgical treatment and prognosis of 44 patients who received surgical treatment from January 1986 to March 1999. Results : The 47 patients presented altogether 108 aneurysms with male to female ratio of 1 : 3.7, and average age 54.9 years(range 33-81 years). Common locations for multiple aneurysms were P-com(31%), MCA(30%) and Acom( 15%). The postoperative good and poor outcomes were 30 cases(68%) and 11 cases(25%), respectively and there were 3 deaths(7%). The analyzed results for 44 surgically treated patients were as follows ; 1) The size of aneurysm was relevant to frequency of rupture ; the lowest for lesions less than 1cm(21%), rising to 85% for lesions greater than 3cm(p<0.05). 2) The surgical outcome was significantly correlated with preoperative clinical status of the patients(p<0.05). 3) The good outcome was associated with surgery within 7 days(especially 24 hours) after clinical onset of symptoms but not with type of operation and laterality of aneurysms. Conclusion : With regard to the surgical treatment for multiple aneurysm cases, surgeons should consider the salient factors in a good prognosis such as patient's preoperative status, size of aneurysm, timing of surgery, and type of operation.