• Anatomy and Cell Biology
• /
• v.56 no.1
• /
• pp.145-149
• /
• 2023

Agenesis or congenital hypoplasia of skeletal muscles occurs infrequently but may occur with specific conditions such as Poland syndrome. The trapezius muscle can vary in the extent of its bony attachments or may have additional slips, however congenital absence or hypoplasia is extremely rare. There are only a few reports of partial or complete absence of the trapezius muscle. Two cases of bilateral absence of the trapezius were both in males and were accompanied by the absence of additional muscle in the pectoral girdle. Herein, we describe a case of a 56-year-old male cadaver with bilateral hypoplasia of the trapezius. The muscle was largely represented by atrophied muscle fibers with an abundance of fibrotic or fatty connective tissue. This subject had very minor hypoplasia of the left pectoralis major muscle, but the remaining muscles of the pectoral girdle were normal. The spinal accessory nerve terminated in the sternocleidomastoid muscle on both sides, failing to reach the trapezius. We interpret these findings to be consistent with a minor variant of Poland syndrome.

• The Journal of Internal Korean Medicine
• /
• v.26 no.3
• /
• pp.670-676
• /
• 2005

The purpose of this case study is to present a case of oculolmotor nerve palsy due to midbrain infarction improved by acupuncture and herb medicine. Oculomotor nerve palsy is a disorder associated with dysfunction in the third cranial nerve, which causes eye movement disorder, diplopia and ptosis. The patient, who was diagnosed with Benedikt's Syndrome(Red Nucleus Syndrome), was given oriental medical treatment. Benetikt's Syndrome has the various symptoms of weakness on one side(contralateral) and eye movement disorder, ptosis, diplopia(ipsilateral) etc., but research on Benetikt's Syndrome or midbrain infarction is scant. Results of this study suggest a role for conservative therapy with herb medicine and acupuncture to treat oculomotor nerve palsy(eye movement disorder, ptosis, diplopia, etc., ipsilateral) and right motor weakness(contralateral) due to midbrain infarction. Further research into oriental medical treatment for such disorders will be forthcoming.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.3
• /
• pp.177-183
• /
• 2012

Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus, an infection most commonly affecting the thoracolumbar trunk. Herpes Zoster Infection (HZI) may affect the cranial nerves, most frequently the trigeminal. HZI of the trigeminal nerve distribution network manifests as multiple, painful vesicular eruptions of the skin and mucosa which are innervated by the infected nerves. Oral vesicles usually appear after the skin manifestations. The vesicles rupture and coalesce, leaving mucosal erosions without subsequent scarring in most cases. The worst complication of HZI is post-herpetic neuralgia; other complications include facial scarring, motor nerve palsy and optic neuropathy. Osteonecrosis with spontaneous exfoliation of the teeth is an uncommon complication associated with HZI of the trigeminal nerve. We report several cases of osteomyelitis appearing on the mandible, caused by HZI, and triggering osteonecrosis or spontaneous tooth exfoliation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.9 no.1
• /
• pp.59-65
• /
• 1998

Instead of brilliant advancement of the organ transplantation in the medical fields, laryngeal transplantation still has couple of problems to be solved before trial on human. Among them functional restoration of the implanted larynx is the most important point. Recent advancement in animal model studies showed possibility of solving the main problem. Eighteen cases of canine laryngeal transplantation in mongrel dogs were done in this department. One cranial artery and two external jugular veins were connected. External and internal branches of the superior layngeal nerve and anterior and posterior branches of the recurrent laryngeal nerve were connected individually. Only two dogs have lived longer than 4 weeks(4weeks, and 10 1/2weeks) and they died unfortunately due to asphixia caused by obstruction of the cannula. Thirteen dogs only lived five days through 15 days. The main causes of the failure were obstruction of the connecting vein, pharyngocutaneous fistula and the wound infection. Although the result was not good enough to evaluate the functional restoration of the implanted larynx, the implanted larynges from the two dogs lived longer than minimum criteria of long term survival(4 weeks) were relatively good in shape at the time of autopsy. This program will be continued after renovation of the animal lab. facilities.

• Parasites, Hosts and Diseases
• /
• v.51 no.6
• /
• pp.735-738
• /
• 2013

Eosinophilic meningitis, caused by the nematode Angiostrongylus cantonensis, is prevalent in northeastern Thailand, most commonly in adults. Data regarding clinical manifestations of this condition in children is limited and may be different those in adults. A chart review was done on 19 eosinophilic meningitis patients aged less than 15 years in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Clinical manifestations and outcomes were reported using descriptive statistics. All patients had presented with severe headache. Most patients were males, had fever, nausea or vomiting, stiffness of the neck, and a history of snail ingestion. Six patients had papilledema or cranial nerve palsies. It was shown that the clinical manifestations of eosinophilic meningitis due to A. cantonensis in children are different from those in adult patients. Fever, nausea, vomiting, hepatomegaly, neck stiffness, and cranial nerve palsies were all more common in children than in adults.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.10
• /
• pp.1333-1339
• /
• 2000

Objective : The goal of this study is to identify the significant radiologic abnormalities in patients complaining headache and to determine predictive factors for clinically significant radiological abnormalities. Method : The study population was 410 patients having underwent CT or MRI study among 1000 patients complaining headache in outpatient basis between 1996-1999. All of these patients answered self-administered questionaire about their headaches. We reviewed the patient's charts and the questionaires and examined the radiologic study results. Result : Of the 410 patients referred for CT or MRI study, male : female ratio was 1 : 1.97. Twenty-five patients(6.1%) revealed clinically significant organic lesions. Mean age was 46.1 in radiologic abnormal group and 48.4 in normal group. Short symptom duration(p<0.01), motor weakness(p<0.05), vomiting(p<0.05), cranial nerve palsy(p<0.05), and trauma history(p<0.05) were factors indicated higher incidence of radiologic abnormality. But, patients age, and severity of headache were not associated with clinically significant radiologic lesion. The ratio of radiologic abnormality was 0.8% in patients not having any risk factor. Conclusion : The results indicate that radiologic study should be done in headache patients having the risk factors such as short symptom duration, motor weakness, vomiting, cranial nerve palsy, trauma history. For patients without any such a risk factor, the radiologic study doesn't seem mandatory.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.6
• /
• pp.442-445
• /
• 2010

Objective : The purpose of this study was to examine the efficacy and safety of microvascular decompression (MVD) for hemifacial spasm (HFS) in elderly patients. Methods : Between 1997 and June 2008, 1,174 patients had undergone MVD for HFS at our institute. Among these, 53 patients were older than 65 years. We retrospectively reviewed and compared the complication and the cure rates of these patients with those of younger patients. Results : There were 38 females and 15 males. The mean duration of symptoms of HFS of these patients was 94.6 months (range, 12-360 months), compared with 67.2 months (range, 3-360 months) in the younger group. The overall cure rate in elderly patients who underwent MVD for HFS during this period was 96.2%. Permanent cranial nerve dysfunctions, such as hearing loss and facial palsy, were seen in 2 patients (3.8%, 2/53) in the elderly group and 19 patients (1.7%, 19/1121) in the younger group. The difference in permanent cranial nerve dysfunction between the two groups was not statistically significant. There was no operative mortality in either group. Conclusion : Microvascular decompression is the most effective surgical modality available for the treatment of HFS. Results of this study indicate that such technique can be performed in the elderly without higher rates of morbidity or mortality. Any patient with HFS, whose general health is acceptable for undergoing general anesthesia, should be considered as a candidate for MVD.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.6
• /
• pp.778-785
• /
• 2000

Objectives : Intraoperative neurophysiologic monitoring(INM) is a well known useful method to reduce intraoperative neurological complications during neurosurgical procedures. Furthermore, INM is required in most cerebellopontine angle(CPA) surgery because cranial nerves or brain stem injuries can result in serious complications. Object of this study is to the correlation between the changes of intraoperative monitoring modalities during cerebellopontine angle tumor surgery and post-operative functional outcomes in auditory and facial functions. Material and Methods : Fifty-seven patients who underwent intraoperative neurophysiologic monitoring during CPA tumor surgery were retrospectively reviewed. Their lesions were as follows ; vestibular schwannomas in 42, other cranial nerve schwannomas in seven, meningiomas in five and cysts in three cases. Pre- and postoperative audiologic examinations and facial nerve function tests were performed in all patients. Intraoperative neurophysiologic monitoring modalities includes brainstem auditory evoked potentials(BAEP) and facial electromyographies(EMG). We compared the events of INM during CPA tumor surgeries with the outcomes of auditory and facial nerve functions. Results : The subjects who had abnormal changes during CPA tumor surgery were twenty cases with BAEP changes and facial EMG changes in twenty one cases. The changes of intraoperative neurophysiologic monitoring did not always result in poor functional outcomes. However, most predictable intraoperative monitoring changes were wave III-V complex losses in BAEP and continuous neurotonic activities in facial EMG. Conclusion : These results indicate that intraoperative neurophysiologic monitoring in CPA tumor surgery usually provide predictive value for postoperative functional outcomes.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.2
• /
• pp.149-151
• /
• 2014

The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A 46-year-old woman complained of 2-year history of severe right throat pain, with ipsilateral episodic otalgic pain. The throat pain was described as an episodic lancinating character confined to the throat. Computed tomography and magnetic resonance imaging revealed a suspicious offending posterior inferior cerebellar artery (PICA) compressing lower cranial nerves including glossopharyngeal nerve. At surgery, a soft, yellowish mass ($2{\times}3{\times}3mm$ in size) was found incorporating the lateral aspect of proximal portion of 9th and 10th cranial nerves. Only microvascular decompression of the offending PICA was performed. Additional procedure was not performed. Her severe lancinating pain remained unchanged, immediate postoperatively. The neuralgic pain disappeared over a period of several weeks. In this particular patient with a fatty neurovascular lump causing glossopharyngeal neuralgia, microvascular decompression of offending vessel alone was enough to control the neuralgic pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.4
• /
• pp.345-348
• /
• 2004

Cephalic tetanus is a rare subtype of tetanus in which trismus is a charateristic symptom. The paralysis of one or more cranial nerves can occur. The 7th cranial nerve is most frequently involved. It account for 1 to 3% of the tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of tetanus cases progress to generalized tetanus. Generally, the symptoms of cephalic tetanus can include : facial pain, trismus, dysphagia, muscle twitching spasms of the face and jaw (risus sardonicus), neck stiffness and malaise. We present a case of cephalic tetanus who 54-year male patient had trismus and dysphagia. There was no history of trauma. As there was a delay in diagnosis of cephalic tetanus, respiratory disorder and intermittent general spasm occurred. The patient was treated by injection of antibiotics, muscle relaxant, and human anti-tetanus immunoglobulin. His symptoms were disappeared, and he was discharged ambulatory.