• Title/Summary/Keyword: Cranial nerve

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A Case of Neurilemmoma Arising from the Nasal Septum (비중격에 발생한 신경초종 1례)

  • 조진희;장한성;김정묵;서병도
    • Korean Journal of Bronchoesophagology
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    • v.5 no.1
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    • pp.85-89
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    • 1999
  • Neurilemmoma is a benign, well-encapsulated neurogenic tumor that arises in cranial, peripheral, or autonomic nerves that have nerve sheaths containing schwann cells. From 16 to 45% of all neurilemmoma cases occur in the head and neck region and only about 4% of those cases are found in the nose and paranasal sinuses, but very rarely found in the nasal septum. Recently, we experienced a case of isolated neurilemmoma which arose from the nasal septum of a 30-year-old female patient who complained of nasal obstruction and postnasal drip. The mass was broadly based on the right anterior portion of the nasal septum and confined to the nasal cavity, displacing the lateral wall of the nasal cavity and middle turbinate, laterally and posteriorly, respectively. The tumor mass was completely excised through transnasal endoscopic surgery under general anesthesia. The final pathological diagnosis viewed under a microscope after H&E and anti S-100 protein stain was a benign neurilemmoma in which Antoni A type and B type both existed. This report presents a case of neurilemmoma which arose from the nasal septum with reviews of the clinicopathologic features.

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Accidental Subdural Block Developed during Epidural Anesthesia (경막외 마취중 사고로 발생한 경막하 차단)

  • Jeon, Jae-Kyu;Kim, Ae-Ra;Lee, Hyan-Rim
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.265-269
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    • 1993
  • Subdural block is a rare but well recognized complication of epidural anesthesia. The placement of local anesthetics into the subdural space can lead to potentially life-threatening conditions. A healthy 46-year-old women underwent total abdominal hysterectomy under continuous lumber epidural anesthesia. The technical procedure for continuous epidural catheterization went smoothly without a single problem. However, signs of high epidural block such as apnea, cranial nerve paralysis and pupil dilatation developed gradually, about 20 minutes after the epidural injection of 2% lidocaine 20 ml through the epidural catheter. Such extensive segmental block can only be explained as the result of injection into subdural space even if it was not confirmed radiologically.

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Sinonasal Undifferentiated Carcinoma of Sphenoid Sinus Invading Cavernous Sinus and Optic Nerve: A Case Report and Review of Literature (해면정맥동 및 시신경을 침범한 접형동 기원의 비부비동 미분화암 1예)

  • Park, Taejung;Jung, Taeyoung;Noh, Woongjae
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.41-46
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    • 2016
  • Sinonasal undifferentiated carcinoma (SNUC) is an extremely rare, highly aggressive malignancy of the nasal cavity and paranasal sinuses. Patients with SNUC usually being asymptomatic until the tumor has extensively progressed therefore frequently present with invasion of the orbit or cranial vault. Most case series of SNUC report very poor prognosis despite aggressive multimodality therapy. We recently experienced a 78-year-old male patient diagnosed as SNUC occurred from the left sphenoid sinus with invasion to the cavernous sinus and orbital content, which was treated intranasal endoscopic debulking surgery combined with curative radiation therapy successfully, and report this case with a review of literature.

Contralateral Submandibular Retropharyngeal Approach for Recurred High Cervical Chordoma

  • Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.39 no.3
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    • pp.231-233
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    • 2006
  • The C2 level is the transition zone between the cranial and cervical spine. Because of its high position and anatomic relationship to vital structures, exposing C2 is challenging and the surgical approach is controversial. We report a of a recurred chordoma in C2 portion, occupying the osseous intraspinal portion. The patient underwent total corpectomy of C3 and gross total removal of tumor by right submandibular approach 3 years previously. We performed a lateral extrapharyngeal approach from contralateral left side with resection C2 central portion followed by gross total removal of mass and placement of graft bone. Although there was transient hypoglossal nerve palsy postoperatively, the patient had full recovery.

Facial diplegia as a delayed complication of scrub typhus

  • Baek, Jong Gyu;Hong, Hyo Lim;Park, Jae Han
    • Annals of Clinical Neurophysiology
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    • v.21 no.2
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    • pp.98-101
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    • 2019
  • A 64-year-old man presented with facial diplegia occurring 2 weeks after scrub typhus diagnosis. The serum scrub typhus antibody titer was elevated to 1:5120. Brain magnetic resonance imaging revealed contrast-enhancement of the signal for both facial nerves. He was administered prednisolone. After two weeks, the symptoms improved, and after one month, he completely recovered from facial diplegia. This is the first case in the literature in which the patient exhibited facial diplegia, a delayed complication, in scrub typhus. Facial diplegia should be considered a type of cranial nerve palsy that may occur as a delayed complication of scrub typhus.

Magnetic resonance imaging features of syringobulbia in small breed dogs

  • Young-Mok Song;In Lee;Yu-Mi Song;Ho-Jung Choi;Young-Won Lee
    • Korean Journal of Veterinary Research
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    • v.63 no.3
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    • pp.26.1-26.5
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    • 2023
  • Syringobulbia is a rare neurological disorder characterized by a fluid-filled cavity in the brainstem. In this study, clinical signs, features on magnetic resonance imaging (MRI), and the diseases present concurrently with syringobulbia were investigated in 33 small breed dogs. Most dogs (97%) had concurrent syringomyelia, and some dogs (24%) presented with vestibular or cranial nerve symptoms associated with the medulla oblongata. MRIs revealed slit-like, bulbous, and vertical linear shapes of the cavities on T2-weighted hyperintense and T1-weighted hypointense signals similar to the cerebrospinal fluid. Chiari-like malformations were identified in all dogs. This study highlights the association of syringobulbia with syringomyelia and Chiari-like malformations in small breed dogs with or without brainstem-associated clinical signs.

Meningeal Layers Around Anterior Clinoid Process as a Delicate Area in Extradural Anterior Clinoidectomy : Anatomical and Clinical Study

  • Yoon, Byul Hee;Kim, Han Kyu;Park, Mun Sun;Kim, Seong Min;Chung, Seung Young;Lanzino, Giuseppe
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.391-395
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    • 2012
  • Objective : Removal of the anterior clinoid process (ACP) is an essential process in the surgery of giant or complex aneurysms located near the proximal internal carotid artery or the distal basilar artery. An extradural clinoidectomy must be performed within the limits of the meningeal layers surrounding the ACP to prevent morbid complications. To identify the safest method of extradural exposure of the ACP, anatomical studies were done on cadaver heads. Methods : Anatomical dissections for extradural exposure of the ACP were performed on both sides of seven cadavers. Before dividing the frontotemporal dural fold (FTDF), we measured its length from the superomedial apex attached to the periorbita to the posterolateral apex which connects to the anterosuperior end of the cavernous sinus. Results : The average length of the FTDF on cadaver dissections was 7 mm on the right side and 7.14 mm on the left side. Cranial nerves were usually exposed when cutting FTDF more than 7 mm of the FTDF. Conclusion : The most delicate area in an extradural anterior clinoidectomy is the junction of the FTDF and the anterior triangular apex of the cavernous sinus. The FTDF must be cut from the anterior side of the triangle at the periorbital side rather than from the dural side. The length of the FTDF incision must not exceed 7 mm to avoid cranial nerve injury.

Alterations in Meningeal Blood Flow by Stimulation of Trigeminovascular System in Rats

  • Kim, Byung-Soo;Choi, Chang-Hwa;Lee, Won-Suk
    • Biomedical Science Letters
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    • v.11 no.3
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    • pp.365-373
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    • 2005
  • The aim of this study was to investigate the alterations in meningeal blood flow by stimulation of trigeminovascular system. An open cranial window was prepared on the right parietal bone of male Sprague-Dawley rats. Trigeminovascular system was stimulated by electrical stimulation of trigeminal ganglion (ETS), somatosensory (whisker) stimulation, or topical applications of capsaicin and neuropeptides including substance P and calcitonin gene-related peptide (CGRP). Neonatal capsaicin pretreatment was performed with subcutaneous administration of capsaicin (50 mg/kg) within the first 24 hours after birth. Changes in regional blood flow of dural artery (rDBF) and pial artery (rPBF) were continuously measured through the cranial window by laser-Doppler flowmetry. Both ETS and capsaicin caused a chain of alterations in rPBF and rDBF responses, i.e., an immediate transient decrease followed by rapid and marked increase in rPBF, which were significantly attenuated not only by pretreatments with L-733,060, a $NK_1$ receptor blocker, $CGRP_{8-37}$, a $CGRP_1$ receptor blocker, and 7-nitroindazole monosodium salt (7-NINA), a neuronal nitric oxide synthase inhibitor but also by neonatal capsaicin treatment. Exogenous neuropeptides including substance P and CGRP increased the meningeal blood flow, which was significantly attenuated not only by pretreatment with L-733,060 and $CGRP_{8-37}$, respectively, but also by pretreatment with 7-NINA. The rPBF response to whisker stimulation was significantly attenuated not only by trigeminovascular system injuries including nasociliary nerve denervation and neonatal capsaicin treatment but also by pretreatments with L-733,060, $CGRP_{8-37}$ and 7-NINA. These results suggest that the stimulation of trigeminovascular system causes prominent alterations in meningeal blood flow, and that neuropeptides as well as nitric oxide in the trigeminovascular system are importantly implicated in the regulation of meningeal blood flow.

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Clinical Outcomes of Intracranial Nonvestibular Schwannomas Treated with Linac-Based Stereotactic Radiosurgery and Radiotherapy

  • Puataweepong, Putipun;Dhanachai, Mantana;Hansasuta, Ake;Saetia, Kriangsak;Dangprasert, Somjai;Sitathanee, Chomporn;Yongvithisatid, Pornpan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3271-3276
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    • 2016
  • Background: Intracranial nonvestibular schwannomas arising from various cranial nerves excluding CN VIII are uncommon. Recently, stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) have been widely reported as effective treatment modalities for nonvestibular schwannomas. The purpose of this study was to study the long term clinical outcome for nonvestibular schwannomas treated with both X-Knife and CyberKnife (CK) radiosurgery at one institution. Materials and Methods: From 2004 to 2013, fifty-two nonvestibular schwannoma patients were included in this study, 33 patients (63%) were treated with CK, and 19 (37%) were treated with X-Knife. The majority of the tumors were jugular foramen schwannomas (38%) and trigeminal schwannomas (27%). HSRT was given for 45 patients (86%), whereas CSRT was for 6 (12%) and SRS for 1 (2%). Results: The median pretreatment volume was $9.4cm^3$ (range, $0.57-52cm^3$). With the median follow up time of 36 months (range, 3-135), the 3 and 5 year progression free survival was 94 % and 88%, respectively. Tumor size was decreased in 13 (25%), stable in 29 (56%), and increased in 10 (19%). Among the latter, 3 (30%) required additional treatment because of neurologic deterioration. No patient was found to develop any new cranial nerve deficit after SRS/SRT. Conclusions: These data confirmed that SRS/SRT provide high tumor control rates with low complications. Large volume tumors and cystic expansion after radiation should be carefully followed up with neurological examination and MRI, because it may frequently cause neurological deterioration requiring further surgery.

Protective Effect of Gastrodia Elata on Neuronal Cell Damage in Alzheimer's Disease (치매병태(癡呆病態)모델에서 천마(天麻)의 신경세포(神經細胞) 손상(損傷) 보호효과(保護效果))

  • Jung, Young-Su;Kang, Jae-Hyun;Prak, Se-Hwan;Kwon, Young-Mi;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.2
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    • pp.125-140
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    • 2010
  • Objectives : The purpose of this study is to examine from various angles the protective effect of Gastrodia elata Blume (GEB) against nerve cell death induced by $\beta$-amyloid by using the cell line SH-SY5Y, which is commonly utilized for toxicity testing in nerve cells, and to find out its mechanism of action. Methods : To begin with, as a result of assessing the rate of cell survival by employing MTT reduction assay, the treatment with $\beta$-amyloid at different concentrations caused cytotoxicity, which was inhibited by preprocessing GEB extract. In addition, after $\beta$-amyloid was processed with the cell SH-SY5Y, apoptosis progressed, which was reduced effectively by processing GEB extract. Results : When cytotoxicity was caused by using hydrogen peroxide, a representative ROS, in order to examine the antioxidant effect of GEB, its protective effect was also observed. Apart from ROS, reactive nitrogen species (RNS) are also known to play a crucial role in nerve cell death. The treatment with the NO donor SNAP increased the production of nitric oxide and the expression of iNOS, which was also inhibited by GEB extract. Meanwhile, as an attempt to find out the mechanism of action explaining the antioxidant effect, the intracellular antioxidant enzyme expressions were measured by RT-PCR, which showed that GEB extract increased the expressions of heme oxygenase-1, GAPDH and $\gamma$-glutamate cysteine ligase. Lastly, GEB extract had a protective effect against impaired memory induced by scopolamine in animal models (in vivo). Conclusions : These findings indicate that GEB has a protective effect against the death of cranial nerve cells, suggesting possibilities for the prevention and treatment of AD.