• Title/Summary/Keyword: Department of Neurosurgery

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A rare case of sacral epidural arteriovenous fistula with concomitant occult multiple lumbar epidural arteriovenous fistulas

  • Katsuya Saito;Takakazu Ushioda;Takahiro Miyata;Keita Mayanagi;Koki Kato;Joji Inamasu;Masashi Nakatsukasa
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.3
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    • pp.322-332
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    • 2023
  • We describe a rare case of sacral epidural arteriovenous fistulas (edAVFs) with atypical clinical course of treatment. A 78-year-old man with a history of spinal surgery presented progressive gait disturbance and urinary incontinence. Spinal angiography demonstrated a sacral spinal AVF fed by bilateral lateral sacral arteries, draining to the venous pouch with subdural drainage. The first treatment by direct interruption of a subdural drainer was incompletely finished. Postoperative reassessment by 3D imaging analysis led to the diagnosis of sacral edAVF and 3D understanding of its angioarchitecture. The second treatment by transarterial embolization (TAE) resulted in complete occlusion of a sacral edAVF. However, spinal venous congestion didn't improve, because the recruitment of occult edAVFs at the multiple lumbar levels and complex-shaped sacral ventral epidural venous plexus (VEP) were involved in the remnant of prior subdural drainage. The third treatment was performed by TAE for three occult edAVFs and the VEP compartment connecting between a patent edAVF and subdural drainage, which resulted in complete disappearance of spinal cord edema. Endovascular embolization of VEP compartment connecting to subdural drainage in addition to fistulous occlusion may be one of the treatment options for several edAVFs at the multiple spinal levels.

Unilateral Hydrocephalus in Congenital Atresia of the Foramen of Monro (선천성 몬로공 폐쇄증에 의한 일측성 수두증)

  • Kim, Jong Hyun;Chung, Yong Gu;Lee, Nam Joon;Kim, Se Hoon;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.434-437
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    • 2000
  • Unilateral hydrocephalus is an uncommon disease which may result from obstruction of the foramen of Monro. Congenital or acquired lesions obstructing this foramen have been reported. We present a case of prenatally diagnosed fetal unilateral hydrocephalus. Ventriculoperitoneal shunt operation was performed and following the procedure, ventricular size was decreased and patients neurological status was improved.

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Two Cases of Intraventricular Arachnoid Cysts - Case Report - (뇌실내 지주막 낭종 - 증례보고 -)

  • Bang, Jae Seung;Oh, Chang-Wan;Kim, Myoung Soo;Choe, Ghee Young;Cho, Byung-Kyu;Hong, Seung-Koan;Han, Dae Hee
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.928-933
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    • 2001
  • Intraventricular arachnoid cyst has been rarely reported. Here we present two cases of symptomatic intraventricular arachnoid cysts in the fourth ventricle and right lateral ventricle. The first patient was a 38-year-old female who complained of headache and left facial hypesthesia. Computed tomography and MR scan revealed large cystic lesion in the fourth ventricle. After cyst wall removal, facial hypesthesia disappeared immediately and headache improved slowly. The second patient was a 9-year-old girl who complained of headache, vomiting and paresthesia in her right low extremity. Cystic lesion in the right lateral ventricle was detected in the CT and MR scan. The symptoms improved after cyst wall removal. Surgical findings of these two cases showed that the cyst walls were attached firmly to the choroid plexus. Symptomatic intraventricular arachnoid cyst must be treated appropriately and we recommend complete cyst wall removal.

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Epithelioid Hemangioendothelioma of the Spinal Cord - A Case Report - (척수에 발생한 상피양 혈관내피종 1예 - 증례보고 -)

  • Kim, Ki Tai;Won, You Sam;Lee, Seung Min;Yang, Jae Young;Choi, Chun Sik;Ju, Mun Bae;Keum, Joo Seob
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.627-632
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    • 2001
  • Hemangioendotheliomas are vascular neoplasms characterized by histologic appearance that are intermediate between hemangiomas and angiosarcomas first described by Weiss and Enzinger in 1982. They are classified into at least 3 subgroups, including epithelioid hemangioendothelioma, spindle cell hemangioendothelioma, and malignant endovascular angioendothelioma, and have been reported principally in soft tissues of the extremities, lung, liver, and bone. The cases involving the central nervous system reported are very rare. We report an intraspinal epithelioid hemangioendothelioma occurring in a 52-year-old man. To our knowledge, it is first case of spinal hemangioendothelioma in Korea.

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Osteochondroma of the Lumbar Spines without Clear Demarcation from Surrounding Normal bone Tissues - Report of A Case - (정상 골조직과 경계가 불명확한 요추 골연골종 - 증례보고 -)

  • Kim, Joo-Han;Oh, Woo-Suk;Chung, Hung-Seob;Lee, Ki-Chan;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.790-794
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    • 2001
  • Spinal osteochondroms are very rare, and are thought to arise through a process of progressive endochondral ossification of aberrant cartilage of a growth plate, as a consequence of congenital defect or trauma. A case of diffuse type osteochondroma involving the posterior elements of L1-L5 that progressed after laminectomy in a 33-year-old man is reported. Usually, the spinal osteochondroma shows clear demarcation between tumor margin and normal spine elements, and can be exised completely. However, there was no clear demarcation between tumor and normal spine element in our case and therefore it was not possible to removal completely.

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