• Title/Summary/Keyword: Department of Neurosurgery

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Expansive Laminoplasty for Cerical Compression Myelopathy (경수 압박으로 인한 척수증 환자에서의 경추강 확장술)

  • Han, Dong-Ro;Doh, Eun-Sig;Kim, Oh-Lyong;Chi, Yong-Chul;Choi, Byung-Yearn;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.141-146
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    • 1989
  • In an attempt to eliminate some negative aspects of conventional extensive laminectomy, 4 cases of multiple level of cervical compression myelopathy, 1 OPLL(ossification of posterior longitudinal ligament) and 3 cervical stenosis, were treated with a technique of expansive laminoplasty. Operative results in all patients were satisfactory without surgical complications and all patients had a neurological improvement. We suggest that our technique is more effective one for cervical canal enlargement with preservation of stability for treating multiple level of cervical canal stenosis, OPLL, and spondylosis than conventional extensive laminectomy.

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Spinal Schwannoma; Analysis of 40 Cases

  • Jeon, Jee-Ho;Hwang, Hyung-Sik;Jeong, Je-Hoon;Park, Se-Hyuk;Moon, Jae-Gon;Kim, Chang-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.43 no.3
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    • pp.135-138
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    • 2008
  • Objective: This study is to report our experience of 40 cases of spinal schwannoma. Methods: From 1995 to 2006, medical records were retrospectively reviewed in 40 cases of spinal schwannoma. Results: We treated 40 spinal schwannomas in 38 (22 male and 16 female) patients. The mean age was 50.2. Four cases were sited in the cervical spine, 11 cases in the thoracic spine, and 25 cases in the lumbar spine. Two patients showed recurrences. Thirty-eight cases were intradural-extramedullary type and 2 cases were extradural. Two cases (5%) including 1 recurred case had no postoperative motor improvement. Ninety-five percents of patients improved on postoperative motor grade. Conclusion: Spinal schwannoma is mostly benign and extramedullary tumor. There were 2 recurred cases (5%) that had history of previous subtotal removal at first operation and had shown worse prognosis compared with the cases without recurrence. To reduce the recurrence of spinal schannoma, total excision of tumor mass should be done.

Dialysis Disequilibrium Syndrome in Neurosurgical Patient - Case Report - (신경외과 환자 치료 중 발생한 Dialysis Disequilibrium Syndrome - 증례보고 -)

  • Woo, Hee-Kyung;Yoo, Do-Sung;Kim, Dal-Soo;Huh, Pil-Woo;Cho, Kyoung-Suok;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.381-383
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    • 2001
  • Neurological symptoms may develope when the blood urea nitrogen is lowered too rapidly by hemodialysis. It is known that these symptoms, known as dialysis disequilibrium are associated with cerebral edema. However, the pathogenesis of brain swelling and neurological deterioration after rapid hemodialysis is controversial. The reverse urea hypothesis suggests that hemodialysis removes urea more slowly from the brain than from the plasma, creating an osmotic gradient that results in cerebral edema. The idiogenic osmole hypothesis proposes that an osmotic gradient between brain and plasma develops during rapid dialysis because of newly formed brain osmoles. Authors report a such case and discuss the possible mechanism and preventive methods.

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A Case of Multiple "De Novo" Aneurysms - Case Report - (다발성 "De Novo" 동맥류 1예 - 증 례 보 고 -)

  • Son, Sung Ho;Jeong, Young Gyun;Kim, Soo Young;Park, Hwa Sung;Park, Hyuck;Rhee, Dong Youl
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.337-339
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    • 2001
  • The development of completely new intracranial aneurysms after previous successfully treated aneurysm is uncommon. A 50-year-old female presented with a case of multiple de novo aneurysm which were an aneurysm of right ophthalmic segment of internal carotid artery and an aneurysm of right A1 artery, 6 years after the clipping of an aneurysm of right posterior communicating artery. She had no history of hypertension, cigarette smoking and use of oral contraceptives, and had no evidence of genetic disorder. The laboratory findings were normal. All de novo aneurysms were clipped by basal anterior interhemispheric approach in one stage due to the direction of the aneurysm of the ophthalmic segment of the internal carotid artery.

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Dural Arteriovenous Malformation on the Anterior Cranial Fossa - Case Report - (전두개와 경막에 발생한 동정맥 기형 - 증례보고 -)

  • Park, Tae Il;Whang, Kum;Pyen, Jhin Soo;Hu, Chul;Hong, Soon Ki;Han, Yong Pyo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.244-249
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    • 2001
  • Dural arteriovenous malformations(AVM) are not uncommon. Reports of intracranial dural AVM have been increasing but most of them deal with dural AVM in the region of the cavernous sinus, posterior fossa and tentorium, but those of the anterior cranial fossa are very rare. Recently, we experienced two cases of right frontal dural arteriovenous malformation fed mainly by both ethmoidal arteries. The angiographic appearance in these two cases is quite uniform. The nidus was located in the frontal dura, although their main feeders were dural arteries. They were drained through an intracerebral cortical vein associated with aneurysmal dilatation of proximal portion into superior sagittal sinus. Spontaneous intracerebral hematoma was the cause of the clinical symptoms. We report two cases of intracerebral hematoma, caused by dural AVM, which was successfully managed by surgical treatment.

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Selective Peripheral Denervation for the Treatment of Spasmodic Torticollis

  • Jang, Kyung-Sool;Park, Hea-Kwan;Joo, Won-Il;Ji, Chul;Lee, Kyung-Jin;Choi, Chang-Rak
    • Journal of Korean Neurosurgical Society
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    • v.37 no.5
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    • pp.350-353
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    • 2005
  • Objective: Various methods of treatment for idiopathic cervical dystonia have been tried in the past with unsatisfactory results. The authors report cases of five patients who underwent selective peripheral denervation for spasmodic torticollis. Methods: Between July 2002 and December 2003, 5 patients underwent surgery at St. Mary's Hospital for spasmodic torticollis. Age of the patient at the onset of symptoms ranged from 29 to 56years (mean 43.75years). Selective peripheral denervation(SPD) was performed at 7 to 11 months after the onset of symptoms (mean 8.75 months). A patient was considered to be the candidate for surgery if conservative methods were unsuccessful and symptoms persisted for longer than 7months. In addition, 2patients who refused treatment with botulinum toxin were also enrolled in this study. Results: Although one patient underwent reoperation, all of the five patients' symptoms were improved after the operation. Clinically, patients with retrocollis showed better improvement than laterocollis patients. Conclusion: Although injection of botulinum toxin is the first-choice in treatment modality, when surgery is required, selective peripheral denervation provides good results with minimum side effects.

Metastatic Adenocarcinoma of Optic Nerve - A Case Report - (시신경에 발생한 전이성 선세포암 - 증 례 보 고 -)

  • Kim, Jin Yong;Park, Sang Keun;Kim, Han Sung;Shin, Hyung Shik;Hwang, Yong Soon;Kim, Sang Jin
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1069-1073
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    • 2000
  • Although the most commonly encountered orbital tumor is metastatic tumor, adenocarcinoma of stomach metastasized to the optic nerve is rarely reported. The authors discuss a rare case of metastatic adenocarcinoma of left optic nerve with a review of literature. A 44-year-old man presented with decreased visual acuity of left eye for 3 months. Neurologic examination revealed left optic neuropathy. On MR imaging, a homogenously wellenhanced mass surrounding left optic nerve around optic canal was noticed. The X-rays and the whole body bone scan sho-wed multiple bony metastasis. Subtotal removal was performed via combined subfrontal and pterional approach and metastatic adenocarcinoma from the stomach was confirmed histologically. Postoperative course was uneventful, but there was no improvement of visual acuity.

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Is Transcranial Doppler Ultrasonography Old-fashioned?: One Institutional Validity Study

  • Han, Pan-Yeal;Kim, Jae-Hoon;Kang, Hee-In;Moon, Byung-Gwan;Lee, Seung-Jin;Kim, Joo-Seung
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.63-66
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    • 2008
  • Objective : The purpose of this study is to investigate the correlation between various transcranial Doppler (TCD) ultrasonography parameters and clinical vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Methods : This study enrolled 40 patients presented with aneurysmal SAH between September 2006 and August 2007. We measured differences of mean blood flow velocity (BFVm), highest systolic blood flow velocity (BFVh), and Lindegaard ratio (LR) in the middle cerebral artery on TCD examination. These parameters were evaluated for correlation with clinical vasospasm by univariate analysis and the receiver operating characteristic analysis. Results : Twelve patients (30%) developed clinical vasospasm. The best TCD parameters for the detection of clinical vasospasm were revealed to be differences of BFVm, BFVh, and LR values between $1^{st}$ TCD test and $3^{rd}$ TCD (7 cm/s. 11.5 cm/s, 0.45 respectively). The positive predictive value of anyone of three parameters was 60% and the negative predictive value was 100%. Conclusion : TCD is still considered a useful tool for screening clinical vasospasm. To confirm the predictive value of the above parameters. further prospective study will be needed.

Posttraumatic Delayed Vertebral Collapse : Kummell's Disease

  • Lim, Jeongwook;Choi, Seung-Won;Youm, Jin-Young;Kwon, Hyon-Jo;Kim, Seon-Hwan;Koh, Hyeon-Song
    • Journal of Korean Neurosurgical Society
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    • v.61 no.1
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    • pp.1-9
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    • 2018
  • Posttraumatic delayed vertebral collapse, known as Kummell's disease, is increasing in number of patients. This disease is already progressive kyphosis due to vertebral collapse at the time of diagnosis and it causes intractable pain or neurologic deficit due to intravertebral instability. Treatment is very difficult after progression of the disease, and the range of treatment, in hospital day, and cost of treatment are both increased. Clinical features, pathogenesis and radiologic findings of these disease groups were reviewed to determine risk factors for delayed vertebral collapse. The purpose of this article is to suggest appropriate treatment before vertebral collapse for patients with osteoporotic vertebral compression fracture who have risk factors for posttraumatic delayed vertebral collapse.

Outcomes in the Management of Spontaneous Cerebellar Hemorrhage

  • Moon, Kang-Seok;Park, Hyung-Ki;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu;Choi, Soon-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.40 no.4
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    • pp.234-238
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    • 2006
  • Objective : The operative indications on cerebellar hemorrhage have been controversial especially when the patient condition is grave. Therefore we investigated whether it can be justifiable if we perform the surgery in poor clinical grade. Methods : Clinical records and computerized tomography[CT] films of the 89 patients, who were undergone hospital treatment due to spontaneous cerebellar hemorrhage between May 1997 and May 2004, were retrospectively researched. Results : The study population consisted of 36 males and 53 female patients. The mean age was 65years [range $23{\sim}89$]. As a result of treatment, the patients, whose Glasgow coma scale[GCS] score were higher, showed better outcomes [p=0.001]. 13 patients [14.6%] were below 5 in GCS score and 10 patients of these were operated. Among 10 patients, 4 patients [40%] showed good outcome and 5 patients [50%] had been dead. 3 patients [60%] of these dead patients had the findings of intraventricular hemorrhage, fourth ventricular obliteration and hydrocephalus in CT scan. Conclusion : This study suggests that operation may be justifiable in clinically poor grade patient with spontaneous intra cerebellar hemorrhage.