• 제목/요약/키워드: Department of Neurosurgery

검색결과 4,099건 처리시간 0.029초

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

  • 김진용;박상근;김한성;신형식;황용순;김상진
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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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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    • 제44권2호
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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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    • 제61권1호
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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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    • 제40권4호
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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.

척추 후방 전위증을 동반한 요추부 활막낭종 1례 (Lumbar Synovial Cyst Associated with Retrolitheis -A Case Report-)

  • 최상준;고삼규;김오룡;지용철;최병연;조수호
    • Journal of Yeungnam Medical Science
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    • 제8권2호
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    • pp.222-226
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    • 1991
  • In advant of high-resolutional CT and MRI, it is not so difficult to detect the lumbar synovial cyst, however the unusual disease should be included in the differential diagnosis of cauda equina compression syndromes. The case of a 55-year-old man who had a low back pain and severe radiating pain on both legs showed a retrolisthesis at L3-4 and L4-5 and epidural enhansing mass just around L4-5 facet joint on MRI. Microscopically a lining of synovial tissue was demonstrated. After surgery of the total resection of synovial cyst and stabilization, the patient's presenting symptoms were improved.

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반복적인 소뇌 출혈로 발현한 후두와 모세혈관 확장증 - 증례보고 - (Capillary Telangiectasia of the Posterior Fossa Presenting with Repeated Cerebellar Hemorrhage - A Case Report -)

  • 이용묵;고현송;조준희;염진영;송시헌;김윤
    • Journal of Korean Neurosurgical Society
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    • 제30권2호
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    • pp.211-216
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    • 2001
  • Hemorrhage due to capillary telangiectasia is rare. We report a case of capillary telangiectasia presenting with repeated cerebellar hemorrhage in a 38-year-old male. To our knowledge this is the first case of repeated cerebellar hemorrhage from the capillary telangiectasia. At the first operation, we removed hematoma only, but rebleeding occurred repeatedly in the same area. Finally, we evacuated the recurrent hematoma and vascular mass of capillary telangiectasia at the second operation under surgical microscope. Based on the findings of this case and a review of the literature, we conclude that capillary telangiectasia can be the cause of the massive repeated hemorrhage.

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자발성 척수내혈종 - 증례보고 - (Spontaneous Hematomyelia - Case Report -)

  • 황정현;성주경;황성규;함인석;박연묵;김승래
    • Journal of Korean Neurosurgical Society
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    • 제29권3호
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    • pp.411-419
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    • 2000
  • Hematomyelia is an extremely rare condition that cause severe neurological symptoms. We reported 4 cases of spontaneous hematomyelia, two cases of cavernous angioma and two cases of hematoma. In all patients, the clinical course was progressive ; motor and sensory abnormalities below the lesion and voiding difficulties were the common presenting symptom complex. The preoperative diagnosis was made by magnetic resonance imaging and the all patients underwent surgical exploration. Complete removal of hematoma was done in 3 patients and complete evacuation after aspiration of hematoma were performed in one patients. Neurological function did not worsen postoperatively in any patients. The early diagnosis with magnetic resonance imaging and immediate surgical treatment of the hematoma and the associated vascular malformation are considered to be the best way to halt the progression of the disease.

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뇌량 주위 동맥 근위부에 발생한 외상성 뇌동맥류 - 증례보고 1예 - (Traumatic Pericallosal Artery Aneurysm - A Case Report -)

  • 우원철;송시헌;고현송;염진영;김성호;김윤
    • Journal of Korean Neurosurgical Society
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    • 제29권2호
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    • pp.265-269
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    • 2000
  • Traumatic aneurysm is a rare complication of head trauma. Unfortunately, it is rarely recognized until their presence is heralded by delayed deterioration or intracranial hematoma, etc,. Early diagnosis and surgical treatment are most important for good outcome. We recently encountered a patient who developed a pericallosal aneurysm after major trauma. With a high index of suspicion about traumatic aneurysm, brain MRI and MRA were performed. Definitive diagnosis was made by transfemoral carotid angiography, revealing a aneurysm of the right proximal pericallosal artery. The aneurysm was explored through right interhemispheric approch. A $15{\times}15mm$ sized traumatic aneurysmal sac, located in proximal portion of right pericallosal artery was noted. It was dissected from the falx of cerebri and its neck was clipped. The postoperative course was uneventful. Traumatic intracranial aneurysm should be suspected in any patient who deteriorates after the trauma. Early recognition and prompt treatment are warranted in this setting. Definitive surgical treatment of all traumatic intracranial aneurysm is recommended.

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두개골을 침범한 Langerhans' Cell Histiocytosis - 증례보고 - (Facto Langerhans' Cell Histiocytosis Involving Skull - Case Report -)

  • 손찬영;박상근;김한성;신형식;황용순;김상진
    • Journal of Korean Neurosurgical Society
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    • 제30권sup1호
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    • pp.124-127
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    • 2001
  • Langerhans' cell histiocytosis is a rare disease showing proliferation of histiocytes in multiple organ system. Bone lesions are the most common radiolologic manifestation of Langerhans' cell hysticytosis. Extraskeletal sites of Langerhans' cell hystiocytosis involvement include the skin, lymph nodes, thymus, lungs, central nervous system, liver, pancrease, spleen, and bowel. The authors have experienced a case of Langerhans' cell histiocytosis which involved the skull. A 3-year-old female presented with soft tissue mass on right periorbital area. Plain skull X-ray showed punched out bone lesion. Computed tomography showed non-enhancing osteolytic lesion on right frontal skull. Histologic findings of an excised mass revealed pathologic features of Langerhans' cell histiocytosis.

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Diffusion-weighted Imaging and Apparent Diffusion Coefficient Maps for the Evaluation of Pyogenic Ventriculitis

  • Kim, Hyeong-Seok;Hong, Jae-Taek;Lee, Sang-Won;Son, Byung-Chul;Sung, Jae-Hoon;Kim, Moon-Chan
    • Journal of Korean Neurosurgical Society
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    • 제38권1호
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    • pp.23-27
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    • 2005
  • Objective : The aim of this study is to assess the significance of an apparent diffusion coefficient[ADC] study for diagnosis of ventriculitis. Methods : Seven patients with ventriculitis were enrolled in this study. Diffusion-weighted[DW] magnetic resonance images[MRI] and ADC maps in the dependent intraventricular collection, periventricular white matter and non-dependent cerebrospinal fluid[CSF] were obtained. The images and ADC data from the different lesions were compared. Results : The DW MRI showed marked hyperintensity in the purulent pus lesion, and the corresponding ADC maps revealed prominent hypointensity and restricted ADC values compared with the non-dependent CSF and normal white matter. Conclusion : The decreased ADC value and increased signal intensity of the dependent intraventricular fluid on the DW MRI show restricted water diffusion in the purulent fluid, which is indicative of a pyogenic ventriculitis diagnosis.