• Title/Summary/Keyword: Department of Neurosurgery

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Keyhole Approach and Neuroendoscopy for Cerebral Aneurysms

  • Cho, Won-Sang;Kim, Jeong Eun;Kang, Hyun-Seung;Son, Young-Je;Bang, Jae Seung;Oh, Chang Wan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.275-281
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    • 2017
  • Treating diseases in the field of neurosurgery has progressed concomitantly with technical advances. Here, as a surgical armamentarium for the treatment of cerebral aneurysms, the history and present status of the keyhole approach and the use of neuroendoscopy are reviewed, including our clinical data. The major significance of keyhole approach is to expose an essential space toward a target, and to minimize brain exposure and retraction. Among several kinds of keyhole approaches, representative keyhole approaches for anterior circulation aneurysms include superciliary and lateral supraorbital, frontolateral, mini-pterional and mini-interhemispheric approaches. Because only a fixed and limited approach angle toward a target is permitted via the keyhole, however, specialized surgical devices and preoperative planning are very important. Neuroendoscopy has helped to widen the indications of keyhole approaches because it can supply illumination and visualization of structures beyond the straight line of microscopic view. In addition, endoscopic indocyanine green fluorescence angiography is useful to detect and correct any compromise of the perforators and parent arteries, and incomplete clipping. The authors think that keyhole approach and neuroendoscopy are just an intermediate step and robotic neurosurgery would be realized in the near future.

Current Status of Neurosurgical and Neurointensive Care Units in Korea : A Brief Report on Nationwide Survey Results

  • Jo, Kwang Wook;Kim, Hoon;Yoo, Do Sung;Hyun, Dong-Keun;Cheong, Jin Hwan;Park, Hae-Kwan;Park, Bong Jin;Cho, Byung Moon;Kim, Young Woo;Kim, Tae Hee;Han, Insoo;Lee, Sang-Weon;Kwon, Taek Hyun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.519-531
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    • 2020
  • Objective : The purpose of this study is identify the operation status of the neurosurgical care units (NCUs) in neurosurgical residency training hospitals nationwide and determine needed changes by comparing findings with those obtained from the Korean Neurosurgical Society (KNS) and Korean Society of Neurointensive Care Medicine (KNIC) survey of 2010. Method : This survey was conducted over 1 year in 86 neurosurgical residency training hospitals and two neurosurgery specialist hospitals and focused on the following areas : 1) the current status of the infrastructure and operating systems of NCUs in Korea, 2) barriers to installing neurointensivist team systems, 3) future roles of the KNS and KNIC, and 4) a handbook for physicians and practitioners in NCUs. We compared and analyzed the results of this survey with those from a KNIC survey of 2010. Results : Seventy seven hospitals (87.5%) participated in the survey. Nineteen hospitals (24.7%) employed a neurointensivist or faculty member; Thirty seven hospitals (48.1%) reported high demand for neurointensivists, and 62 hospitals (80.5%) stated that the mandatory deployment of a neurointensivist improved the quality of patient care. Forty four hospitals (57.1%) believed that hiring neurointensivist would increase hospital costs, and in response to a question on potential earnings declines. In terms of potential solutions to these problems, 70 respondents (90.9%) maintained that additional fees were necessary for neurointensivists' work, and 64 (83.1%) answered that direct support was needed of the personnel expenses for neurointensivists. Conclusion : We hope the results of this survey will guide successful implementation of neurointensivist systems across Korea.

Meningeal Hemangiopericytoma : Study of 6 Cases and Review of the Literatures

  • Kim, Jong-Hyun;Kwon, Taek-Hyun;Kim, Joo-Han;Park, Youn-Kwan;Chung, Yong-Gu;Chung, Heung-Seob
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.32-35
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    • 2006
  • Objective : Hemangiopericytoma is known as a malignant tumor originating from pericytes and rarely occurs in the central nervous system. We present 6 cases of pathologically confirmed meningeal hemangiopericytoma. Methods : Retrospective study was done based on patient's recordings including radiological studies. Each case of tumors was treated surgically and postoperative radiotherapy was done. Results : There were 5 cases of intracranial and 1 case of spinal hemangiopericytomas. Three of 5 intracranial hemangiopericytomas were located at tentorial region. Total tumor removal was done in 4 cases and postoperative local recurrence (or regrowth) was noted in 3 cases despite of postoperative external radiation therapy, 2 of which had died. Conclusion : Our cases show more frequent tentorial locations and poor clinical outcomes of hemangiopericytomas compared with meningiomas.

Brain Metastasis of Renal Cell Carcinoma in Von Hippel-Lindau Disease - Case Report - (본 히펠 린다우병에서 발생한 신장암의 뇌전이 - 증례보고 -)

  • Yang, Seung Min;Park, Sang Woo;Suk, Jong Sik;Park, Jong Hyuk;Kwon, Jeong Taik;Min, Byung Kook
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.1019-1022
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    • 2001
  • Although brain metastasis of renal cell carcinoma is a major cause of death in Von Hippel-Lindau disease(VHL), it is not easy to distinguish local recurrence of hemangioblastoma from distant metastasis. In addition, hemangioblastoma has several characteristics suitable for recipient of "tumor-to-tumor metastasis". Authors report a case of Von Hippel-Lindau disease that had metastases of renal cell carcinomas.

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A Case of Intracardiac Migration of Distal Ventriculo-Peritonal(V-P) Shunt Catheter - Case Report - (뇌실-복강 단락 원위도관의 심장내전위 - 증례보고 -)

  • Kim, Byung Joo;Cha, Seung Heon;Park, Dong June;Song, Geun Sung;Choi, Chang Hwa;Lee, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.270-273
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    • 2000
  • Ventriculoperitoneal(V-P) shunt has been used as a popular method for surgical treatment of hydrocephalus. But complications such as infection, mechanical obstruction and failure of flow rate sometimes make painful stress to neurosurgeons and patients. Of particular, migration of distal V-P shunt catheter to extraperitoneal space has rarely been reported. Even rarer is intracardiac migration of distal V-P shunt catheter. Authors report a such case and discuss the possible mechanism and preventive method.

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Using Blood Donating Set for the Treatment of Subgaleal Hematoma - Technical Note - (헌혈 세트를 이용한 두피하 혈종의 치료 - 치료 수기 -)

  • Suh, Dong-Sang;Kim, Bum-Tae;Cho, Sung-Jin;Shin, Won-Han;Choi, Soon-Kwan;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1519-1522
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    • 2000
  • Sugaleal hematoma usually develop one to eight days after minor head trauma or clotting disorders in children. The galeal aponeurosa in children is loosely attatched to the pericranium, allowing the collection of large quantity of blood. Most cases of subgaleal hematomas resolve spontaneously, however some cases require surgical intervention, aspiration of subgaleal hematoma often alleviate symptoms briefly and but do not shorten the time to resolution. Reaccumulation, infection following aspiration also had been reported. Here, we report the efficacy of using the blood donating set for the treatment of subgaleal hematoma in our series.

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A Case of Intraorbital Pseudotumor - Case Report - (안와내 가성종양 1예 - 증 례 보 고 -)

  • Chang, In Bok;Cho, Byung Moon;Hwang, Hyung-Sik;Park, Se-Hyuck;Shin, Dong-Ik;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.85-88
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    • 2001
  • Intraorbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. The authors report a case of intraorbital pseudotumor presenting with painful exophthalmos. A 45-year-old male patient had a two-week history of acute progressive exophthalmos and diplopia. Right orbit was explored through transcranial route and the mass was biopsied, which revealed dense inflammatory cells and fibrosis. He subsequently underwent corticosteroid therapy and symptoms improved gradually. The literatures were reviewed.

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Hemangioblastoma of the Conus Medullaris - Case Report - (척수원추에 발생한 혈관모세포종 - 증례보고 -)

  • Moon, Soo-Hyeon;Kim, Se-Hoon;Kwon, Taek-Hyon;Park, Youn-Kwan;Chung, Heung-Seob;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.836-840
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    • 2000
  • Intramedullary spinal hemagioblastomas usually develope in cervical or thoracic region of spinal cord, but rarely in conus medullaris. We report a case of hemangioblastoma developed in conus medullaris. The 19-year-old male patient presented with slowly progressing low back pain and paresthesia of both legs. MRI and spinal angiography revealed a well-vascularized mass lesion in the conus medullaris with syrinx formation. Total excision of hemangioblastoma was achieved via posterior approach. Postoperatively, patient's walking difficulty was worsened transiently, but it was improved at discharge.

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A Case of Delayed Intracerebellar Hematoma after Head Injury (두부외상 후 발생한 지연성 소뇌 혈종 1례)

  • Kim, Sahng Hyun;Whang, Kum;Pyen, Jin Soo;Hu, Chul;Hong, Soon Ki;Han, Young Pyo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.407-410
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    • 2000
  • The traumatically induced mass lesions of the posterior cranial fossa are unusual. Various types of traumatic posterior fossa hematoma have been described ; the most common forms is epidural hematomas, and frequently traumatic intracerebellar hemorrhage is encountered. A sixty-six-old male patient was initially presented with the occipital skull fracture and contusional hemorrhage on the both frontal lobe, a developed delayed cerebellar hemorrhage. The patient was operated for hematoma removal with good postoperative recovery. We advise a consideration for delayed intracerebellar hematoma in patients with cerebellar contusion following trauma.

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Ruptured Fusiform Anterior Cerebral Artery Aneurysm in an Infant : Case Report and a Literature Review

  • Wonseok Lee;Jong-Kook Rhim;Jin-Deok Joo;Ji Soon Huh;Ki-Bum Sim;You-Nam Chung
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.743-747
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    • 2023
  • Ruptured intracranial aneurysms in infants are rare and infantile fusiform anterior cerebral artery (ACA) aneurysms are much rarer. In this report, we described the case of a 7-month-old infant with a ruptured fusiform ACA aneurysm who presented with seizure and underwent endovascular treatment. The patient was initially in a coma and the neurologic condition did not improve after treatment. The clinical characteristics of the case and literature review were discussed.