• Annals of Clinical Neurophysiology
• /
• v.17 no.1
• /
• pp.41-43
• /
• 2015

• Journal of Korean Neurosurgical Society
• /
• v.49 no.6
• /
• pp.373-376
• /
• 2011

We report a case of a non traumatic spinal subdural hematoma or subarachnoid hematoma manifesting as lumbago, leg pain and bladder dysfunction that showed angiographically occult vascular malformation (AOVM). Although the spinal angiogram did not reveal any vascular abnormality, the follow-up magnetic resonance image showed AOVM. Complete surgical removal was performed due to the aggravated bladder dysfunction. This case highlights the need to consider bleeding due to spinal AOVM, even when angiography is negative.

• Journal of Korean Neurosurgical Society
• /
• v.45 no.4
• /
• pp.253-255
• /
• 2009

Spontaneous spinal subarachnoid hematoma (SSH) is a rare entity to cause spinal cord or nerve root compression and is usually managed as surgical emergencies. We report a case of spontaneous SSH manifesting as severe lumbago, which demonstrated nearly complete clinical resolution with conservative treatment A 58-year-old female patient developed a large SSH, which was not related to blood dyscrasia, anticoagulation, lumbar puncture. or trauma. Patient had severe lumbago but no neurologic deficits. Because of absence of neurologic deficits, she was treated conservatively. Follow-up magnetic resonance (MR) image showed complete resolution. Conservative treatment of SSH may be considered if the patient with spontaneous SSH has no neurologic deficits.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.6
• /
• pp.445-454
• /
• 2015

Objective : In the present study we analyzed neuroprotective and antiapoptotic effect of the difumarate salt S-15176, as an anti-ischemic, an antioxidant and a stabilizer of mitochondrial membrane in secondary damage following spinal cord injury (SCI) in a rat model. Methods : Three groups were performed with 30 Wistar rats; control (1), trauma (2), and a trauma+S-15176 (10 mg/kg i.p., dimethyl sulfoxide) treatment (3). SCI was performed at the thoracic level using the weight-drop technique. Spinal cord tissues were collected following intracardiac perfusion in 3rd and 7th days of posttrauma. Hematoxylin and eosin staining for histopatology, terminal deoxynucleotidyl transferase dUTP nick end labeling assay for apoptotic cells and immunohistochemistry for proapoptotic cytochrome-c, Bax and caspase 9 were performed to all groups. Functional recovery test were applied to each group in 3rd and 7th days following SCI. Results : In trauma group, edematous regions, diffuse hemorrhage, necrosis, leukocyte infiltration and severe degeneration in motor neurons were observed prominently in gray matter. The number of apoptotic cells was significantly higher (p<0.05) than control group. In the S-15176-treated groups, apoptotic cell number in 3rd and 7th days (p<0.001), also cytochrome-c (p<0.001), Bax (p<0.001) and caspase 9 immunoreactive cells (p<0.001) were significantly decreased in number compared to trauma groups. Hemorrhage and edema in the focal areas were also noticed in gray matter of treatment groups. Results of the locomotor test were significantly increased in treatment group (p<0.05) when compared to trauma groups. Conclusion : We suggest that difumarate salt S-15176 prevents mitochondrial pathways of apoptosis and protects spinal cord from secondary injury and helps to preserve motor function following SCI in rats.

• Journal of Korean Neurosurgical Society
• /
• v.45 no.3
• /
• pp.176-178
• /
• 2009

Traumatic brainstem hemorrhage after blunt head injury is an uncommon event. The most frequent site of hemorrhage is the midline rostral brainstem. The prognosis of these patients is poor because of its critical location. We experienced a case of traumatic brainstem hemorrhage. A 41-year-old male was presented with drowsy mentality and right hemiparesis after blunt head injury. Plain skull radiographs and brain computerized tomography scans revealed a depressed skull fracture, epidural hematoma, and hemorrhagic contusion in the right parieto-occipital region. But, these findings did not explain the right hemiparesis. T2-weighted magnetic resonance (MR) image of the cervical spine demonstrated a focal hyperintense lesion in the left pontomedullary junction. Brain diffusion-weighted and FLAIR MR images showed a focal hyperintensity in the ventral pontomedullary lesion and it was more prominent in the left side. His mentality and weakness were progressively improved with conservative treatment. We should keep in mind the possibility of brainstem hemorrhage if supratentorial lesions or spinal cord lesions that caused neurological deficits in the head injured patients are unexplainable.

• Journal of Korean Neurosurgical Society
• /
• v.38 no.3
• /
• pp.211-214
• /
• 2005

Objective : Post-traumatic hydrocephalus is a complication of head injury and can present with several different clinical symptoms. However, the developing factors of post-traumatic hydrocephalus and treatment are still not well known. The authors design the study to focus on incidence, causing diseases and treatment of post-traumatic hydrocephalus. Methods : The 789patients of traumatic head injury followed by admission treatment over 7days from Jan. 1997 to Dec. 2001, were divided shunt group and shunt free group. We analyzed age, sex, causing diseases, developing time of hydrocephalus and effects of shunt operation in post-traumatic hydrocephalus. Results : The incidence of post-traumatic hydrocephalus for requiring shunt was 9.2% [64cases]. Chronic hydrocephalus which developed after 14days of injury was higher incidence [51cases]. We found following variables were significantly related to shunt-dependent hydrocephalus : low GCS score at admission, initial CT finding of traumatic subarachnoid hemorrhage and intracerebral hemorrhage [including intraventricular hemorrhage]. The effect of shunt operation was not related with the spinal pressure, but had statistically significant correlation with the response of lumbar drainage. Conclusion : We conclude that development of hydrocephalus after head trauma is related to low GCS score, intracerebral hemorrhage [including intraventricular hemorrhage] and subarachnoid hemorrhage. The effect of preoperative lumbar drainage has a significant role in predicting the result of shunt operation in patient with post-traumatic hydrocephalus.

• Journal of Cerebrovascular and Endovascular Neurosurgery
• /
• v.25 no.3
• /
• pp.316-321
• /
• 2023

Developmental venous anomalies (DVAs) are composed of mature venous vessels that lack malformed or neoplastic elements. Although the hemorrhage risk is considered negligible, some patients may have neurological symptoms attributable to acute infarction or intracranial hemorrhage secondary to thrombosis, in the absence of a coexisting cavernous malformation. We report the case of a 42-year-old patient who presented with acute left-hand paresis secondary to a subcortical hemorrhage. This bleeding originated from a DVA in the corticospinal tract area and was surgically drained through an awake craniotomy. To accomplish this, we used a trans-precentral sulcus approach. After the complete removal of the coagulum, small venous channels appeared, which were coagulated. No associated cavernoma was found. Although the main DVA trunk was left patent, no signs of ischemia or venous infarction were observed after coagulating the small venous channels found inside the hematoma cavity. Two weeks after the procedure, the patient's hand function improved, and he was able to resume desktop work. DVA-associated hemorrhage within the cortico-spinal tract could be safely removed with modern awake mapping techniques. This technique allowed the patient to rapidly improve his hand function.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.3
• /
• pp.269-271
• /
• 2014

Spinal subdural hematoma is a rarely reported disease and spontaneous spinal subdural hematomas (SSDH) without underlying pathological changes are even rarer. The patients usually show typical symtoms such as back pain, quadriplegia, paraplegia or sensory change. But rarely, patients may show atypical symptoms such as hemiparesis and misdiagnosed to cerebrovascular accident. We recently experienced a case of SSDH, where the patient initially showed vague symptoms, such as the sudden onset of headache which we initially misdiagnosed as subarachnoid hemorrhage. In this case, the headache of patient improved but the neck pain persisted until hospital day 5. Therefre, we conducted the MRI of cervical spine and finally confirmed SSDH. The patient was managed conservatively and improved without recurrence. In this case report, we discuss the clinical features of SSDH with emphasis on the importance of an early diagnosis.

• Journal of Trauma and Injury
• /
• v.33 no.3
• /
• pp.175-180
• /
• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely performed as an adjunct to resuscitation or bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It is a crucial adjunct for the maintenance of cerebral and coronary perfusion during resuscitation. However, in polytrauma patients with concomitant neurotrauma, such as traumatic brain injury (TBI) or spinal cord injury, the physiological effects of REBOA are unclear. In this report on REBOA performed in a clinical setting for polytrauma patients with spinal cord injury or TBI, the physiological effects of REBOA in neurotrauma are reviewed.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.1
• /
• pp.58-60
• /
• 2013

Intramuscular stimulation (IMS) is widely used to treat myofascial pain syndrome. IMS is a safe procedure but several complications have been described. To our knowledge, spinal subarachnoid hematoma has never been reported as a complication of an IMS. The authors have experienced a case of spinal subarachnoid hematoma occurring after an IMS, which was tentatively diagnosed as intracranial subarachnoid hemorrhage because of severe headache. Patient was successfully treated with surgery. Here, we report our case with a review of literature.