• Title/Summary/Keyword: intracranial

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"Misery Collaterals" as Poor Angiographic Findings - Definition, Classification, and Practical Application -

  • Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.159-163
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    • 2006
  • Objective : Unique Internal carotid artery angiographic findings have been found especially in very poor grade aneurysmal subarachnoid hemorrhage[SAH] patients before and during the endovascular coiling. The author investigates their patterns and classifies them into lour subtypes. Methods : Among Hunt&Hess grade IV, V SAH patients, the author could gather eight patients who showed abnormal intracranial circulation in cerebral catheter-based angiography. Results : The author introduces new term 'misery collaterals' first and has classified them into four types with the case illustrations. Type 1 is the worst condition defined as almost no intracranial circulation. Type 2 is the condition of little intracranial circulation with contrast filling just only at vessels of brain base, type 3 is of no or little cortical circulation with contrast filling at bilateral large vessels of brain base through circle of Willis channel and type 4 is of visible bilateral cortical circulation but delayed intracranial circulation time. The prognosis of these eight patients showed misery collaterals were disappointed. Conclusion : These finding can be used as the supportive information in deciding a management plan in poor grade SAH patients.

Intracranial Lipoma in Medulla Oblongata

  • Yun, Ji-Kwang;Kim, Dae-Won;Kim, Tae-Young;Kim, Jong-Moon
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.330-332
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    • 2007
  • Intracranial lipomas are rare, and most of these tumors are found in the region of the corpus callosum, followed by cerebellopontine angle. We present a case of a intracranial lipoma in 30-year-old man. Brain computed tomography [CT] scan and magnetic resonance images [MRI] showed a mass in the medulla oblongata extending to foramen magnum. The histopathologically, diagnosis of lipoma was confirmed. Although there were several cases of cervical intraspinal lipoma extending into posterior cranial fossa, there have been no previous reports of a lipoma arising from the medulla oblongata that extended into the foramen magnum. We describe a rare case of intradural subpial lipoma in the medulla oblongata with a review of the literature.

Surgical Management of Intracranial Aneurysms in the Endovascular Era : Review Article

  • Mason, Alexander M.;Cawley, C. Michael III;Barrow, Daniel L.
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.133-142
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    • 2009
  • The advent of endovascular therapy for intracranial aneurysms and the rapid advances in that field have supplanted microsurgical treatment for many intracranial aneurysms. Applying current outcome data and other parameters, nuances of selecting the modality of treatment for intracranial aneurysms are reviewed. Patient factors, such a age, co-morbidities, vasospasm and other medical conditions, are addressed. A custom-tailored multimodality treatment paradigm for the management of ruptured and unruptured aneurysms will maximize the favorable results seen in this difficult patient population.

Traumatic Spinal Subdural Hematoma Accompanying intracranial hematoma: Spontaneous Resolution after Pumbar Puncture (외상성 구개강내 출혈과 동반된 척추경막하 출혈; 요추 전자부 자연흡수)

  • Lee, Won Tae;Kim, Seok Won
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.93-96
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    • 2006
  • A traumatic spinal subdural hematoma is a rare condition, and only nine cases have been reported until now. We report a rare case of concomitant intracranial hemorrhage and spinal subdural hematoma with a review of the literature. A 45-year-old man was referred to our institute after being stroke by a car. He complained of nausea, headache, back pain, and bilateral sciatica. Brain computed tomography and lumbar spine magnetic resonance images revealed both an intracerbral hemorrhage and a subdural hematoma in the L4 to S1 level. After performing a lumbar spinal puncture and draining the hemorrhagic cerebrospinal fluid (CSF), the intracranial and spinal hematomas were resolved completely without any neruologic deficits.

Spontaneous Concomitant Intracranial and Spinal Subdural Hematomas in Association with Anticoagulation Therapy

  • Wang, Ui-Suk;Ju, Chang-Il;Kim, Seok-Won;Kim, Sung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.237-239
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    • 2012
  • Simultaneous intracranial and spinal subdural hematomas are extremely rare. In most cases, they are attributed to major or minor trauma and iatrogenic causes, such as those resulting from spinal puncture. To the best of the authors' knowledge, there has been only two reports of spontaneous concomitant intracranial and spinal subdural hematomas in a patient receiving anticoagulant therapy who had an absence of evident trauma history. We report on a case of spontaneous concomitant intracranial and spinal subdural hematomas that occurred in association with anticoagulant therapy and present a review of the relevant literature.

Intracranial ipoma : CT and MRI Findings

  • Lee, Jong-Deok;Choi, Chang-Min
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.3
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    • pp.830-833
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    • 2005
  • Intracranial lipomas are rare lesions, which are believed to be congenital malformations. They are usually asymptomatic incidental findings and localized in the midline. However, they may occasionally produce neurological symptoms such as seizure, headache, mental changes, paresis. Currently, diagnosis of intracranial lipomas is made on based of imaging modalities, particularly Magnetic resonance imaging(MRI). Because Lipomas are strongly adherent to the surroundings and typically enclose both vessels and nerves, Surgical approach is rarely indicated.

A Case Report of Spontaneous Intracranial Hypotension Treated with Cervical Epidural Blood Patch -A case report- (경추부 경막외 혈액 봉합술로 치료한 자발성 두개내 저압 -증례 보고-)

  • Chung, Sung-Won;Do, Hyun-Woo;Lee, Jung-Koo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.157-161
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    • 1999
  • We report a patient with spontaneous intracranial hypotension. In addition to the cardinal feature of a postural headache and a low CSF pressure, the patient also had subdural hematoma demonstrated by brain MRI. Radionuclide cisternography revealed a CSF leakage in the intracranium. CSF leakage from spinal meningeal defects may be the most common cause of this syndrome. The headache is a consequence of the low CSF pressure producing displacement of pain-sensitive structures. Methods of treatment are identical to those for post-dural puncture headaches. We experienced a patient with spontaneous intracranial hypotension developed in the intracranium who was successfully managed with a cervical blood patch.

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Intracranial Dissemination from Spinal Cord Anaplastic Astrocytoma

  • Jeong, Seong-Man;Chung, Yong-Gu;Lee, Jang-Bo;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.68-70
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    • 2010
  • We report a case of intracranial dissemination developing approximately 4 months after partial removal of a spinal cord anplastic astrocytoma in a 22-year-old male. He presented with paraplegia on initial admission at a local hospital. Spinal magnetic resonance (MR) images disclosed multiple intramedullary lesions at the T3-11. The tumor was partially removed. The final histologic diagnosis was anaplastic astrocytoma. Four months after the operation, he was admitted with the symptoms of headache and deterioration of consciousness. MR images showed enhanced lesions in the anterior horn of the left lateral ventricle, and septum pellucidum. He underwent computed tomography-guided stereotactic biopsy and histological appearance was consistent with anaplastic astrocytoma. The clinical course indicates that the tumor originated in the spinal cord and extended into the subarachnoid space, first the spinal canal and later intracranial.

A Case of Different Response of Miliary Lung and Intracranial Nodules to Antituberculous Therapy (항결핵제에 다른 반응을 보인 속립성 폐 결절과 두개강내 결절 1예)

  • Park, Kwang Young;Lee, Ho Jin;Jung, Jae Wook;Choi, Yoon Hee;Nam, Seung Bum;Ahn, Se Han;Kim, Cheol Hyeon;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.153-157
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    • 2008
  • Although a paradoxical response of tuberculosis to antituberculous therapy is not a rare phenomenon, it can be a clinical challenge to differentiate a paradoxical response from treatment failure. A 25-year-old woman was admitted for miliary lung nodules and multiple intracranial nodules. Antituberculous treatment was started with a preliminary diagnosis of tuberculosis based on the history and clinical findings. After one month, the military lung nodules improved while the intracranial nodules increased in size and number. Based on a stereotactic biopsy, it was confirmed that the intracranial lesions were tuberculomas. Although the therapeutic regimen was not changed, the symptoms eventually were ameliorated and the intracranial nodules improved two months later.

Surgical Results of Unruptured Intracranial Aneurysms in the Elderly: Single Center Experience in the Past Ten Years

  • Jung, Young-Jin;Ahn, Jae-Sung;Park, Eun-Suk;Kwon, Do-Hoon;Kwun, Byung-Duk;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.329-333
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    • 2011
  • Objective : As medical advances have increased life expectancy, it has become imperative to develop specific treatment strategies for intracranial aneurysms in the elderly. We therefore analyzed the clinical characteristics and outcomes of the treatment of unruptured intracranial aneurysms in patients older than 70 years. Methods : We retrospectively reviewed the medical records and results of neuroimaging modalities on 54 aneurysms of 48 consecutive patients with un ruptured intracranial aneurysms. ($mean{\pm}SD$ age, $72.11{\pm}1.96$ years; range, 70-78 years) who underwent surgical clipping over 10 years (May 1999 to June 2010). Results : Of the 54 aneurysms, 22 were located in the internal carotid artery, 19 in the middle cerebral artery, 12 in the anterior cerebral artery, and 1 in the superior cerebellar artery. Six patients had multiple aneurysms. Aneurysm size ranged from 3 mm to 17 mm ($mean{\pm}SD$, $6.82{\pm}3.07$ mm). Fifty of the 54 aneurysms (92.6%) were completely clipped. Three-month outcomes were excellent in 50 (92.6%) aneurysms and good and poor in 2 each (3.7%), with 1 death (2.0%). Procedure-related complications occurred in 7 aneurysms (13.0%), with 2 (3.7%) resulting in permanent neurological deficits, including death. No postoperative subarachnoid hemorrhage occurred during follow-up. The cumulative rates of stroke- or death-free survival at 5 and 10 years were 100% and 78%, respectively. Conclusion : Surgical clipping of unruptured intracranial aneurysms in elderly group could get it as a favorable outcome in well selected cases.