• Title/Summary/Keyword: progressive patient

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Isolated Cortical Vein Thrombosis with Long Cord Sign

  • Ban, Seung Pil;Chung, Young Seob;Park, Sung Bae;Son, Young-Je
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.476-478
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    • 2015
  • Isolated cortical vein thrombosis (ICVT) is a rare disease, accounting for less than 1% of strokes. A 46-year-old woman presented with progressive left side weakness. Magnetic resonance (MR) imaging with $T2^*$-gradient echo ($T2^*$-GE) sequence showed long cord sign at the right frontal cortex. The patient was treated with low molecular weight heparin, followed by oral warfarin for 6 months. The 3-month follow-up MR imaging showed recanalization of the previously thrombosed cortical vein. She was completely recovered without neurological deficits after 6 months. This provides that MR imaging with $T2^*$-GE sequence can help to diagnosis the ICVT and outcomes of the ICVT are generally favorable.

Glioblastoma Following Radiosurgery for Meningioma

  • Lee, Hyun-Seok;Kim, Jong-Hyun;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.98-101
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    • 2012
  • We report a patient who underwent gamma knife radiosurgery to treat recurrent meningioma after microsurgery and thereafter developed secondary malignancy adjacent to the original tumor. A 47-year-old woman had underwent resection of the olfactory groove meningioma. Then radiosurgery was done three times over 4 year period for the recurrent tumor. After 58 months from the initial radiosurgery, she presented with headache and progressive mental dullness. Huge tumor in bifrontal location was revealed in MRI. Subsequent operation and pathological examination confirmed diagnosis of glioblastoma. This case fits the criteria of radiation-induced tumor and the clinical implication of the issue is discussed.

Thoracic Extraosseous Epidural Cavernous Hemangioma

  • Yaldiz, Can;Asil, Kiyasettin;Ceylan, Davut;Erdem, Sahin
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.65-67
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    • 2015
  • Cavernous hemangiomas were first reported in 1929 by Globus and Doshay, and are defined as benign vascular structures developed between the neural tissues occurring in the central nervous system, consisting of a dilated vascular bed. Cavernous hemangiomas comprise nearly 5-12% of all spinal vascular malformations; however, existence in the epidural space without bone involvement is rare. Only 4% of all cavernous hemangiomas (0.22/1.000.000) are purely epidural cavernous hemangiomas. In this case report, we removed a hemorrhagic thoracic mass presenting with progressive neurological deficits in a 55-year-old male patient. We found this case to be appropriate for presentation due to the rare occurrence of this type of cavernous hemangioma.

Intraorbital Encephalocele Presenting with Exophthalmos and Orbital Dystopia : CT and MRI Findings

  • Asil, Kiyasettin;Gunduz, Yasemin;Yaldiz, Can;Aksoy, Yakup Ersel
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.58-60
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    • 2015
  • A 15-year-old female patient with progressive pulsatile exophthalmos caused by intraorbital encephalocele was evaluated with computed tomography (CT) and magnetic resonance imaging (MRI) in our clinic. She had no history of trauma or reconstructive surgery. When she was a little girl, she had undergone surgery for congenital glaucoma on the right eye. On the three-dimensional image of CT, a hypoplasic bone defect was observed in the greater wing of the right sphenoid bone. MRI and CT scan showed herniation through this defect of the arachnoid membrane and protruded cerebral tissue into the right orbita. Intraorbital encephalocele is an important entity that can cause pulsatile exophthalmos and blindness.

Hemifacial Spasm Caused by Fusiform Aneurysm at Vertebral Artery-Posterior Inferior Cerebellar Artery Junction

  • Choi, Seok-Keun;Rhee, Bong-Arm;Park, Bong-Jin;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.399-400
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    • 2008
  • Hemifacial spasm induced by intracranial aneurysm is a rare clinical condition. A 45-year-old male patient presented with a 3-year history of progressive involuntary twitching movement on right face. On radiological study, a dilated vascular lesion compressing the brain stem was found at the junction of vertebral artery and posterior inferior cerebellar artery. On operative field, we found the posterior inferior cerebellar artery and the fusiform aneurysm compressing root exit zone of facial nerve. Microvascular decompression was performed and the facial symptom was relieved without complications.

Primary Intracranial Squamous Cell Carcinoma in the Brain Stem with a Cerebellopontine Angle Epidermoid Cyst

  • Kim, Min-Su;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.401-404
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    • 2008
  • Primary intracranial squamous cell carcinoma is extremely rare, with most cases arising from a preexisting benign epidermoid cyst. We report a rare case of primary intracranial squamous cell carcinoma in the brain stem with a cerebellopontine angle (CPA) epidermoid cyst. A 72-year-old female suffered from progressive left hemiparesis, difficulty in swallowing, and right hemifacial numbness. Diffusion-weighted magnetic resonance imaging revealed a high signal intensity (SI) lesion in the CPA region and an intra-axially ring-enhanced cystic mass in the right brain stem with low SI. Whole-body positron emission tomography showed no evidence of metastatic disease. The histological findings revealed a typical epidermoid cyst in the CPA region and a squamous cell carcinoma in the brain stem. We speculate that the squamous cell carcinoma may have been developed due to a chronic inflammatory response by the adjacent epidermoid cyst. The patient underwent a surgical resection and radiotherapy. After 12 months, she had no evidence of recurrence.

Infiltrating Spinal Angiolipoma

  • Han, Seong-Rok;Yee, Gi-Taek;Choi, Chan-Young;Lee, Chae-Heuck
    • Journal of Korean Neurosurgical Society
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    • v.52 no.2
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    • pp.161-163
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    • 2012
  • Spinal angiolipomas are rare lesions usually found in the epidural space of the thoracic spine. The infiltrating type of spinal angiolipomas is extremely rare. This report presents the case and reviews the related literature. A 58-year-old man was presented with a 7-month history of progressive weakness and sensory change of lower extremities. Magnetic resonance images showed a well-enhanced mass infiltrating the vertebral foramen at the T4-5 level. Resection of the tumor was performed. Histological study revealed the tumor as an angiolipoma. The patient was relieved from symptoms after tumor resection.

Hemifacial Spasm Caused by Epidermoid Tumor at Cerebello Pontine Angle

  • Choi, Seok-Keun;Rhee, Bong-Arm;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.196-198
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    • 2009
  • Hemifacial spasm (HFS) is almost always induced by vascular compression but in some cases the cause of HFS are tumors at cerebellopontine angle (CPA) or vascular malformations. We present a rare case of hemifacial spasm caused by epidermoid tumors and the possible pathogenesis of HFS is discussed. A 36-year-old female patient presented with a 27-month history of progressive involuntary facial twitching and had been treated with acupuncture and herb medication. On imaging study, a mass lesion was seen at right CPA. Microvascular decompression combined with mass removal was undertaken through retrosigmoid approach. The lesion was avascular mass and diagnosed with an epidermoid tumor pathologically. Eventually, we found a offending vessel (AICA : anterior inferior cerebellar artery) compressing facial nerve root exit zone (REZ). In case of HFS caused by tumor compression on the facial nerve REZ, surgeons should try to find an offending vessel under the mass. This case supports the vascular compression theory as a pathogenesis of HFS.

Total Ankle Replacement (족관절 인공 관절 치환술)

  • Choi, Gi-Won;Choi, Woo-Jin;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.132-138
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    • 2011
  • Although first generation total ankle replacement (TAR) had high failure rates, recent investigations have reported good results of the newer generations of TAR due to advances in implant designs and techniques. Patient selection is critical to performing TAR to obtain promising outcomes and to decrease complication rate. As the current concepts of correcting the accompanying deformity have been established, TAR in moderate to severe varus deformity of the ankle result in favorable outcomes and indications for TAR are expanding. Correction of deformity and hindfoot fusion should be performed in conjunction with TAR if needed. If radiolucency around components or osteolysis is progressive during follow-up, CT should be carried out as a confirmative diagnostic method. TAR is an effective treatment modality alternative to ankle fusion. However, we should recognize that TAR is a demanding procedure, which requires accurate techniques, enough experience, and preoperative plan for a concomitant deformity.

A Case of Lymphangioleiomyomatosis Looked Like Miliary Tuberculosis (속립성 결핵으로 오인된 폐임파관평활근종증)

  • Won, Kyoung-Sook;Park, Keun-Uk;Park, Hyun-Jin;Kim, In-Soo;Jeong, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.244-249
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    • 1995
  • We experienced one case of pulmonary lymphangioleiomyomatosis in 26-year-old female patient. She had taken antituberculous medication under the impression of miliary tuberculosis on simple chest X-ray at peripartum period. On outpatient follow-up she complained of progressive exertional dyspnea in spite of medication. Through careful history taking and physical examination, high resolutional CT, and open lung biopsy she was diagnosed as pulmonary lymphangioleiomyomatosis combined with incomplete type of tuberous sclerosis. So, we presented the case with the brief review the literatures.

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