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Cystoperitoneal Shunting after Fenestration of an Enlarging Arachnoid Cyst

  • Jeon, Ik-Chan;Kim, Min-Su;Kim, Seong-Ho;Jang, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.160-164
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    • 2008
  • A two-month-old girl with a history of an incidental arachnoid cyst in the prenatal period (38 weeks) presented with persistent irritability. A follow-up computed tomographic (CT) scan revealed an enlarged arachnoid cyst with hydrocephalus. We performed craniotomy and fenestration, but the cyst size did not decrease, and hydrocephalus had worsened on a follow-up CT scan performed 13 months after fenestration. The patient was treated with cystoperitoneal shunting. Follow-up magnetic resonance imaging (MRI) performed 5 years later revealed that the arachnoid cyst had decreased in size and that the hydrocephalus had resolved. Enlarging arachnoid cysts are not common, and optimal surgical treatment is uncertain. Based on the features of this case, we believe cystoperitoneal shunting is an advisable surgical intervention for patients with enlarging arachnoid cysts presenting with hydrocephalus.

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A Case of Decannulation Difficulty Due to Cricoid Stenosis (윤상연골 협착에 의한 기관 Cannula 발거곤란증의 치험 1례)

  • 송기준;김흥곤;이형석;추광철;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.12-12
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    • 1982
  • We have recently experienced a case of decannulation difficulty resulted from head and thoracic injury. The patient was 21-year-old male who undergone craniectomy and tracheotomy at other hospital about 7 months ago prior to admission On admission, there was swelling in glottic and subglottic region in indirect laryngoscopy and bronchoscopy with fixation of vocal cords in paramedian position. We tried to reestablish an adequate air way with bougination using Jackson esophageal bougie but there was no effect with it. So we performed vertical incision through cricoid cartilage and tracheal rings and insertion of Teflon tube in stenotic lesion for 9 months and removed it. At present time, the patient has been satisfactory corking training course.

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Progression of Subdural Effusion after Surgical Treatment (뇌경막하수종의 수술적 치료에 따른 임상 경과)

  • Kim, Jaehyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1765-1773
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    • 2013
  • The purpose of this study was to contribute to the medical treatment of subdural effusion through clinical sequence analysis of patients who experienced improvement of subdural drainage and had a second operation for subdural drainage or subduroperitoneal shunt. Sixteen cases of the whole patients who have been underwent subdural effusion and subdural drainage were analyzed during the period from 2006 July to 2012 June. The study gave us a result that all of patients, who was taking aspirin, have been under the second operation(p<0.001) and these group have had a subduraoperitoneal shunt(p=0.014)). According to the comparative analysis for the patients group that divided into two; one had subduroperitoneal shunt and the other had no subduroperitoneal shunt, the outcomes of this study were shown as follows. First, their median line deviation was serious in their brain CT. In addition, their subdural effusion increased or did not change with a headache, vomiting, fever and dyspnea. As a result of those symptoms. subduraoperitoneal shunt was carried out(p=0.006). The surgical method for patients who were taken asprin must be cautiously selected and the prevention of sudden disappearance of cerebrospinal fluid and excessive change of intracranial pressure is very important in operation craniectomy.

The Effect for Intracranial Pressure during Laryngoscopy and Endotracheal Intubation (기관내삽관이 뇌압변동에 미치는 영향)

  • Kim, Heung-Dae;Chi, Yong-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.45-51
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    • 1985
  • It is well known that intracranial pressure (ICP) and mean arterial pressure (MAP) are increased by laryngoscopy and endotracheal intubation during induction of general anesthesia, and It may be very dangerous in neurosurgical patients who had increased ICP. Therefore, this study was performed to know the range of ICP increase during induction of the conventional general anesthesia with intubation following thiopental and succinylcholine injections. Intracranial pressure and MAP were measured in 13patients who underwent cramotomy. All the patients were monitored cerebral epidural ICP and intra-arterial pressure pre-operatively. The results were as follow: 1. Intracranial pressure was increased of $7.1{\pm}7.23mmHg$. 2. Arterial pressure was increased of $43.5{\pm}25.46mmHg$. 3. Cerebral perfusion pressure was increased of $33.3{\pm}27.53mmHg$. It is stressed that certain procedures are necessary to prevent from further increase of ICP due to induction of general anesthesia in patients with increased ICP.

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Case Report of Brain Metastsis of Primary Cardiac Chondrosarcoma without Primary Recurrence (원발성 심장 연골육종 증례보고)

  • 왕영필;연성모;조건현;곽문섭;김세화;문석환
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1276-1280
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    • 1996
  • Because of paucity of primary cardiac tumors, primary cardiac tumors are of much interest to the pathologist, cardiologist and cardiac surgeon. A cardiac chondrosarcoma, which very rare, is presented as follows: This 37 year-old female patient was admitted under the diagnosis of a left atrial tumor(myxoma) on July 3, 1993. Using the CPB, she underwent complete removal of tumor including the atrial septum. And final pathology report was chondrosarcoma. The adjuvant irradiation with total dose of 5040 cGy(28 fractiations for 2 months) and chemotherapy(VP-16 and ifosfamide) was completed. She had no evidence of recurrence until May 2, 1995. when she was admitted due to brain metastasis, which was detected by MRI scan with a tumor free interval for 2 years. A tumor, located around the frontoparital cortex was removed neurosurgern on Sep. 13, 1995 and the final pathology report was also a chondrosarcoma on pathologic exam. The postoperative course was uneventful.

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A Case Study of Eyelid Edema Post Craniotomy (개두술 후 발생한 안검부종에 대한 치험 1례)

  • Kim, Seo-young;Choi, Jeong-woo;Yim, Tae-bin;Lee, Hye-jin;Cho, Seung-yeon;Park, Seong-uk;Park, Jung-mi;Ko, Chang-nam
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.939-948
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    • 2021
  • Objectives: This study considered the effectiveness of Korean medicine for the treatment of eyelid edema post craniotomy. Methods: The patient was diagnosed with Taeumin-one of the four constitution types in Korean medicine-and treated with herbal medicines: Cheongsimyeunja-tang, Chungpyesagan-tang, and Hwangryunhaedok-tang pharmacoacupuncture treatment. The severity of eyelid edema was assessed using Kara and Gokalan's scale, daily imaging of the patient's eyelids, and the ratio of the length of the left eye to that of the right. Results: Following treatment, the Kara and Gokalan score decreased from 3 to 0. The changes in the ratios were 29% and 50%, respectively. The visual field defect due to edema in the left eye was also repaired. Conclusion: This study suggests that Korean medical treatment could be an effective option for treating eyelid edema following craniotomy.

A Case of Cerebral Metastasis from Malignant Fibrous Histiocytoma (뇌로 전이한 악성 섬유성 조직구종 1례)

  • Kang, Kwan-Soo;Lee, Jung-Il;Suh, Yeon Lim
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1340-1344
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    • 2001
  • This is a rare case of cerebral metastasis from malignant fibrous histiocytoma(MFH) of the soft tissue. A 62-year-old man underwent craniotomy for resection of multiple intracerebral masses under the impression of metastatic brain tumor with unknown primary site. Preoperative investigation failed to detect any extracranial lesion. At six months after the operation and whole brain radiotherapy, right shoulder mass was detected to grow and excised. Specimen from the brain and shoulder lesions revealed identical pathological findings of malignant fibrous histiocytoma except existence of glial fibrillary acidic protein(GFAP)-positive cells only in brain lesions. Palliative radiotherapy was performed for subsequently developing metastatic lesions in skeletal system. At twelve months after initial diagnosis recurrent lesion at right shoulder was detected and chemotherapy is given. This case is unique because metastatic brain lesion from MFH is rare and also cerebral metastasis as an initial manifestaion of MFH has not been reported before. Another important finding is that there was expression of GFAP only in brain lesions but not in extracranial primary site lesion. Although the presence of GFAP-positive cells is thought as one of characteristic histological findings of primary intracrainal MFH, our observation supports the hypothesis that GFAP-positive cells in primary intracranial MFH may be nonneoplastic astrocytes secondarily involved by MFH.

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Radiotherapy for the Low-grade Astrocytomas (양성 성상세포종의 방사선치료)

  • Kim, Dae-Yong;Kim, Il-Han;Chi, Je-Geun
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.1-7
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    • 1995
  • Purpose : To evaluate the efficacy of radiotherapy for the low-grade astrocy-tomas and confirm the variables influencing treatment results. Materials and Methods : Forty-six patients with low-grade astrocytoma received radiotherapy after surgical removal (36 patients) or biopsy (10 patients) from 1979 to 1990. Twenty patients had grade I histology and 26 had grade II. External radiotherapy was done by conventional schedule with the total dose of 45 to 60 Gy (median: 54 Gy). The median follow-up period was 5 years. Results : The 2- and 5-year survival rates were $80\%$ and $72\%$, respectively and the 2- and 5-year progression-free survival was $75\%$ and $63\%$, respectively. The survival was influenced significantly by the histologic grade, the histologic type, and performance status. Major complication was not found. Conclusion: In spite of good survival, the local failure was still the major problem. Age and the extent of surgery as well as three favorable factors should be considered in the future treatments.

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Clinical Analysis of C.N.S. Cysticercosis (뇌 낭미충증에 관한 임상적 연구)

  • Cho, Soo-Ho;Moon, Choong-Bae;Choi, Byung-Yearn
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.25-34
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    • 1984
  • During last 10 years we experienced 25 cases of C.N.S. cysticercosis. Now clinical analysis and evaluation of our cases were made and the results are followings: 1. Prevalence in man and women are nearly same and about 70% of cases are distributed between 20-50 years old. 2. According to Nieto's classification, mostly are ventricular (44%) and parenchymal type (36%). 3. Clinical manifestations were IICP (92%), focal neurological deficits (68%), seizure (48%), altered mental status (36%) and others listed on table 7. 4. In ventricular type, IICP and cerebellar dysfuction signs were predominated but seizure and focal neurological deficits were commonly seen in parenchymal type. 5. Subcutaneous cysticercus nodules were palpated in 32 % of cases. 6. Positive stool ova was observed in 29% of cases. 7. Radiologic studies revealed as followings: 16 % of cases showed abnormal findings on plain film, 84% on angiography, 94% on ventriculography and 100% on computed tomography and myelography. Computed tomography looks like most helpful diagnostic method for C.N.S. cysticercosis, they ususally revealed lucent cystic lesion, hydrocephalic findings and contrast enhancement. 8. Suboccipital craniectomy, craniotomy with removal of parenchymal cyst or laminectomy were done according to location and types of lesion. 72 % of operated cases revealed good results and motarlity was 4 % of cases.

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The Effectiveness of Bladder Training on Self Voiding after Removal of Catheter in Female Patients with Craniotomy (개두술 여성환자에게 시행한 방광훈련이 유치도뇨관제거후 자가배뇨에 미치는 효과)

  • Lee, Jung-Lim;Kim, Keum-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.72-84
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    • 1999
  • The purpose of this study was to identify the effectiveness of bladder training on self voiding after removal of catheter in female patients with craniotomy, finally to develop a bladder rehabilitation program for cognitive impaired patients. Nonequivalent control group posttest design was used. The population of this study consisted of 34 hospitalized neurosurgical patients, all patients have been received craniotomy. 17 patients were assigned to the experimental group and another 17 patients to the control group. The homogeneity of general characteristics of the subjects was no significant difference. Bladder training program consisted of pre-training education, the bladder training, positive verbal reinforcement. The experimental group has been received bladder training and the control group has been received gravity drainage. The dependent variable, the frequency of voiding trial untill self voiding achieves, the frequency of urinary retention, the amount of residual urine, the occurrence, of urinary incontinence, were measured during 3 days after catheter removed. The data analyzed with SPSSWIN ; frequency, percentage, t-test and $X^2$-test were used to analyze homogeneity of general characteristics of subjects between the experimental and the control group. T-test, Mann-Whitney U test, and $X^2$-test were used to determine the effect of bladder training. The result of the study were as follows : There was significant difference in the frequency of voiding trial untill self voiding achieves between the experimental group and the control group. There was no significant difference in the frequency of urinary retention between the experimental group and the control group. There was no significant difference in the amount of residual urine between the experimental group and the control group. However, there was significant difference in the amount of residual urine in urinary retention patients. There was significant difference in the occurrence of urinary incontinence between the experimental group and the control group. In conclusion, bladder training program as a nursing intervention was effective in conclusion, bladder self voiding ability after removal of catheter for craniotomy patients. Therefore, it is recommended to use the bladder training program clinically for the bladder management of cognitive impaired patients.

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