• Title/Summary/Keyword: Brain Lesion

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Preoperative Evaluation of Brain Lesion with $^{201}Tl$ Brain SPECT: Is It Useful to Differentiate Benign and Malignant Lesions? (수술 전 뇌 병변의 $^{201}Tl$ 뇌 SPECT: 양성과 악성 병변을 감별하는데 유용한가?)

  • Sohn, Hyung-Sun;Kim, Euy-Neyng;Kim, Sung-Hoon;Chung, Yong-An;Chung, Soo-Kyo;Bong, Yong-Gil;Lee, Youn-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.371-380
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    • 2000
  • Purpose: Thallim-201 ($^{201}Tl$) brain SPECT, which can represent cellular activity of brain lesions, may provide more useful information in differentiating between benign and malignant brain lesions more so than CT of MRI, that merely represents anatomic changes or breakdown of blood brain barrier. We used $^{201}Tl$ brain SPECT prospectively to evaluate the utility of $^{201}Tl$-indices as an indicator of benign or malig nant lesions. Materials and Methods: We studied 28 patients. There were 13 cases of benign lesions (3: nonspecific benign lesion, 3: meningioma, 2: low grade glioma, 1: tuberculoma, central neurocytoma, hemangioblastoma, radiation necrosis, and choroid plexus papilloma) and 15 cases of malignant lesions (6: glioblastoma multiforme, 5: anaplastic glioma, 2: medulloblastoma, 1: metastasis and lymphoma). In all patients, CT and/or MRI were obtained and then $^{201}Tl$ brain SPECT was obtained with measuring mean $^{201}Tl$ index and peak $^{201}Tl$ index. An unpaired t-test was performed to compare the $^{201}Tl$-indices and pathologic diagnoses to evaluate the utility of $^{201}Tl$-indices as all indicator of benign or malignant lesions. Results: There were no statistically significant difference in $^{201}Tl$-indices between benign and malignant brain lesion (p>0.05). Conclusion: These results demonstrated that we could not use $^{201}Tl$ indices on brain SPECT alone as an indicator of benign or malignant brain lesions.

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Periodic Lateralized Epileptiform Discharges Are lctal Phenomena, and Need an Antiepileptic Treatment (주기편측간질모양방전은 발작현상으로서 항경련제 치료가 필요하다)

  • Kim, Jae-Moon
    • Annals of Clinical Neurophysiology
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    • v.13 no.1
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    • pp.21-25
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    • 2011
  • Periodic lateralized epileptiform discharges (PLEDs) had been debated whether it is ictal or non-ictal phenomenon. As most of PLEDs occur in patients with acute structural lesions, some epileptologists prefer PLEDS as a non-ictal phenomenon, rather an obscure epiphenomenon of etiological diseases. But, almost half of the patients with PLEDs do not have acute structural lesions in the brain and metabolic disorders or old CNS lesions may cause PLEDs and even more, no brain lesion was identified in some patients. There are many data supporting PLEDs as ictal phenomena. Occurrence of PLEDs usually accompanied by decreased mentality and is improved as PLEDs disappeared. Current SPECT study showed marked hyperperfusion in the lesion side of PLEDs, that is striking evidence of PLEDs as ictal phenomena. Also careful review of EEG with PLEDs revealed it is a dynamic process rather than a static state. Despite of these evidences, as PLEDs are an end-stage of animal status epilepticus models, it may be a transition of ictal to interictal state.

Intraventricular Glioblastoma Multiforme with Previous History of Intracerebral Hemorrhage : A Case Report

  • Kim, Young-Jin;Lee, Sang-Koo;Cho, Maeng-Ki;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.405-408
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    • 2008
  • GBM is the most common primary brain tumor, but intraventricular GBM is rare and only few cases have been reported in the literature. The authors report a case of 64-year-old man who had a remote history of previous periventricular intracerebral hemorrhage. Brain computed tomography (CT) and magnetic resonance (MR) imaging showed an intraventricular lesion with inhomogeneous enhancement, infiltrative borders and necrotic cyst, and obstructive hydrocephalus. The patient underwent surgical removal through transcortical route via the bottom of previous hemorrhage site and the final pathologic diagnosis was GBM. We present a rare case of an intraventricular GBM with detailed clinical course, radiological findings, and pathological findings, and the possible origin of this lesion is discussed.

Effects of Olfactory Bulbectomy on Catalepsy Induced by Haloperidol in Rats (흰쥐에서 할로페리돌에 의해서 유발된 강경증에 미치는 후구 적출의 영향)

  • Chun, Seoung-Ho;Kim, Seon-Jang;Bae, Ki-Hwan;Lee, Soon-Chul
    • YAKHAK HOEJI
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    • v.36 no.5
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    • pp.427-432
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    • 1992
  • We attempted to clarify the effect of bilateral olfactory bulbectomy on catalepsy induced by haloperidol in rats. The incidence of catalepsy induced by haloperidol remarkably increased after lesion of olfactory bulb, which was significantly inhibited by L-5-hydroxytryptophan, L-DOPA, and ginseng's total saponin but reserpine and ${\alpha}-methyl-p-tyrosine$ were ineffective. The dopamine content of brain was significantly decreased by olfactory bulbectomy, but this result was reversed by ginseng's total saponin.

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MR Imaging and Histological Findings of Experimental Cerebral Fat Embolism in Cats

  • Park Byung-Rae;Ko Seong-Jin;Kim Hwa-Gon
    • Biomedical Science Letters
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    • v.10 no.3
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    • pp.285-291
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    • 2004
  • To determine the magnetic resonance (MR) imaging findings and natural history of cerebral fat embolism in a cat model, and to correlate the MR imaging and histologic fmdings. Intemel carotid artery of 11 cats was injected with 0.1 ml of triolein. T2-weighted, T1-weighted and Gd-enhanced T1-weighted images were obtained serially for 2 hours, 1 days, 4 days, 1 week, 2 weeks and 3 weeks after embolization. Any abnormal signal intensity was evaluated. After MR imaging at 3 weeks, brain tissue was obtained for light microscopic (LM) examination using hematoxylin-eosin (HE) and Luxol fast blue staining, and for electron microscopic examination. The LM examination with HE staining revealed normal histological findings in the greater part of an embolized lesion. Cystic change was observed in the gray matter of 8 cats, while in the gray and white matter of 3 cats. At LM examination, Luxol fast blue, staining demonstrated demyelination around the cystic change occurring in the white matter, and EM examination of the embolized cortex revealed sporadic intracapillary fat vacuoles (n=11) and disruption of the blood-brain barrier (n=4). Most lesions were normal, however, and perivascular interstitial edema and cellular swelling were mild compared with the control side. The greater part of an embolized lesion showed reversible findings at MR and histological examination. Irreversible focal necrosis was, however, observed in gray and white matter at weeks 3.

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Traumatic Brainstem Hemorrhage Presenting with Hemiparesis

  • Se, Young-Bem;Kim, Choong-Hyun;Bak, Koang-Hum;Kim, Jae-Min
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.176-178
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    • 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.

Involvement of Cortical Damage in the Ischemia/Reperfusion-Induced Memory Impairment of Wistar Rats

  • Hong, Jin-Tae;Ryu, Seung-Rel;Kim, Hye-Jin;Lee, Sun-Hee;Lee, Byung-Moo;Kim, Pu-Young
    • Archives of Pharmacal Research
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    • v.23 no.4
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    • pp.413-417
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    • 2000
  • The effect of ischemia/reperfusion-induced neuronal damage on the memory impairment were investigated using active avoidance and Morris water maze tasks in Wistar rats. Focal ischemia was induced by 1 h occlusion of the right middle cerebral artery (MCA) of Wistar male rats. Reperfusion was induced by releasing the occlusion and restoring the blood circulation for 24 h. The acquisition and preservation memory tested by active avoidance showed a significant difference between the sham and ischemia/reperfusion group. The water maze acquisition performance was also significant difference between sham and ischemia/repefusion groups in both latency and moving distance. The infarction volume was increased by the ischemia/reperfusion. Furthermore, the cresyl violet staining of the ischemia/reperfusion brain showed severe neuronal damage (pyramidal cell loss) in the cortex in addition to the striatum lesion of brain. This study shows that pyramidal cell damage in the cortex lesion may be partially related to memorial disturbance in the ischemia/reperfusion brain injury.

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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.

Sacral Intradural Cysticercosis Misdiagnosed as Brain Tumor Metastasis

  • Kim, Seok-Won;Lee, Seung-Myung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.67-69
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    • 2005
  • Spinal intradural cysticercosis is a rare manifestation of neurocysticercosis that may present as an isolated lesion. We report a case of sacral intradural cysticercosis misdiagnosed as a metastasis through cerebrospinal fluid seeding in a 48-year-old patient who underwent ependymoma surgery 3 months ago. We performed S1-2 laminectomy with the total removal of intradural lesion. The cysticercosis was confirmed histologically. The patient was given albendazole with corticosteroid.

Clinical Outcomes according to Radiological Classification of Brainstem Hemorrhages (방사선학적 출혈양상에 근거한 뇌간출혈의 분류에 따른 임상결과)

  • Cho, Won Jung;Moon, Seong Ho;Lee, Seung Min;Yang, Jae Young;Choi, Chun Sik;Ju, Mun Bae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.217-221
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    • 2000
  • Objective : Brainstem hemorrhages usually result in much higher mortality and morbidty than any other intracranial vascular lesions. The purpose of the study is to evaluate the relationship of the radiological classification of the lesions and the clinical outcomes, and to evaluate the value of such classification on the choice of management modality. Method : Thirty seven patients with primary brainstem hemorrhage were managed medically or surgically between Oct. 1995 and Mar. 1998. The lesions were classified as two groups based on radiological findings as follows : Focal subependymal hematoma(group I, n=7) and diffuse tegmentobasilar hemorrhage(group II, n=30). The outcomes at discharge were retrospectively reviewed according to such classification. Result : The most common clinical pictures and radiological findings in each group were as followings : 1) Group I : focal compressive lesion which displaces rather than destroys brain tissue. It occurs in a younger age group and causes neurological deficits which are often partially reversible. Operative hematoma evacuation was performed in 43.3%. Their mean improved Glasgow Coma Scale(GCS) score was 4.7. 2) Group II : hypertensive brain stem hemorrhage. It usually causes a diffuse lesion occurring in an older age group and most often associated with profound irreversible neurological deficits which are often fatal. Operative hematoma evacuation was performed in 16.7%. Their mean improved GCS score was 1.4. In both conservatively treated group I and II has no siginificant clinical improvement. Conclusion : Although there is an overlap among them and the size of the group is small, the pathophysiologic classification of this lesion based on clinical features and radiological findings may be useful for decision of treatment method.

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