• 한국임상수의학회지
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• 제26권1호
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• pp.104-108
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• 2009

Global cerebral ischemia occurs commonly in patients who have a variety of clinical conditions including cardiac arrest and shock. Cerebral ischemia results in a rapid depletion of energy stores that triggers resulting in excitotoxic death. Imaging studies of the brain with computed tomography(CT) or magnetic resonance imaging(MRI) are necessary to confirm the clinical neurolocalization, identify any associated mass effect, and rule out other causes of focal brain disorders. Cardiopulmonary arrest was occurred by propofol anesthesia in a 1 year old, intact female Beagle dog. After successful cardiopulmonary resuscitation was performed within 5 minutes, clinical signs such as vocalization, paddling, opisthotonus and seizure were represented. At the 12th day, CT and MRI examinations of the brain were performed to evaluate the brain. After euthanasia, histopathologic examination was performed. On transverse image of CT, lesions appeared as a hypodense in the right dorsal surface of the frontal lobe and level of optic canal, and dorsomedial surface of occipital lobe of cerebrum. No contrast enhancement was represented following intravenous contrast administration. On MR images of brain, the lesions were seen as a hyperintense on T2-weighted(T2W) images and a isointense or mild hypointense on T1-weighted(T1W) images. Hyperintense lesions both T2W and T1W images were observed at the surrounding cerebral sulcus. There was no significant signal changes on contrast T1WI. Histopathologic examination after euthanasia revealed that the lesion was necrosis of the cerebral cortex caused by cerebral ischemia.

• 한국정밀공학회지
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• 제23권1호
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• pp.209-215
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• 2006

The present study purposed to examine differences between 20s and 40s in visuospatial performance, the number of activated yokels and cerebral lateralization using functional Magnetic Resonance Imaging (fMRI). For this study, eight college students in their twenties (21.5 years on the average) and six adults in their forties (45.7 years on the average) participated in the experiment. Functional brain images were taken from 37 MRI using the single-shot EPI method. Compared to the twenties the forties showed lower visuospatial performance and longer reaction time. In addition, compared to the twenties the forties had a smaller number of activated yokels and less cerebral lateralization. The results of this study show that people's visuospatial performance and number of activated yokels decrease with aging. In addition, they also suggest that cerebral lateralization decreases in order to supplement the lowering of visuospatial performance, which in turn symmetrizes the activation of the left and right hemisphere.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.181-184
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• 2010

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions.

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.246-249
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• 2012

Intracranial extraskeletal myxoid chondrosarcoma is extremely rare, with only seven patients previously reported. We present a case report of a 21-year-old woman admitted for weakness in her right extremities and symptoms of increased intracranial pressure. Magnetic resonance imaging (MRI) revealed hydrocephalus and a well-enhanced large mass around her left thalamus. A left parietal craniotomy and a cortisectomy at the superior parietal lobule were performed. Total surgical resection was also performed, and pathology results confirmed an extraskeletal myxoid chondrosarcoma. Postoperative MRI showed no residual tumor, and the patient underwent radiotherapy. After six months of radiotherapy, the patient's headache and weakness had improved to grade IV. This malignant tumor showed high rates of recurrence in previous reports. We here report another occurrence of this highly malignant and rare tumor in a patient treated using total surgical excision and adjuvant radiotherapy.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.515-517
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• 2011

Hypoglossal nerve palsy (HNP) is an uncommon neurological abnormality that can provoke characteristic clinical signs, including unilateral atrophy of the tongue musculature. We present the case of a healthy 11-year-old Korean male who was admitted to the outpatient department of our institution with acute onset dysarthria, tongue fasciculations, and right-sided tongue weakness upon awakening. His evaluation included a virology work-up, neck magnetic resonance imaging (MRI), brain MRI, and otorhinolaryngological physical examination; all tests were normal and showed no evidence of inflammation. Fifteen days after the onset of symptoms, the patient recovered completely. Herein, we report a case of idiopathic isolated HNP in a Korean male.

• Childhood Kidney Diseases
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• 제10권2호
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• pp.238-243
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• 2006

Nephrotic syndrome in childhood is known to be associated with a hypercoagulable state and thromboembolic complications, among which cerebral venous thrombosis is a very rare and serious one, with only a few isolated reports in the literature. A 9-year-old boy with known nephrotic syndrome was admitted due to a relapse with massive proteinuria and generalized edema. He complained of a prolonged frontal headache. The enhanced brain magnetic resonance imaging(MRI) showed a high signal in the region of the superior sagittal sinus and right transverse sinus consistent with a thrombus. He was managed with steroids, cyclosporine and warfarin. His headache subsided 2 weeks later and proteinuria resolved 1 month later. An MRI 2 months later was normal. We describe this case and review the literature to emphasize the importance of recognizing this potentially life threatening complication and initiating anticoagulation therapy.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.822-825
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• 2000

Lymphocytic infundibuloneurohypophysitis is a rare inflammatory disorder, which may be caused by autoimmune response, affecting the infundibulum and the posterior lobe of the pituitary gland. The authors present a 15-year-old man with central diabetes insipidus, whose sellar magnetic resonance imaging (MRI) showed a focal thickening of the infundibulum and loss of high signal of the normal neurohypophysis on T1-weighted images. The histopathological diagnosis was lymphocytic infundibuloneurohypophysitis. When a patient presents with central diabetes insipidus and infundibular thickening on brain MRI, this entity should be included in the differential diagnosis though it is very rare. The significance of this entity in treatment is that it is basically not a surgical one, and surgery is needed only for tissue diagnosis. Symptomatic treatment and observation make it regress spontaneously.

• Journal of Korean Neurosurgical Society
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• 제45권2호
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• pp.118-121
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• 2009

Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma or an adjacent pituitary gland. Pituitary apoplexy may be associated with a variety of neurological and endocrinological signs and symptoms. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe two cases of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. In one case, brain magnetic resonance imaging (MRI) revealed a mass in the pituitary fossa with signs of hemorrhage, upward displacement of the optic chiasm, erosion of the sellar floor and invasion of the right cavernous sinus. In the other case, MRI showed a large area of insufficient enhancement in the anterior pituitary consistent with pituitary infarction or Sheehan's syndrome. We performed neurosurgical decompression via a transsphenoidal approach. Both patients showed an uneventful recovery. Both cases of isolated third cranial nerve palsy with ptosis completely resolved during the early postoperative period. We suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and that prompt neurosurgical decompression should be considered for the preservation of third cranial nerve function.

• Journal of Korean Neurosurgical Society
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• 제45권2호
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• pp.107-111
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• 2009

Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.

• 한국임상수의학회지
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• 제29권4호
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• pp.328-330
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• 2012

본 환축은 안구진탕, 좌측 편측보행을 주증으로 내원하여 MRI 검사 및 조직병리학적 검사로 수막종으로 진단 하였다. 초기에 prednisolone과 hydroxyyrea를 투약하였으나 증상의 악화로 중단하였으며, 이후 lomustine 화학요법을 실시하여 임상 증상이 개선되어 유지해오다가 증상이 발현 된지 18개월째에 자연사한 증례이다.