• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.110-113
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• 2001

The cerebral arteriovenous malformation(AVM) rarely coexists with primary intracranial tumor. The authors experienced a patient with intracerebral hematoma due to AVM rupture in whom intracranial meningioma and intracranial aneurysms coexisted. The meningioma was located at convexity of right frontal lobe, and arteriovenous malformation at temporo-occipital lobe of same hemisphere with feeding from right middle cerebral artery, and three intracranial aneurysms exist at the cavernous portion of right internal carotid artery, AVM feeding artery, and intranidal of the AVM. The authors report a rare case of coexisted intracranial AVM, meningioma and aneurysms with review of literatures.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.49-52
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• 2007

The authors report a unique case of unilateral Moyamoya disease with a rare combination of arteriovenous malformation (AVM) who presented with intracerebral hemorrhage (ICH). A 50-year-old man suffered from sudden onset of mental deterioration and right hemiparesis. Brain computed tomography (CT) showed intracerebral hemorrhage on left thalamus. Brain CT angiography and cerebral digital subtraction angiography (DSA) revealed AVM combined with unilateral moyamoya disease involving left middle cerebral artery (MCA) and choroid plexus in left lateral ventricle. Intraventricular hemorrhage and hydrocephalus were managed conservatively. A rare case of unilateral Moyamoya disease accompanied by a cerebral arteriovenous malformation is described and discussed with review of pertinent literature.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1030-1036
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• 2000

본 논문에서 뇌동정맥기형에 대해 포톤나이프로 정위적 방사선 수술을 시행한 후 방사선학적으로 10명의 환자중 6례에서 완전 폐색, 4례에서 부분적 폐색을 보였으며, 특히 3cm이하의 작은 뇌동정맥기형 7례중 6례에서 완전 폐색을 보였다(완전 폐색율 : 85.7%). 모든 환자에서 방사선 수술로 인한 방사선학적 합병증의 발병은 없었다. 신경학적으로도 모든 환자에서 방사선 수술 전에 보이던 증상들이 호전을 보였다. 포톤나이프 방사선 수술 시스템은 이미 실험적으로 안정성이 검증된 것으로 이 논문에서 임상적으로 방사선 수술의 안정성 및 정확성을 다시 확인할 수 있었다. 정위적 방사선 수술은 지금까지 치료 불가능했던 부위에 생긴 병소, 수술이나 다른 치료방법으로 완전 제거에 실패한 경우, 노인환자나 다른 내과적 질환으로 수술이 어렵거나 수술적 치료를 거부하는 환자에서도 좋은 치료 방법으로 사용되어지며, 특히 뇌 중요부위나 심부병변에 위치한 경우 또는 최대직경이 3cm 이하의 소 동정맥기형으로 발견 당시 출혈량이 많지 않고 신경학적 결손이 경미한 환자에서 좋은 적응증이 되리라 사료된다.

• Radiation Oncology Journal
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• 제13권1호
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• pp.87-94
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• 1995

Since March 1992, total 200 patients who visited our hospital as functional or organic lesions of central nervous system were treated by gamma knife stereotactic radiosurgery for 27 months. Thirty-nine patients of total cases was diagnosed as cerebral arteriovenous malformation. The rate of magnification on X-ray film was reduced by cutting fixation adaptor from 1.0 to below 1.45 times. In order to treat the deep- and lateral-seated cerebral arteriovenous malformation, we slightly modified the angiographic indicator, the commercial Leksell system, by cutting each inner sides about 5mm, We performed the more distinction of the scales by adapting 0.5mm or 1mm copper filter to angiographic indicator. The center point of indicator(X=100mm, Y=100mm, Z=100mm) is corrected by adjusting scales of X-, Y-, Z-axis to each inner 100 and outer 100 point within 1-2mm by repeated exposure of X-ray on films in trial-and-errors. We have developed the 'GKANGIO' programed as the Fortran-77 in Microvax - 3100, which can save treatment planning time and perform accurate pretreatment planning using the theoretical target metrix center. The theoretical description of the simplified method is presented for the reduction of experimental and numerical errors in treatment planning of radiosurgery.

• Tuberculosis and Respiratory Diseases
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• 제52권5호
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• pp.545-549
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• 2002

임신시에 발생한 폐동정맥기형은 드문 질환으로 유전성 출혈성 모세혈관확장증과 같이 유전적으로 동반되어 나타날 수 있는 질환이다. 저자들은 임신시에 발생한 호흡곤란과 흉부방사선촬영상의 종괴를 주소로 내원한 환자에서 발견된 폐동정맥기형 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.83-88
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• 2015

Organized hematoma is a rare complication that can develop following gamma knife radiosurgery (GKS) for cerebral arteriovenous malformation (AVM). Here, we describe 5 patients with growing organized hematomas that developed from completely obliterated AVMs several years after GKS. The patients were 15, 16, 30, 36, and 38 years old at the time of GKS, respectively, and 3 patients were female. Four AVMs were located in the lobe of the brain, and the remaining AVM were in the thalamus. Between 2-12 years after GKS, patients developed progressive symptoms such intractable headache or hemiparesis and enhancing mass lesions were identified. Follow-up visits revealed the slow expansion of the hematomas and surrounding edema. Steroids were ineffective, and thus surgery was performed. Histology revealed organized hematomas with a capsule, but there was no evidence of residual AVMs or vascular malformation. After surgery, the neurological symptoms of all patients improved and the surrounding edema resolved. However, the hematoma continued to expand and intraventricular hemorrhage developed in 1 patient whose hematoma was only partially removed. GKS for cerebral AVM can be complicated by growing, organized hematomas that develop after complete obliteration. Growing hematomas should be surgically evacuated if they are symptomatic. Radical resection of the hematoma capsule is also strongly recommended.

• Journal of Korean Neurosurgical Society
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• 제66권2호
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• pp.199-204
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• 2023

It is critical to identify the ruptured cerebral arteriovenous malformations (AVMs) for secondary prevention. However, there are rare cases unidentified on the radiological evaluation. We report on a patient with the delayed appearance of radiologically occult AVM as a probable cause of the previous intracerebral hemorrhage (ICH). An 18-year-old male patient presented with a right temporal ICH. The preoperative radiological examination did not reveal any causative lesions. Because of the intraoperative findings suggesting an AVM, however, only hematoma was evacuated. Disappointedly, there were no abnormal findings on postoperative and follow-up radiographic examinations. Eleven years later, the patient presented with an epileptic seizure, and an AVM was identified in the right temporal lobe where ICH had occurred before. The patient underwent partial glue embolization followed by total surgical resection of the AVM and anterior temporal lobe. Based on the literature review published in the era of magnetic resonance imaging, common clinical presentation of radiologically occult AVMs included headache and seizure. Most of them were confirmed by pathologic examination after surgery. In cases of the ICH of unknown etiology in young patients, long-term follow-up should be considered.

• Journal of Korean Neurosurgical Society
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• 제38권6호
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• pp.471-474
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• 2005

Pure sylvian fissure arteriovenous malformations[AVMs] are vascular malformations confined to the sylvian fissure without parenchymal involvement. Surgical removal is regarded as difficult because the nidus is located just lateral to important structures such as the basal ganglia and the internal capsule. Because most feeding arteries to the nidus are branches of the middle cerebral artery[MCA], differentiation between these feeders from en passant and normal vessels is of great importance in order to reduce morbidity and mortality from surgical intervention. We report a case of pure sylvian fissure AVM who presented with an intra-temporal lobe hematoma that was located around venous aneurysms distant from the nidus. The clinical characteristics of this AVM and the surgical methods employed to avoid complications are discussed.

• Korean Journal of Radiology
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• 제1권4호
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• pp.208-211
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• 2000

We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed microcatheter, was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superselective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recognition and closure of the perforation site is essential for good prognosis.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.401-404
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• 2009

Arteriovenous malformations (AVM) are generally considered to be cured following angiographically proven complete resection. However, rare instances of AVM recurrence have been reported in both children and adults with negative findings on postoperative angiography. The authors present the case of a 12-year-old boy with recurrent AVM. The AVM was originally fed by the pericallosal arteries on both sides, and it showed changing patterns of supply at recurrence. The authors concluded that a negative postoperative angiogram is not necessarily indicative of a cure. Repeat angiography and regular follow-up examinations should be performed to exclude the possibility of recurrence, especially in children.