• Clinical and Experimental Pediatrics
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• v.61 no.8
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• pp.245-252
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• 2018

Purpose: This study investigated patterns of ischemic injury observed in brain images from patients with neonatal group B Streptococcal (GBS) meningitis. Methods: Clinical findings and brain images from eight term or near-term newborn infants with GBS meningitis were reviewed. Results: GBS meningitis was confirmed in all 8 infants via cerebrospinal fluid (CSF) analysis, and patients tested positive for GBS in both blood and CSF cultures. Six infants (75.0%) showed early onset manifestation of the disease (<7 days); the remaining 2 (25.0%) showed late onset manifestation. In 6 infants (75%), cranial ultrasonography showed focal or diffuse echogenicity, suggesting hypoxic-ischemic injury in the basal ganglia, cerebral hemispheres, and periventricular or subcortical white matter; these findings are compatible with meningitis. Findings from magnetic resonance imaging (MRI) were compatible with bacterial meningitis, showing prominent leptomeningeal enhancement, a widening echogenic interhemisphere, and ventricular wall thickening in all infants. Restrictive ischemic lesions observed through diffusion-weighted imaging were evident in all eight infants. Patterns of ischemic injury as detected through MRI were subdivided into 3 groups: 3 infants (37.5%) predominantly showed multiple punctuate lesions in the basal ganglia, 2 infants (25.0%) showed focal or diffuse cerebral infarcts, and 3 infants (37.5%) predominantly showed focal subcortical or periventricular white matter lesions. Four infants (50%) showed significant developmental delay or cerebral palsy. Conclusion: Certain patterns of ischemic injury are commonly recognized in brain images from patients with neonatal GBS meningitis, and this ischemic complication may modify disease processes and contribute to poor neurologic outcomes.

• Journal of Veterinary Clinics
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• v.22 no.3
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• pp.190-193
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• 2005

The concentration of tartrate resistant acid phosphatase (TRAP) in synovial fluid of normal stifle joint was investigated in order to establish a baseline data to distinguish between healthy joint and joint with injury of cranial cruciate ligament (CCL). Twenty three mixed-breed healthy dogs free from joint diseases (fourteen adult and nine young) were used in this study. The dogs were sedated and synovial fluid was collected from the femoropatellar compartment of stifle joints by direct arthrocentesis. The concentration of TRAP in synovial fluid was determined using the method of Lang. The concentration of TRAP were $0.083{\pm}0.039$ IU/ml in adult dogs, $0.064{\pm}0.023$ IU/ml in young dogs, $0.075{\pm}0.028$ IU/ml in large dogs (>22 kg), $0.076{\pm}0.046$ IU/ml in small dogs (<22 kg), $0.085{\pm}0.036$ IU/ml in neutered dogs and $0.056{\pm}0.022$ IU/ml in intact dogs. The concentration of TRAP in the neutered dogs was significantly (p<0.05) higher than the intact dogs. This data can be used baseline data for a comparison with joint with injury of cranial cruciate ligament.

• Journal of Korean Neurosurgical Society
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• v.58 no.2
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• pp.125-130
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• 2015

Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.

• Journal of Korean Neurosurgical Society
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• v.48 no.1
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• pp.73-78
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• 2010

Objective : Streptococcus pyogenes is a beta-hemolytic bacterium that belongs to Lancefield serogroup A, also known as group A streptococci (GAS). There have been five reported case in terms of PubMed-based search but no reported case of brain abscess caused by Streptococcus pyogenes as a result of penetrating skull injury. We present a patient who suffered from penetrating skull injury that resulted in a brain abscess caused by Streptococcus pyogenes. Methods : The patient was a 12-year-old boy who fell down from his bicycle while cycling and ran into a tree. A wooden stick penetrated his skin below the right lower eyelid and advanced to the cranium. He lost consciousness on the fifth day of the incident and his body temperature was measured as $40^{\circ}C$. While being admitted to our hospital, a cranial computed tomography revealed a frontal cystic mass with a perilesional hypodense zone of edema. There was no capsule formation around the lesion after intravenous contrast injection. Paranasal CT showed a bone defect located between the ethmoidal sinus and lamina cribrosa. Results : Bifrontal craniotomy was performed. The abscess located at the left frontal lobe was drained and the bone defect was repaired. Conclusion : Any penetrating lesion showing a connection between the lamina cribrosa and ethmoidal sinus may result in brain abscess caused by Streptococcus pyogenes. These patients should be treated urgently to repair the defect and drain the abscess with appropriate antibiotic therapy started due to the fulminant course of the brain abscess caused by this microorganism.

• Journal of the Korean Society of Radiology
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• v.7 no.5
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• pp.353-358
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• 2013

Recently, the Percutaneous Coronary Intervention has become a main treatment for treating Coronary because of increase of Circulatory Disease. Because of this reason, the increase of intervention using radiation causes the radiation exposure to workers. Therefore, the latent radiation injury can be increased. Thus, this study/experiment measured around under knee whether using radiation collimator shielding or not. We measured the exposure does by the experiment methods which are using 60kV, 200mA, and 10ms of Automatic exposure conditions and using the major method of the Cinefluography of Coronary in our hospital. As the result of right coronary artery test cases, LAO $30^{\circ}$ when the curtains if you use lead 98.4%, $Cranial30^{\circ}$ 98.3% have a protective effect of the radiation. left circumflex coronary artery test cases, Caudal $30^{\circ}$ if the shielding effect of 90.2%, Caudal $30^{\circ}LAO$ $30^{\circ}$ 88.7% have a protective effect of the radiation. left anterior descending artery test cases, Cranial $30^{\circ}$ 98.3%, Cranial $30^{\circ}RAO$ $30^{\circ}$ 80.3%, Cranial $30^{\circ}$LAO $30^{\circ}$ 98% of the radiation has a protective effect. OS(Spider view) in the case of test Caudal $40^{\circ}LAO$ $40^{\circ}$ 71.2% appeared to have the effect of radiation shielding. For these reasons, radiation workers need to be aware on taking care of their radiation exposure by using the radiation collimator shielding even though it is uncomfortable for them.

• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.98-107
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• 2002

Multifocal motor neuropathy (MMN) is a chronic immune-mediated peripheral myelinopathy. The major clinical features include slowly progressive, painless, and asymmetric weakness, usually of distal limb muscle. Early in the course of the disease, weakness is not necessarily associated with muscle atrophy, owing to the initial primary involvement of peripheral myelin. Chronic progressive weakness is often associated with some degree of concurrent axonal loss and subsequent muscle atrophy. Sensory symptoms are usually mild or absent, and involvement of cranial and respiratory muscles is rare. The findings of multifocal motor conduction block, abnormal temporal dispersion, and focal conduction slowing at segments not at risk for common entrapment or compression injury, associated with normal sensory conduction studies along the same segments, are the hallmark electrophysiologic features of MMN. The slow progression and absence of upper motor neuron signs are the major clinical points that separate MMN from amyotrophic lateral sclerosis. The role of GM1 antibodies, found in high titers in 22~84% of MMN patients, remains uncertain. The contention that MMN is an autoimmune disorder is largely based on the often dramatic improvement in symptoms following the administration of intravenuos immunoglobulin or cyclophosphamide.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.195-197
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• 2015

Artifacts can seriously degrade the quality of computed tomography (CT) images, sometimes to the point of making them diagnostically unusable. Here, we report an unusual CT artifact that could have resulted in the misdiagnosis of a hyperdense hemorrhagic lesion in a 55-year-old man. The author recommend that when hemorrhagic lesion in posterior fossa is suggested on CT, the physician should carefully consider all patient-related clinical data prior to considering surgical intervention or a biopsy. Cranial magnetic resonance imaging (MRI) can help in preventing the misdiagnosis as hemorrhage of CT scan.

• Journal of Korean Neurosurgical Society
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• v.42 no.5
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• pp.416-418
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• 2007

Hematomas caused by ruptured traumatic pseudoaneurysms of the middle meningeal artery (MMA) usually present with extradural hematomas, whereas intradural intraparenchymal hematomas are extremely rare. We report a case of traumatic pseudoaneurysm of the MMA giving rise to an intracerebral hematoma after head trauma. A 70-year-old man suffered a massive intracerebral temporoparietal hemorrhage after a head injury. CT angiogram of the brain revealed a large hematoma in the right middle cranial fossa extending to the right sylvian fissure. Cerebral angiogram also revealed a pseudoaneurysm of the MMA, which was successfully treated surgically. Although traumatic MMA pseudoaneurysm producing intracerebral hematoma (ICH) is rare, it should be considered as a possible cause of intracerebral hematoma.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.310-312
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• 2005

We report a case of endodermal cyst of the posterior fossa. A 44-year-old man presented with headache for three months. Computed tomography and magnetic resonance imaging revealed a $6{\times}2.5{\times}2cm$ sized extra-axial non-enhancing cystic lesion on the ventral aspect to brain stem. To avoid retraction injury to brain stem, far lateral transcondylar approach was selected. Right suboccipital craniotomy and partial removal of occipital condyle with resection of C-1 and C-2 hemilaminae exposed the extra-axial cyst well. The cyst has a whitish thick membrane. It was not adherent to brain stem and lower cranial nerves. Total removal of the cyst was done without difficulty. Histological analysis disclosed a layer of pseudostratified columnar epithelium with basement membrane. The result of immunohistochemical study was consistent with endodermal cyst.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.59-61
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• 2013

Authors report a rare case of acute intracranial subdural and intraventricular hemorrhage that were caused by intracranial hypotension resulted from cerebrospinal fluid leakage through an unidentified dural tear site during spinal surgery. The initial brain computed tomography image showed acute hemorrhages combined with preexisting asymptomatic chronic subdural hemorrhage. One burr hole was made over the right parietal skull to drain intracranial hemorrhages and subsequent drainage of cerebrospinal fluid induced by closure of the durotomy site. Among various methods to treat cerebrospinal fluid leakage through unidentified dural injury site, primary repair and spinal subarachnoid drainage are well known treatment options. The brain imaging study to diagnose intracranial hemorrhage should be taken before selecting the treatment method, especially for spinal subarachnoid drainage. Similar mechanism to its spinal counterpart, cranial cerebrospinal fluid drainage has not been mentioned in previous article and could be another treatment option to seal off an unidentified dural tear in particular case of drainage of intracranial hemorrhage is needed.