• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.446-452
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• 2011

Objective : We retrospectively investigated the long-term results of percutaneous radiofrequency thermocoagulation (RFT) using fluoroscopic image-guidance for treatment of trigeminal neuralgia. Methods : A total of 38 patients diagnosed and treated with RFT as an idiopathic trigeminal neuralgia were investigated. To minimize the risks related to conventional technique based on cutaneous landmarks, and to eliminate the need to frequent reposition of cannula, we adopted a technique of image-guided fluoroscopic cannulation of the foramen ovale. To minimize sensory complication following thermal lesion, our target response was a generation of a lesion with mild to moderate hypalgesia rather than dense hypalgesia. Results : The immediate pain-relief was achieved in all patients underwent RFT. With mean duration of follow-up of 38.2 months (range,12-72), 11 (28.9%) experienced recurrence of pain. The mean timing of recurrence was 26.1 months (range,12-46). A 42.7% recurrence rate was estimated by Kaplan-Meier analysis for the 38 patients at 46 months; 20.2% within 2 years, 29.1% within 3 years. In the long-term, 27 patients (71%) and 6 patients (15.8%) showed Barrow Neurological Institute (BNI) score I and BNI score II responses. Three (7.9%) patients was assessed as BNI score III, 2 patients (5.3%) showed BNI score IV response. As a complication, troublesome dysesthesia occurred in 3 of 38 patients (7.9%), however, there was no permanent cranial nerve palsy or morbidity. Conclusion : These results indicates that RFT under fluoroscopic image-guided cannulation of foramen ovale is a safe, effective, and reliable means of treating trigeminal neuralgia.

• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.62-68
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• 2020

Acute bacterial sinusitis is one of the most common diseases in children, and 5-13% of patients with viral upper respiratory infection experience secondary bacterial sinusitis as a complication. Isolated sphenoid sinusitis is rarer than frontal, maxillary, and ethmoid sinusitis. However, it presents potentially devastating complications, such as cranial nerve involvement, brain abscess, and meningitis, owing to its anatomical location. Nontypeable Haemophilus influenzae (NTHi) commonly causes acute bacterial sinusitis but rarely causes bacteremia, particularly in immunocompetent patients. We present a rare case of a 14-year-old boy with bacteremia due to isolated sphenoid sinusitis caused by NTHi.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.172-176
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• 1999

Background: An increasing number of traumatic, infectious, degenerative, benign, and malignant lesions of the clivus and cervical spine are treated by head and neck surgeons. Surgical techniques vary according to the exact level of the lesion. Objectives: The purpose of this article are to introduce the surgical approach and to discript our experience and to analyze the advantage of the each methods. Materials and Methods: Transpalatal approach in clivus chordoma, transoral approach in C2 fibrous dysplasia, trans mandibular approach in clivus meningioma and transcervical approach in neulilemmoma were reviewed from the medical record. Results: Postoperative complications occured. Otitis media with effusion were observed in transoral and trans mandibular approach. Cranial nerve paralysis was observed in transcervical approach. But other complications such as swallowing difficulty persisting over 6 weeks, malunion of mandible, orocutaneous fistula, hemorrhage from major vessel were not observed. Conclusion: The various surgical techniques to be described herein serve to give the best exposure of each level of the lesions. Therefore head and neck surgeon plays a major role in the treatment of lesion in the clivus and anterior cervical spine according to the lower incidence of postoperative morbidity.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.456-469
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• 1997

The cerebral infarction arised from occulsion of cerebral artery has a high mortality rate and fatal sequelae. Sohabhyangwon(蘇合香元) is generally regarded to have a effect of walking up the patient from unconsiousness and promoting the flow of Qj(氣) by warming channel. METHOD The purpose of this study is to find out the effections of Sohabhyangwon(蘇合香元) on regional cerebral blood flow and relative cerebral infarction area in the experimentally induced infartion in rats In this experiment, 12 Spraque-Dawley rats weighting 280-350g were used. Cerebral ischemia induced by intraluminal suture technique of Kozumi's and Zea-Longer's method. $Co_{2},\;O_2$, pH, arterial blood pressure in rats were checked by Blood Gas Analyzer every 30 minutes for 2 hours. And regional cerebral blood flow were checking by hydrogen clearance technique, cerebral infarcted area was megsured by Image Analysis System. RESULTS 1. During the experiment, $CO_{2},\;O_2$, pH, arterial blood pressure in rats had no change in both sample group and control group. 2. Cortical cerebral blood flow decreased at same rate in both sample group and control group after inducing cerebral infarction. 3. On comparison of relative cerebral infarcted area, Sohabhyangwon(蘇合香元) perfused group showed a significant decrease. CONCLUSION According to the result above, Sohabhyangwon has a protection effect on cranial nerve and-has no effect on cerebral blood flow.

• Journal of Acupuncture Research
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• v.29 no.3
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• pp.139-148
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• 2012

Objectives : The purpose of this case is to report the improvement of two patients diagnosed with eight and a half syndrome after combination therapy of oriental and western medicine. Methods : We treated the patients with combination therapy of oriental and western medicine such as acupuncture, moxibustion, herbal medication, antithrombotic agents and steroid therapy. Changes of peripheral facial paralysis were evaluated using House-Brackmann facial grading system and the degree of dizziness, tenderness and pain of upper abdomen were assessed using numerous rating scale. Changes in motor grade of upper and lower extremities were evaluated using medical research council scale. Results : We have recently experienced two cases of eight and a half syndrome - a syndrome characterized by the coexistence of one and a half syndrome, a rare ophthalmoparetic syndrome characterized by a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other, and cranial nerve VII palsy. The one and a half syndrome was caused by acute cerebral infarction. Two patients in this report were improved through combination therapy of oriental and western medicine. Conclusions : We report the clinical course and treatment methods of eight and a half syndrome.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.189-196
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• 1989

Twenty five patients with tumors of the brain stem were treated with radiotherapy between 1979 and 1987. Histological diagnosis could be obtained in 6 cases, and other 19 patients were diagnosed by neurologic findings and CT or MRI. Eighteen patients were treated by radical radiotherapy and 6 patients received both operation and radiotherapy, while 1 patient received chemotherapy after radiotherapy. Total dose ranged from 50 Gy to 55 Gy. By an clinical scoring scale at 2 months after radiotherapy, no complete response was obtained, but 16 cases achieved partial response, 2 cases were stable, and 4 cases were deteriorated. The overall survival rate at 3 years was $36\%$ Age, performance status at diagnosis, degree of cranial nerve involvement, CT pattern of post-contrast enhancement, and clinical responese by scoring scale were correlated with survival.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.352-355
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• 2001

The authors report two cases of familial hemifacial spasm according to the clinical and three dimensional shortrange magnetic resonance angiography(3D-SRMRA) findings. In the family of the first case, there were five patient's with acquired hemifacial spasm in successive generations. Three male and two female patients in successive generations of the same family developed acquired hemifacial spasm. Four patients were on the left side and one was on the right side. In the family of the second case, there were three patient's with acquired hemifacial spasm in successive generations. Two brothers developed left-sided hemifacial spasm. 3D-SRMRA finding of the probands demonstrated that both anterior inferior cerebellar artery in first case and anterior inferior cerebellar artery & vertebral artery in second case offend the 7th cranial nerve respectively. The presence of familial clustering of these rare disorders suggest an underlying genetic predisposition. All family pedigrees suggest that a pattern of autosomal-dominant inheritance with partial penetrance.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.330-335
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• 2000

Objective : The purpose of this report is to assess the morbidity and mortality associated with clipping of intracranial unruptured aneurysms. Methods : At the authors' institution between May 1989 and December 1998, a total of 128 unruptured aneurysms in 110 patients were treated with surgical clippings. The medical records and neuroimaging studies of the patients were reviewed retrospectively. Results : The main locations of the aneurysms were : middle cerebral artery 31%, internal carotid-posterior communicating artery 28%, anterior communicating artery 16%, paraclinoid 6.5%, internal carotid-anterior choroidal artery 7%, posterior circulation 7%. Forty three percent of the aneurysms were symptomatic and 57% asymptomatic. The overall outcome of the surgery was : Glasgow outcome scale(GOS) I 86%, GOS II 6%, GOS III 4.3%, GOS IV 0% and GOS V(death) 3.5%. The operative risk is higher for large to giant aneurysms, and for aneurysms in posterior circulations. Patients with non-giant aneurysm in anterior circulation showed no mortality, but morbidity of 8.2%, and in posterior circulation : 25% of mortality and 75% of morbidity. Patients with giant anterior circulation aneurysm have 22% of mortality and 22% of morbidity. For patients with giant posterior circulation aneurysm, mortality and morbidity were 25% and 25%, respectively. The postoperative deaths were related to occlusion of the major parent artery in 3 cases(75%). The postoperative morbidity was related to occlusion of artery(9/13), intraoperative rupture(3/13), and cranial nerve injury(1/13). Conclusion : This report documents 3.5% mortality and 13% of morbidity in the clipping surgery for unruptured intracranial aneurysms, and the relatively low risk of surgical clipping in non-giant and those located in anterior circulation. The natural history, especially risk of bleeding, of the unruptured intracranial aneurysms is still controversial. However, with respect to surgical results, unruptured non-giant aneurysm located in anterior circulation should be operated in patients with low risk.

• Journal of Convergence for Information Technology
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• v.9 no.5
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• pp.77-85
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• 2019

This study is a descriptive study to identify the burden of family burden, general characteristics, and disease characteristics of patients undergoing cranial nerve rehabilitation in hospitalized rehabilitation hospitals and to identify the factors influencing the integration. The questionnaire was administered to 113 family members who were the primary care providers of rehabilitation in rehabilitation hospitals and analyzed using the SPSS statistics 22 program. The results of this study showed that the level of burden of the patient family was 3.16, the burden of the family was significantly different in the age of the caregiver, the educational level, and the relationship with the caregiver. There was no difference. Finally, the factors influencing family burden were identified as predictors of carer's age, education, religion, and relationship with the patient. It will be necessary to consider general characteristics in the development of an intervention program that lowers the burden of family rehabilitation.

• Journal of Yeungnam Medical Science
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• v.38 no.3
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• pp.202-207
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• 2021

Background: Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. Microvascular decompression (MVD) is the most widely used surgical treatment for TN. We undertook this study to analyze the effects of and complications of MVD and to refine the surgical procedure for treating TN. Methods: A total of 88 patients underwent for TN underwent surgery at our hospital. Among them, 77 patients underwent MVD alone, and 11 underwent partial sensory rhizotomy (PSR) with or without MVD. The medical records of these patients were retrospectively analyzed for patient characteristics, clinical results, offending vessels, and complications if any. Results: The mean follow-up duration was 43.2 months (range, 3-216 months). The most common site of pain was V2+V3 territory (n=27), followed by V2 (n=25) and V3 (n=23). The most common offending vessels were the superior cerebellar artery and anterior inferior cerebellar artery in that order. The overall rate of postoperative complications was 46.1%; however, most complications were transient. There were two cases of permanent partial hearing disturbance. In the MVD alone group, the cure rate was 67.5%, and the improvement rate was 26.0%. Among 11 patients who underwent PSR with or without MVD, the cure rate was 50.0%, and the improvement rate was 30.0%. Conclusion: The clinical results of MVD were satisfactory. Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery.