• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.521-524
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• 2013

Ependymoma can spread via cerebrospinal fluid, but late spinal recurrences of intracranial tumor are very rare. We describe a case of a 33-year-old male who presented with multiple, delayed, recurrent lesions in the spinal cord from an intracranial ependymoma. The patient underwent gross total resection and postoperative radiation therapy 14 years prior to visit for a low grade ependymoma in the 4th ventricle. The large thoraco-lumbar intradural-extramedullary spinal cord tumor was surgically removed and the pathologic diagnosis was an anaplastic ependymoma. An adjuvant whole-spine radiation therapy for residual spine lesions was performed. After completion of radiation therapy, a MRI showed a near complete response and the disease was stable for three years.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.684-687
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• 2000

Primary anaplastic oligodendroglioma in brain stem is extremely rare. The authors present a case of a anaplastic oligodendroglioma arising from pons. A 29 year-old male patient was admitted because of cranial nerve palsy and visual disturbance. Neurological examination revealed bilateral sixth and left seventh cranial nerve plasies. Near-total resection of tumor mass was performed through midline suboccipital appraoch. Tumor was not related with choroid plexus and major vessels but it was firmly attached to the fourth ventricle floor. Tumor was considered to be arised from the tegmental portion of pons, growing dorsally into the 4th ventricle. Hitopathological exmination revealed primary anaplastic oligodendroglioma. Postoperative course was uneventful. The authors believe that this type of tumor with dorsally growing pattern can be successfully resected without major neurological deficit.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.102-107
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• 2017

A true collision tumor is a rare entity composed of two histologically distinct neoplasms coinciding in the same organ. This paper reports a unique case of cerebral collision tumor consisting of two benign components. On the first hand, meningioma which is usually a benign lesion arising from the meningothelial cell in the arachnoidal membrane. On the other, cerebral cavernoma which is a well-circumscribed, benign vascular hamartoma within the brain. To our knowledge, there is no previously documented case of cerebral collision tumor consisting of two benign components. A 56-year-old Caucasian male suffered in 2002 from an atypical meningioma WHO $II^{\circ}$ located in the left lateral ventricle. Three years after the tumor extirpation, the patient suffered from a hematoma in the fourth ventricle due to a recurrently haemorrhaged cavernoma. In 2008, a recurrence of the tumor in the left lateral ventricle was discovered. Additionally, another tumor located in the quadrigeminal lamina was detected. After surgical resection of the tumor in the left lateral ventricle, the pathological examination confirmed the diagnosis of a collision tumor consisting of components of a meningioma WHO $II^{\circ}$ and a cavernoma. Postoperatively, no adjuvant treatment was needed and no tumor recurrence is discovered up to the present. A possible explanation for the collision of those two different tumors may be migration of tumor cells mediated by the cerebrospinal fluid. After 5-years of follow-up, there is no sign of any tumor recurrence; therefore, surgical tumor removal without adjuvant therapy seems to be the treatment of choice.

• Applied Microscopy
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• v.30 no.4
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• pp.377-387
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• 2000

There are a few tanycytes between the general ependymal cells lining the ependymal layer of the brain ventricle. These cells are considered as modified ependymal cells which possess a long basal process. Tanycytes are known to have an ability to communicate by absorbing substances from cerebrospinal fluid and transporting them to the blood vessels and/or to the neurons in the CNS. The third and fourth ventricular tanycytes were mainly studied as subjects but it's rare to find reports about the tanycytes of the area postrema. Glial fibrillary acidic protein is an intermediate filament protein that is expressed especially in astrocytes of the CNS. But GFAP is also found in filament of the tanycytes and its process. Therefore this study was carried out for the examination of the GFAP immunoreactive tanycytes lining the area postrema of the bat, and we also examined the ultrastructure of tanycytes using electron microscope. GFAP immunoreactive tanycytes were located in the caudal portion of the fourth ventricle, and especially mainly in the transitional zone between the floor of the caudal fourth ventricle and ependymal layer lining the area postrema. A few GFAP immunoreactive tanycytes were also found in the ependymal layer lining the area postrema, and some groups of tanycytes were found in the ependymal layer of the area postrema near the floor of the caudal fourth ventricle , The processes of tanycytes were stained deeply with anti-GFAP antibody. Especially the GFAP immunoreactive tanycytes lining the area postrema had very long processes that cross the whole width of the area postrema. In the electron microscope, the cell body of ependymal tanycyte was located on the ependymal layer and had a long basal process. Intermediate filaments were observed around the nucleus and well developed in the process of tanycrte. Longitudinal oriented long mitochondria and a few lipid droplets were also found in this process. After immunocytocheical staining, the gold particles were found only in the intermediate filaments. We could not determine the function of the tanycytes in the area postrema. Thus, further investigation is required to determine the functional relationship between the tanycytes and the area postrema in hibernating animal, the bat.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.203-209
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• 1992

The Arnold-Chiari malformation(ACM) is an anomaly of the hindbrain consisting of two components : a variable displacement of a tongue of tissue derived from the inferior cerbellar vermis in the upper cervical cannal and a similar caudal dislocation of the medulla and fourth ventricle. Hydrocephalus and meningomyelocele are another abnormalities that associated frequently. We present a case of Arnold-Chiari malformation with hydrocephalus and meningomyeolcele and a brief review of the literatures was added.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.61-65
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• 2014

Neurocutaneous melanosis (NCM) is a rare congenital syndrome consisting of benign or malignant melanotic tumors of the central nervous system with large or numerous cutaneous melanocytic nevi. The Dandy-Walker complex (DWC) is characterized by an enlarged posterior fossa with high insertion of the tentorium, hypoplasia or aplasia of the cerebellar vermis, and cystic dilatation of the fourth ventricle. These each two conditions are rare, but NCM associated with DWC is even more rare. Most patients of NCM with DWC present neurological symptoms early in life such as intracranial hemorrhage, hydrocephalus, and malignant transformation of the melanocytes. We report a 14-year-old male patient who was finally diagnosed as NCM in association with DWC with extensive intracerebral and spinal cord involvement.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.10 no.2
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• pp.5-32
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• 2004

We have studied the effect and application of CST which is the function and disease of the autonomic nerve system based on recovery of flexibleness of the autonomic nerve. CST purpose to keep sustenance of human body by recovering joints have limitation of mobility and controlling autonomic nerve system by diminution tense of the sympathetic nerve. CST makes well flowing of CSF by pressure the fourth ventricle of the brain or relaxation of soft tissues of the base of a cranial bone. There is no result of studies about CST in Korea yet. It will bring a benefit if it prove the effect of CST in countries depend on drugs way high such as Korea. It needs positive approach and definite research for the improvement.

• Korean Journal of Veterinary Research
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• v.42 no.3
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• pp.429-436
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• 2002

Hydrocepbalus may be an acquired or a congenital condition. We have studied the macroscopic and microscopic changes in the hydrocephalus of an inbred Sprague-Dawley rat at postnatal week 8. The animal suspected with the hydrocephalus showed clinical syndromes such as depression, severe ataxia, eye abnormalities, dome-shaped head, and persistent fontanelle. With the postmortem examination, the suspected animal was clearly revealed as a severe internal hydrocephalus. In this animal, severe ventriculomegaly was limited to the third and lateral ventricles, and cortical thining was most apparent in the parieto-occipital region. With the routine histological examination, brain tissue showed aqueductal obstruction, thinning of the cerebral cortex, severe ependymal damage, subependymal edema, damage of choroid plexus of fourth ventricle, enlarged cortical vessels, and expanded ventricles. Aqueductal obstruction was observed with the appearance of simple stenosis at the level of rostral colliculus. Subsequently, the other structures of brain such as septal nucleus, caudate nucleus, and hippocampus etc. were abnormally reconstructed by hydrocephalus. This study suggests that the hydrocephalus can be taken place by primary aqueductal obstruction and this type of hydrocephalus is classified as uncommunicating type. Though the mechanism of aqueductal obstruction is not clear, the morphological studies of this case may be helpful for the further study of hydrocephalus.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.250-253
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• 2012

We report a rare case of cerebellar liponeurocytoma with an unusually aggressive histopathology. A 49-year-old man presented with a four-month history of headache, vertigo, and progressive swaying gait. Magnetic resonance imaging showed a $3{\times}3.5cm$ sized relatively well-demarcated round mass lesion in the fourth ventricle, characterized by high signal intensity on T2-weighted images. Postcontrast images revealed strong enhancement of the solid portion and the cyst wall. The patient underwent suboccipital craniectomy and tumor removal. The pathologic diagnosis was cerebellar liponeurocytoma. Adjuvant radiotherapy was offered due to concerns related to the high proliferative index (Ki-67, 13.68%) of the tumor. At the last routine postoperative follow-up visit (12 months), the patient complained of no specific symptom and there was no evidence of tumor recurrence. However, longterm follow-up and the analysis of similar cases are necessary because of the low number of reports and the short follow-up of cases.

• Journal of Korean Neurosurgical Society
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• v.57 no.1
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• pp.50-53
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• 2015

Usually fungal infections caused by opportunistic and pathogenic fungi had been an important cause of morbidity and mortality among immunocompromised patients. However clinical data and investigations for immunocompetent pathogenic fungal infections had been rare and neglected into clinical studies. Especially Cryptococcal brainstem abscess cases mimicking brain tumors were also much more rare. So we report this unusual case. This 47-year-old man presented with a history of progressively worsening headache and nausea for 1 month and several days of vomituritions before admission. Neurological and laboratory examinations performed demonstrated no abnormal findings. Previously he was healthy and did not have any significant medical illnesses. A CT and MRI scan revealed enhancing $1.8{\times}1.7{\times}2.0$ cm mass lesion in the left pons having central necrosis and peripheral edema compressing the fourth ventricle. And also positron emission tomogram scan demonstrated a hot uptake of fluoro-deoxy-glucose on the brainstem lesion without any evidences of systemic metastasis. Gross total mass resection was achieved with lateral suboccipital approach with neuronavigation system. Postoperatively he recovered without any neurological deficits. Pathologic report confirmed Cryptococcus neoformans and he was successively treated with antifungal medications. This is a previously unreported rare case of brainstem Cryptococcal abscess mimicking brain tumors in immunocompetent host without having any apparent typical meningeal symptoms and signs with resultant good neurosurgical recovery.