• 제목/요약/키워드: Intracranial surgery

검색결과 307건 처리시간 0.023초

두개강내압 상승 환자에서 저체온법의 유용성 - 임 상 연 구 - (Usefulness of Hypothermia Treatment in Patients with Increased Intracranial Pressure)

  • 이종무;안재성;김정훈;김창진;권양;이정교;권병덕;전상룡
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.316-321
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    • 2001
  • Objectives : The goal of this study is to evaluate the usefulness of mild hypothermia treatment in patients with increased intracranial pressure(ICP). Material and Method : From November 1999 to May 2001, 11 patients were treated with mild hypothermia ($32-34^{\circ}C$) in whom ICP maintained at higher than 20mmHg in spite of decompressive surgery and high dose barbiturate therapy. The patient's rectal temperature were lowered by external cooling. Hypothermia was maintained for not more than 7 days and then the patients were rewarmed slowly for 24 hours. If increased ICP persisted for 2 days of hypothermia, this treatment was continued for several days. The functional outcome of each patient was assessed according to Glasgow Outcome Scale(GOS). Results : All cases except two cases showed decrease of ICP after hypothermia therapy. In 1 case which was right middle cerebral artery(MCA) infarct, ICP re-increased after 24 hours and in another 1 case, ICP was not controlled initially. Among 11 cases, 3 cases showed favorable outcome. Conclusion : Mild hypothermia treatment in patients with increased ICP was effective in controlling ICP and mortality was so decreased. More clinical experience and controlled study was need to determine the effectiveness.

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Combined extracranial and intracranial approach for resection of dermoid cyst of the sphenoid bone with a cutaneous sinus tract across the frontal branch of the facial nerve

  • Ishii, Naohiro;Fukazawa, Emi;Aoki, Tomoko;Kishi, Kazuo
    • 대한두개안면성형외과학회지
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    • 제20권2호
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    • pp.116-120
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    • 2019
  • Frontotemporal dermoid cysts with a cutaneous sinus tract in the sphenoid bone are rarely found, and furthermore, the spreading of these cysts across the frontal branch of the facial nerve has not been reported. Herein, we present a 5-year-old case of a dermoid cyst successfully resected with preservation of this nerve using a combined extracranial and intracranial approach. This approach is recommended for a safe and radical resection of the lesion and for securing an aesthetic outcome.

Spinal Subdural Hematoma : A Complication of Intracranial Surgery

  • Kim, Tae-Wan;Heo, Wean;Park, Hwa-Seung;Rhee, Dong-Youl
    • Journal of Korean Neurosurgical Society
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    • 제39권1호
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    • pp.68-71
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    • 2006
  • Spinal subdural hematoma[SSDH] is rare disease. Furthermore, it rarely occurs as a complication of intracranial surgery. There are few case reports which describing SSDH after craniotomy. Although the exact pathogenetic mechanism is obscure, some investigators propose that downward migration of intracranial hematoma by the effect of gravity is one of the cause of SSDH, and which is commonly suggested. But others propose that cerebrospinal fluid[CSF] hypotension is an another possible mechanism In this paper, we report two cases of SSDH after clipping of an aneurysmal neck.

Urgent Intracranial Carotid Artery Decompression after Penetrating Head Injury

  • Kim, Seong Joon;Park, Ik Seong
    • Journal of Korean Neurosurgical Society
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    • 제53권3호
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    • pp.180-182
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    • 2013
  • We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient.

총순환정지를 이용한 두개강내 거대동맥류 치험 1례 (Surgical Management of Giant Aneurysm of Intracranial Artery Under Circulatory Arrest -one case report-)

  • 홍종면;김오곤;이석재;홍장수;민경수;김상태;임승운;송우익
    • Journal of Chest Surgery
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    • 제32권1호
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    • pp.80-83
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    • 1999
  • 일반적인 미세수술 방법만으로 위험하다고 생각되는 뇌내혈관 동맥류 수술에 있어서 체외순환을 이용한 초저체온하의 총순환정지는 필수적인 방법이 되었다. 총순환정지를 위한 체외 순환 방법에는 개흉술을 통해 직접 심장을 노출시키는 방법과 개흉하지 않고 대퇴 혈관에 캐뉼라를 삽입하여 체외순환하는 두가지 방법을 들 수 있다. 저자들은 1예의 뇌내 거대 동맥류 환자에서 개흉하지 않고 대퇴혈관에 경피적 캐뉼라 삽입으로 체외순환하여 초저온하에 총순환정지를 이용하여 뇌내 거대 동맥류를 효과적으로 수술할 수 있었다.

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A Critical Analysis of Intracranial Hemorrhage as a Fatal Complication of Dengue Fever

  • Andre Marolop Pangihutan Siahaan;Steven Tandean;Bahagia Willibrordus Maria Nainggolan;Junita Tarigan;Johan Samuel Sitanggang
    • Journal of Korean Neurosurgical Society
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    • 제66권5호
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    • pp.494-502
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    • 2023
  • Dengue fever is the most rapidly spreading mosquito-borne virus in the world, infecting about 100 million individuals. A rare but possibly dangerous consequence of dengue illness is intracranial hemorrhage (ICH). Currently, the pathogenesis of ICH is unknown. A number of studies have found a variety of risk factors for ICH in dengue. In addition, studies have reported the use of emergency surgery while monitoring thrombocytopenia in the therapy of dengue ICH. This review enumerates the potential predictors of ICH in dengue, discusses the use of brain imaging, and mentions the possibility of emergency surgery.

Multiple, Sequential, Remote Intracranial Hematomas Following Cranioplasty

  • Moon, Hong-Joo;Park, Ju-No;Kim, Sang-Dae;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • 제42권3호
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    • pp.228-231
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    • 2007
  • The intracranial hemorrhage in regions remote from the site of initial operations is unusual but may present as fatal surgical complication. We report a rare case of multiple, sequential, remote intracranial hematomas after cranioplasty in a patient who did not have any prior risk factors. A 51-years-old man was transferred to the hospital after a head trauma. The brain computed tomography (CT) revealed acute subdural hemorrhage on the right hemisphere with prominent midline shifting. After performing decompressive craniectomy and hematoma removal, the patient recovered without any complications. However, the patient showed neurological deterioration immediately after cranioplasty, which was done three months after the first surgery. There was extensive hemorrhage in the posterior fossa remote from the site of the initial operation site. The brain CT taken soon after removing this hematoma evacuation displayed large epidural hematoma on the left hemisphere. This case represents posterior fossa hemorrhage after supratentorial procedure and sequential delayed hematoma on the contralateral supratentorial region thus seems very rare surgical complications. Despite several possible pathogenetic mechanisms for such remote hematomas, there are usually no clear cut relationships with each case as in our patient. However, for the successful outcome, prompt evaluation and intensive management seem mandatory.

Osteoma of the Frontal Sinus with Secondary Subdural Empyema Formation

  • Cho, Sung-Yun;Kim, Jeong-Whun;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • 제40권3호
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    • pp.202-205
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    • 2006
  • Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. The authors report an unusual case of a frontal sinus osteoma leading to subdural emyema formation. A 19-year-old man presented with headache and fever one month after minor facial trauma. Neuroradiological studies revealed subdural empyema in left frontal lobe with moderate cerebral edema and a osteoma in the left frontal sinus with sinusitis of maxillary sinus. The patient was surgically treated in one stage operation of decompressive craniectomy, removal of subdural empyema with frontal sinus osteoma, and endoscopic sinus surgery via cranial and nasal route. The patient recovered very well after surgery and postoperative antibiotic therapy. The etiology of intracranial infection and the treatment strategy are to be discussed.

Dermoid Cyst of Nasal Tip with a Sinus Tract Extending to the Intracranium: A Case Report

  • Lee, Seungjun;Kim, Seong-Ik;Kim, Min-Seo;Kim, Jong-Ho
    • Archives of Plastic Surgery
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    • 제49권5호
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    • pp.648-651
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    • 2022
  • Nasal dermoid cysts are rare congenital anomalies that affect one in 20,000 to one in 40,000 individuals. Herein, we report a case of an initially misdiagnosed nasal dermoid cyst with intracranial extension. Among nasal dermoids, the lesion of the nasal tip is considered uncommon. Therefore, this should always be considered as a differential diagnosis of midline nasal masses, and a proper diagnostic approach should be taken.

Intracranial Extraskeletal Myxoid Chondrosarcoma : Case Report and Literature Review

  • Park, Jin Hoon;Kim, Mi-Jung;Kim, Chang Jin;Kim, Jeong Hoon
    • 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.