• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.437-441
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• 2010

Objective : The precise intra- vs. extradural localization of aneurysms involving the paraclinoid internal carotid artery is critical for the evaluation of patients being considered for aneurysm surgery. The purpose of this study was to investigate the clinical usefulness of T2-weighted threedimensional (3-D) fast spin-echo (FSE) magnetic resonance (MR) imaging in the evaluation of unruptured paraclinoid aneurysms. Methods : Twenty-eight patients with unruptured cerebral aneurysms in their paraclinoid regions were prospectively evaluated using a T2- weighted 3-D FSE MR imaging technique with oblique coronal sections. The MR images were assessed for the location of the cerebral aneurysm in relation to the dural ring and other surrounding anatomic compartments, and were also compared with the surgical or angiographic findings. Results : All 28 aneurysms were identified by T2-weighted 3D FSE MR imaging, which showed the precise anatomic relationships in regards to the subarachnoid space and the surrounding anatomic structures. Consequently, 13 aneurysms were determined to be intradural and the other 15 were deemed extradural as they were confined to the cavernous sinus. Of the 13 aneurysms with intradural locations, three superior hypophyseal artery aneurysms were found to be situated intradurally upon operation. Conclusion : High-resolution T2-weighted 3-D FSE MR imaging is capable of confirming whether a cerebral aneurysm at the paraclinoid region is intradural or extradural, because of the MR imaging's high spatial resolution. The images may help in identifying patients with intradural aneurysms who require treatment, and they also can provide valuable information in the treatment plan for paraclinoid aneurysms.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1523-1526
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• 2000

It has been known that hemangioblastoma of spinal cord occurs about 4% of all the spinal tumors. The authors present a rare case of intradural extramedullary(IDEM) hemangioblastoma of distal spinal cord in 41-year-old male patient. This IDEM mass at the level of conus medullaris showed iso-signal intensities on T1-weighted image(T1-WI) and high-signal intensities on T2-WI, and was enhanced homogeneously on MRI. At surgery, T12- L1 total laminectomy and enbloc mass removal were performed. This IDEM hemangioblastoma was confirmed by histopathologic findings. For less postoperative complication in IDEM tumors, we suggest that precise preoperative evaluation and complete excision via proper surgical approach to distal conus should be reemphasized.

• Journal of Korean Neurosurgical Society
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• 제53권2호
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• pp.118-120
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• 2013

We report a rare case of remote cerebellar hemorrhage after intradural disc surgery at the L1-2 level. Two days after the spine surgery, patient complained unexpected headache, dizziness, nausea and vomiting. From the urgently conducted brain CT, it was reported that the patient had cerebellar hemorrhage. Occipital craniotomy and hematoma evacuation was performed, and hemorrhagic lesion on the right cerebellum was effectively removed. After occipital craniotomy, the patient showed signs of improvement on headache, dizziness, nausea and vomiting. He was able to leave the hospital after two weeks of initial operation without any neurological deficit. Remote cerebellar hemorrhage following spinal surgery is extremely rare, but may occur from dural damage of spinal surgery, accompanied with cerebrospinal fluid leakage. Early diagnosis is particularly important for the optimal treatment of remote cerebellar hemorrhage.

• Investigative Magnetic Resonance Imaging
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• 제12권2호
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• pp.201-205
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• 2008

경막내 척수외 결핵종은 척추 결핵의 드문 형태로, 몇몇 증례들이 보고되었다. 저자들은 최근 흉추에 발생한 광범위한 경막내 척수외 결핵종 2예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.168-171
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• 2009

Intradural lumbar disc herniation (ILDH) is rare. In this report, authors present 2 cases of ILDHs associated with severe adhesion between the dural sac and posterior longitudinal ligament. In a 40-year-old man, ILDH occurred in association with epidural adhesion due to ossification of the posterior longitudinal ligament (OPLL). In other 31-year-old man, ILDH occurred in presence of epidural adhesion due to previous spine surgery.

• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.544-546
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• 2010

Paraplegia following spinal epidural anesthesia is extremely rare. Various lesions for neurologic complications have been documented in the literature. We report a 66-year-old female who developed paraplegia after left knee surgery for osteoarthritis under spinal epidural anesthesia. In the recovery room, paraplegia and numbness below T4 vertebra was checked. A magnetic resonance image (MRI) scan showed a spinal thoracic intradural extramedullary (IDEM) tumor. After extirpation of the tumor, the motor weakness improved to the grade of 3/5. If a neurologic deficit following spinal epidural anesthesia does not resolve, a MRI should be performed without delay to accurately diagnose the cause of the deficit and optimal treatment should be rendered for the causative lesion.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.314-316
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• 2006

Intradural lumbar disc herniation[ILDH] is a rare pathology. The pathogenesis of ILDH is not known with certainty. Adhesions between the ventral wall of the dura and the posterior longitudinal ligament[PLL] could act as a preconditioning factor. Diagnosis of ILDH is difficult and seldom suspected preoperatively. Prompt surgery is necessary because the neurologic prognosis appears to be closely related to preoperative duration of neurologic symptoms. Despite preoperatively significant neurological deficits, the prognosis following surgery is relatively good. We report on case of ILDH at L3/4 with differential diagnoses, and the possible pathogenic factors are discussed.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.245-247
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• 2005

Most chordomas show extradural extension and bone destruction. A 32-year-old man presented with neck pain and progressive paraparesis. He had been diagnosed a clival chordoma and underwent an operation seven years ago. Radiological studies revealed that the tumor was recurred in a retroclival area and invaded into intradural region. We removed the tumor by two staged operations. After surgery, satisfactory results were achieved.

• 대한영상의학회지
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• 제81권6호
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• pp.1466-1471
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• 2020

척추 경막 내 신경집종에 염전이 동반되는 경우는 드물다. 우측 엉치 통증과 하지 방사통을 주소로 내원한 63세 남자의 요추 수준에서 경막 내 신경집종이 발견되었다. 이 신경집종은 조영증강 자기공명영상에서 조영증강이 잘되지 않았고, 자기공명영상 및 척수조영-전산화단층촬영 영상에서 검사할 때마다 위치가 바뀌었다. 환자는 수술적 절제를 받았으며 신경집종은 염전을 동반하고 있었다.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.361-363
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• 2001

Intradural extramedullary hemangioblastoma of the spinal cord is uncommon tumor. Symptom onset is typically in the forth decade. Complete excision offers the best chance for cure. We report a case of extramedullary hemangioblastoma of the spinal cord in old age. A 76 -year old man presented with 1 month history of paraparesis. Multiple enhancing lower thoracic and lumbar spinal masses were seen on magnetic resonance imaging(MRI). Surgical exploration for symptomatic lesion revealed intradural-extramedullary mass, which had hypervascularity. The excised spinal masses were diagnosed as hemangioblastoma. Postoperative course was uneventful and symptoms improved gradually.