• Annals of Clinical Neurophysiology
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• v.8 no.2
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• pp.186-189
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• 2006

A 69 year-old woman was admitted with sudden left facial weakness. She had no other neurologic deficit, except for left peripheral type facial palsy. She had a presumptive diagnosis of Bell's palsy. The blink test was indicative of left facial neuropathy due to left medullary lesion. Diffusion weighted (DWI) brain MRI demonstrated high signal signal lesion in left dorsolateral ponto-medullary junction. Apperant diffusion coefficient (ADC) brain MRI showed low signal lesion in the same area. We present an unusual case of ipsilateral peripheral facial palsy in dosolateral ponto-medullary infarction without other neurologic deficits.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1163-1169
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• 2001

Objective : To assess the surgical outcome for patients with primary spondylitis who were treated surgically. Materials and Methods : We retrospectively analyzed the clinical characteristics of 19 patients who underwent surgical treatment from september 1997 to October 1999 in our department. Results : The 19 patients presented 13 tuberculous spondylitis and 6 pyogenic spondylitis. The male to female ratio was 1.4 : 1 and average age 48.4 years(range 15-68 years). The most prevalent location was thoracic region(47%) and paraparesis was frequently seen in patients with middle and lower spinal lesions. Operative approaches were either anterior(13) or posterior(6). All patients with neurologic deficits improved after surgery. Autogenous rib and/or iliac strut bone grafting was performed, followed by spinal instrumentation. Solid bone fusion was obtained in all patients. There was no need for prolongation of duration of antituberculous drug therapy and no increased incidence of secondary infection due to spinal instrumentation. Conclusion : From the results, it may be advised that patients of primary spondylitis who had neurologic deficit should receive an aggressive opeation in their early stage.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.42-52
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• 2021

Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.923-928
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• 2000

Objective : The reliability of transcranial doppler sonography(TCD) for predicting delayed ischemic neurologic deficit( DIND) was investigated in patients with aneurysmal subarachnoid hemorrhage(SAH). Methods : The velocity of blood flow through the middle cerebral artery was measured by TCD in 70 patients treated surgically within 72 hours due to ruptured cerebral aneurysm. A correlation between measured maximal mean blood flow velocities and clinical factors including age, hypertension, Hunt-Hess grade, Fisher grade, DIND, and outcome was made. Results : An age-dependent reduction of the measured maximal mean velocities was found(r＝-0.4043, p<0.001). Flow velocities in hypertensive patients were significantly lower than in the normotensive individuals(two-tailed T test, p<0.05). There was no significant difference between the flow velocities and evaluated other clinical factors. When the flow velocities of 14 patients who developed DIND were compared with those of patients without deficits, no significant difference was seen. A significant increase in flow velocities in the days before the onset of DIND was found only in 4 of 14 cases. High flow velocities did not necessarily mean impending neurological deficits : 6 of 70 patients tolerated flow velocities over 160cm/s. Conclusion : We suggest that TCD readings have limited utility for predicting DIND following SAH, especially in older or hypertensive patients. More direct measurements of blood flow are necessary to adequately predict which patients are at high risk of DIND.

• Annals of Clinical Neurophysiology
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• v.10 no.1
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• pp.29-32
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• 2008

Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

• Journal of Korean Neurosurgical Society
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• v.41 no.2
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• pp.95-99
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• 2007

Objective : The purpose of this reports is to describe the influence of continuous external ventricular drainage [EVD] on delayed ischemic neurologic deficit [DIND] after early surgery in ruptured aneurysmal patients. Methods : The authors reviewed 229 patients with aneurysmal subarachnoid hemorrhage [SAH] who had been treated with clipping at a single institution between 1998 and 2004. Of these, 121 patients underwent continuous EVD [Group A] postoperatively, whereas 108 patients did not [Group B]. EVD was performed at ipsilateral Kocher's point and maintained 2 to 14 days postoperatively. Results : DIND occurred in 15.7% [19 cases] of patients in Group A, 25% [27 cases] from Group B [P value=0.112]. Compared with Group A, Group B was more likely to suffer acute symptom of DIND and showed poor response to 3- H therapy. Major symptoms of DIND in Group A were mild confusion [36.8%] and mild deterioration of mental state [26.3%], contrary to weakness of extremities [59.2%] in Group B. At discharge, Glasgow Outcome Scales [GOS] of Group A were : good recovery [63.2%], moderately disabled [21%], severely disabled [10.5%], dead [5.3%] and Group B : good recovery [48.1%], moderately disabled [37%], severely disabled [14.8%] and dead [0%]. Of 121 patients from group A, 35 patients [28.9%] suffered ventriculitis. Conclusion : Continuous EVD after aneurysmal clipping in patients with SAH reduced the risk of DIND and its sequelae, relieved its symptoms, and improved the outcome.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.74-76
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• 2009

We present an extremely rare case of the atypical choroid plexus papilloma in an adult which developed at the trigone of right lateral ventricle. A 62-year-old woman presented with the history of intermittent and gradually progressive headache and left side hemiparesis for 6 months. The brain magnetic resonance image showed highly enhanced and well demarcated mass at the trigone of lateral ventricle attached to the choroid plexus. Gross total resection was performed by transcortical approach via the middle temporal gyrus. The tumor was diagnosed as an atypical choroid plexus papilloma. She had no neurologic deficit after the surgery. We report a case of atypical choroid plexus papilloma in adult and introduce newly classified pathologic characteristics of this tumor.

• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.360-362
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• 2010

A sphenoid mucocele often presents late due to its deep seated anatomical site. And it has varied presentation due to its loose relationship to the cavernous sinus and the base of the skull. We describe a case of large sphenoid sinus mucocele. A middle aged old man suddenly developed third cranial nerve palsy. Brain imaging study revealed an isolated sphenoid sinus mucocele, compressing right cavernous sinus. Endoscopic marsupialization of the mucocele via transnasal approach led to complete resolution of the third cranial nerve palsy. Involvement of the third cranial nerve in isolated mucocele is rare but important neurosurgical implications which must be excluded. In addition, proper and timely treatment must be performed to avoid permanent neurologic deficit.

• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.83-86
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• 2003

Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.

• Journal of Chest Surgery
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• v.33 no.6
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• pp.525-527
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• 2000

Subarachnoid-pleural fistula after routine thoracotomy is a rare complication but a very serious problem. Twenty one cases have been reported in the literature. We report a care of subarchnoid-pleural fistula that dveloped after the esecation of posterior mediastinal neurogenic tumor. The patient presented with large amount of clear pleural fluid with mild headache and dizziness. Surgical intervention following a trial of conservative therapy was undertaken because we strongly suspected subarachnoid-pleural fistula. A dural tear was found at the level of resected intercostal nerve root. The dura was closed by way of direct suture and fibrin glue. In this case, the recognition of subarachnoid-pleural fistula formation is difficult because the patient had not presented any neurologic deficit.