• Title/Summary/Keyword: Neurosurgical intervention

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Spontaneous Pneumocephalus Associated with Pneumosinus Dilatans

  • Lee, Jung-Sup;Park, Yong-Sook;Kwon, Jeong-Taik;Suk, Jong-Sik
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.395-398
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    • 2010
  • The majority of cases of pneumocephalus are secondary to trauma or medical intervention. Spontaneous, non-traumatic pneumocephalus is an uncommon condition. Most cases of spontaneous pneumocephalus require surgery. However, if there is no evidence of infection or cerebrospinal fluid leak, bed rest and follow-up imaging is an alternative treatment. Herein, we report a 31-year-old man with spontaneous pneumocephalus associated with pneumosinus dilatans.

Using Blood Donating Set for the Treatment of Subgaleal Hematoma - Technical Note - (헌혈 세트를 이용한 두피하 혈종의 치료 - 치료 수기 -)

  • Suh, Dong-Sang;Kim, Bum-Tae;Cho, Sung-Jin;Shin, Won-Han;Choi, Soon-Kwan;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1519-1522
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    • 2000
  • Sugaleal hematoma usually develop one to eight days after minor head trauma or clotting disorders in children. The galeal aponeurosa in children is loosely attatched to the pericranium, allowing the collection of large quantity of blood. Most cases of subgaleal hematomas resolve spontaneously, however some cases require surgical intervention, aspiration of subgaleal hematoma often alleviate symptoms briefly and but do not shorten the time to resolution. Reaccumulation, infection following aspiration also had been reported. Here, we report the efficacy of using the blood donating set for the treatment of subgaleal hematoma in our series.

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Bilateral Visual Loss as a Sole Manifestation Complicating Carotid Cavernous Fistula

  • Yu, Jeong-Keun;Hwang, Gyo-Jun;Sheen, Seung-Hun;Cho, Yong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.229-230
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    • 2011
  • Visual loss is one of the ocular symptoms resulting from a carotid cavernous fistula (CCF), but has rarely been reported as the sole manifestation in CCF. Visual impairment is known to be associated with a poor outcome unless timely intervention is employed. Herein, the authors report a patient with bilateral rapid progressing visual loss as a sole manifestation in CCF. Vision was successfully restored by transarterial embolization. The authors discuss the necessity of urgent fistula obliteration in patients with visual loss.

Spontaneous Spinal Epidural Hematoma in an Infant : A Case Report and Review of the Literature

  • Lim, Jae-Joon;Yoon, Soo-Han;Cho, Ki-Hong;Kim, Sang-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.84-87
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    • 2008
  • Spontaneous spinal epidural hematoma (SSEH) is rare in children. especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.

Enlargement of Extraspinal Cysts in Spinal Dysraphism : A Reason for Early Untethering

  • Kim, Kyung Hyun;Wang, Kyu-Chang;Lee, Ji Yeoun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.3
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    • pp.342-345
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    • 2020
  • Some types of spinal dysraphism can be accompanied by extraspinal cysts, including myelomeningocele, myelocystocele, myelocele, meningocele, limited dorsal myeloschisis, lipomyelomeningocele, and terminal myelocystocele. Each disease is classified according to the developmental mechanism, embryologic process, site of occurrence, or internal structure of the extraspinal cyst. In most cystic spinal dysraphisms except meningocele, part of the spinal cord is attached to the cyst dome. Most open spinal dysraphisms pose a risk of infection and require urgent surgical intervention, but when the cyst is accompanied by closed spinal dysraphism, the timing of surgery may vary. However, if the extraspinal cyst grows, it aggravates tethering by pulling the tip of the cord, which is attached to the dome of the cyst. This causes neurological deficits, so urgent surgery is required to release the tethered cord.

Pleomorphic Xanthoastrocytoma with an Intracystic Hemorrhage : A Case Report and Literature Review

  • Lee, Dae-Kyu;Cho, Keun-Tae;Im, So-Hyang;Hong, Seung-Koan
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.410-412
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    • 2007
  • Pleomorphic xanthoastrocytoma (PXA) has been considered as a low grade tumor of adolescents and young adults. Although this tumor often shows cystic component, the hemorrhage within the cyst is extremely rare. The authors report a rare case of cystic PXA with a hemorrhage within the cyst and the mural nodule in the left frontal lobe. A 64-year-old male presented with a week history of the right side hemiparesis. After gross total resection of the tumor, the patient was fully recovered from neurological deficit. It is suggested that this typically benign tumor could be presented with hemorrhage, causing a rapid neurological deterioration. Prompt surgical intervention, especially total removal of the tumor can provide an excellent functional recovery.

Staging in Vestibular Schwannoma Surgery : A Modified Technique

  • Kim, Eal-Maan;Nam, Sung-Il
    • Journal of Korean Neurosurgical Society
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    • v.43 no.1
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    • pp.57-60
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    • 2008
  • The authors herein propose the staged excision as a novel strategy to preserve facial nerve and minimize complication during microsurgery of large vestibular schwannoma (VS). At the first stage, for reducing mass effect on the brain stem and cerebellum, subtotal tumor resection was performed via a retrosigmoid craniotomy without intervention of meatal portion of tumor. With total resection of the remaining tumor, the facial nerve was decompressed and delineated during the second stage translabyrinthine approach at a later date. A 38-year-old female who underwent the staging operation for resection of her huge VS is illustrated.

Traumatic Carotid-cavernous Fistula Bringing about Intracerebral Hemorrhage

  • Lee, Chang-Ju;Choi, Seung-Won;Kim, Seon-Hwan;Youm, Jin-Young
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.155-157
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    • 2005
  • Spontaneous intracerebral hemorrhage associated with traumatic carotid-cavernous fistula is rare. The cardinal symptoms of traumatic carotid-cavernous fistula are confined to ocular manifestations. This article describes a case of traumatic carotid-cavernous fistula which was initially diagnosed as an intracerebral hemorrhage, after ocular symptoms were overlooked. Because some cases of carotid-cavernous fistula have an atypical drainage which can result in intracerebral hemorrhage, early diagnosis and intervention are vital to prevent this unwanted intracerebral hemorrhage.

Extravasation from the Distal Anterior Choroidal Artery Aneurysm in Moyamoya Patient during Computed Tomographic Angiography

  • Chong, Jong-Yun;Yi, Hyeong-Joong;Kim, Kwang-Myung;Lee, Seung-Ro
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.340-342
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    • 2007
  • Three-dimensional computed tomographic angiography [CTA], a representative noninvasive radiologic technique, is being widely used for detecting vascular lesions in specific intracranial bleeding under a certain circumstance [acute nontraumatic subarachnoid hemorrhage]. We encountered a case of extravasation of the contrast medium on CTA images that appeared as ribbon-like high-attenuation lesion from an aneurysm at the distal anterior choroidal artery in a young adult moyamoya patient. As CTA is used more frequently, it is imperative to understand such unusual but, potentially lethal image findings to conduct a prompt intervention.

Acute Spinal Subdural Hematoma Presenting with Spontaneously Resolving Hemiplegia

  • Oh, Seung-Hun;Han, In-Bo;Koo, Young-Ho;Kim, Ok-Joon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.390-393
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    • 2009
  • Although prompt diagnosis and emergent surgical intervention are important in acute spinal subdural hematoma (SSDH), some cases with spontaneous remission of symptom and hematoma without surgery have been reported. We present a case of acute nontraumatic SSDH presenting with transient left hemiplegia for 4 hours. A magnetic resonance imaging study of cervical spine confirmed SSDH with C3-6 cervical cord compression at the left side. The patient had conservative management without recurrence. Although hemiplegia is an unusual clinical manifestation of SSDH, it should be differentiated from that of cerebrovascular origin promptly. Conservative management may be an alternative therapeutic option for selective cases with transient neurological deficits.