• Title/Summary/Keyword: Neurosurgical operation

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Neuromyelitis Optica Mimicking Intramedullary Tumor

  • Oh, Si-Hyuck;Yoon, Kyeong-Wook;Kim, Young-Jin;Lee, Sang-Koo
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.316-319
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    • 2013
  • Neuromyelitis optica (NMO) is considered to be a rarer autoimmune disease than multiple sclerosis. It is very difficult to make a diagnosis of MNO for doctors who are not familiar with its clinical features and diagnostic criteria. We report a case of a young female patient who had been suffering motor weakness and radiating pain in both upper extremities. Cervical MRI showed tumorous lesion in spinal cord and performed surgery to remove lesion. We could not find a tumor mass in operation field and final diagnosis was NMO. NMO must be included in the differential diagnosis of lesions to rescue the patient from invasive surgical interventions. More specific diagnostic tools may be necessary for early diagnosis and proper treatment.

Massive Calcified Cerebellar Pilocytic Astrocytoma with Rapid Recurrence : A Rare Case

  • Aydemir, Fatih;Kardes, Ozgur;Kayaselcuk, Fazilet;Tufan, Kadir
    • Journal of Korean Neurosurgical Society
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    • v.59 no.5
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    • pp.533-536
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    • 2016
  • Pilocytic astrocytomas (PAs) are World Heath Organization Grade I tumors and are most common in children. PA calcification is not a common finding and has been reported more frequently in the optic nerve, hypothalamic/thalamus and superficially located cerebral tumors. We present a cerebellar PA in a 3-year-old male patient with cystic components and massive calcification areas. The residual tumor grew rapidly after the first operation, and the patient was operated on again. A histopathological examination revealed polar spongioblastoma-like cells. Massive calcification is not a common feature in PAs and can lead to difficulties in radiological and pathological differential diagnoses.

From Exoscope into the Next Generation

  • Nishiyama, Kenichi
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.289-293
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    • 2017
  • An exoscope, high-definition video telescope operating monitor system to perform microsurgery has recently been proposed an alternative to the operating microscope. It enables surgeons to complete the operation assistance by visualizing magnified images on a display. The strong points of exoscope are the wide field of view and deep focus. It minimized the need for repositioning and refocusing during the procedure. On the other hand, limitation of magnifying object was an emphasizing weak point. The procedures are performed under 2D motion images with a visual perception through dynamic cue and stereoscopically viewing corresponding to the motion parallax. Nevertheless, stereopsis is required to improve hand and eye coordination for high precision works. Consequently novel 3D high-definition operating scopes with various mechanical designs have been developed according to recent high-tech innovations in a digital surgical technology. It will set the stage for the next generation in digital image based neurosurgery.

A Case of Thoracic Vertebral Chondroblastoma, Treated with 3-D Image Guided Resection and Reconstruction

  • Lee, Yoon-Ho;Shin, Dong-Ah;Kim, Keung-Nyun;Yoon, Do-Heum
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.154-156
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    • 2005
  • We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

Guillain-Barr$\acute{e}$ Syndrome Following Spinal Fusion for Thoracic Vertebral Fracture

  • Son, Dong-Wuk;Song, Geun-Sung;Sung, Sun-Ki;Kim, Sung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.464-467
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    • 2011
  • There have been very few reports in the literature of Guillain-Barr$\acute{e}$ syndrome (GBS) after spinal surgery. We present a unique case of GBS following spinal fusion for thoracic vertebral fracture. The aim of this report is to illustrate the importance of early neurological assessment and determining the exact cause of a new neurological deficit that occurs after an operation.

Bilateral Subdural Hematoma due to an Unnoticed Dural Tear during Spine Surgery

  • Jung, Youn-Young;Ju, Chng-Il;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.316-318
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    • 2010
  • We report a rare case of intracranial hypotension that was complicated by a subdural hematoma following spine surgery. Intraoperatively, we did not notice any breach of the dura. However, the patient continued to have fluid leakage from the inferior edge of the lumbar incision. During revision surgery, a small dural tear was identified and repaired. It is likely that a small dural tear was overlooked or the dura was weakened during the initial operation and caused a subdural hematoma associated with intracranial hypotension.

Cerebral Aneurysm in the Long Fenestration at the Middle Portion of M1 Segment

  • Sim, Ki-Bum;Lee, Chang-Sub;Park, Jung-Cheol;Huh, Ji-Soon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.434-437
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    • 2010
  • We report a unique case of bilateral mirror image M1 aneurysms, one of which was an unruptured aneurysm arising from the proximal end of right middle cerebral artery fenestration with long loop and the other ruptured aneurysm from the contralateral side. We clipped ruptured aneurysm first and unruptured one in three months after the first operation. The difficulties of identifying this unusual vascular anomaly and possible problems during the surgery of an aneurysm at the site of fenestration are discussed with a review of the literature.

Intraparenchymal Myeloid Sarcoma and Subsequent Spinal Myeloid Sarcoma for Acute Myeloblastic Leukemia

  • Eom, Ki-Seong;Kim, Tae-Young
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.171-174
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    • 2011
  • Myeloid sarcoma is a solid, extramedullary tumor composed of leukemic myeloblasts or immature myeloid cells. Intraparenchymal myeloid sarcoma without the involvement of the skull or meninges is extremely rare. Here, we present the case of a 49-year-old man who developed intraparenchymal myeloid sarcoma on the left cerebellum after allogeneic bone marrow transplantation (BMT). He received radiotherapy after complete removal of intraparenchymal myeloid sarcoma, but he was diagnosed spinal myeloid sarcoma three month later. Nine months after the operation, new intracranial and spinal myeloid sarcoma were diagnosed and the patient's condition had been worsened rapidly. Although the spinal myeloid sarcoma was not histologically diagnosed, this report provides valuable insights into the clinical course of progression of intraparenchymal myeloid sarcoma.

Disseminated Intravascular Coagulation in a Patient Undergoing Removal of Metastatic Brain Tumor

  • Eom, Ki-Seong;Kim, Jong-Moon;Kim, Tae-Young
    • Journal of Korean Neurosurgical Society
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    • v.44 no.5
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    • pp.341-344
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    • 2008
  • The authors present a case of 68-year-old woman who underwent resection of a metastatic adenocarcinoma in the left parietooccipital area. The intraoperative course was uneventful; however, after closure of the scalp incision, increased bleeding from the suture line was noted. A computerized tomography scan that was performed immediately after operation revealed acute epidural hemorrhage with mass effect under the bone flap. The patient developed disseminated intravascular coagulation and immediate re-exploration was performed. This patient was successfully treated owing to early recognition of the condition and immediate treatment with transfusion. Neurosurgeons should be alert that hypercoagulabe state is common in cancer patients and consumptive coagulopathy can occur after resection of metastatic brain tumor.

Intracranial Dissemination from Spinal Cord Anaplastic Astrocytoma

  • Jeong, Seong-Man;Chung, Yong-Gu;Lee, Jang-Bo;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.68-70
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    • 2010
  • We report a case of intracranial dissemination developing approximately 4 months after partial removal of a spinal cord anplastic astrocytoma in a 22-year-old male. He presented with paraplegia on initial admission at a local hospital. Spinal magnetic resonance (MR) images disclosed multiple intramedullary lesions at the T3-11. The tumor was partially removed. The final histologic diagnosis was anaplastic astrocytoma. Four months after the operation, he was admitted with the symptoms of headache and deterioration of consciousness. MR images showed enhanced lesions in the anterior horn of the left lateral ventricle, and septum pellucidum. He underwent computed tomography-guided stereotactic biopsy and histological appearance was consistent with anaplastic astrocytoma. The clinical course indicates that the tumor originated in the spinal cord and extended into the subarachnoid space, first the spinal canal and later intracranial.