• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.98-101
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• 2012

We report a patient who underwent gamma knife radiosurgery to treat recurrent meningioma after microsurgery and thereafter developed secondary malignancy adjacent to the original tumor. A 47-year-old woman had underwent resection of the olfactory groove meningioma. Then radiosurgery was done three times over 4 year period for the recurrent tumor. After 58 months from the initial radiosurgery, she presented with headache and progressive mental dullness. Huge tumor in bifrontal location was revealed in MRI. Subsequent operation and pathological examination confirmed diagnosis of glioblastoma. This case fits the criteria of radiation-induced tumor and the clinical implication of the issue is discussed.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.367-369
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• 2012

Terson syndrome was originally used to describe a vitreous hemorrhage arising from aneurysmal subrarachnoid hemorrhage. Terson syndrome can be caused by intracranial hemorrhage, subdural or epidural hematoma and severe brain injury but is extremely rare in intraventricular hemorrhage associated with moyamoya disease. A 41-year-old man presented with left visual disturbance. He had a history of intraventicular hemorrhage associated with moyamoya disease three months prior to admission. At that time he was in comatose mentality. Ophthalmologic examination at our hospital detected a vitreous hemorrhage in his left eye, with right eye remaining normal. Vitrectomy with epiretinal membrane removal was performed. After operation his left visual acuity was recovered. Careful ophthalmologic examination is mandatory in patients with hemorrhagic moyamoya disease.

• Journal of Korean Neurosurgical Society
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• 제43권6호
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• pp.300-303
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• 2008

Shunt infections are a common complication of ventriculoperitoneal (VP) shunts, but the formation of a brain abscess related to a shunt system is very rare. A 44-year-old woman had a VP shunt inserted for hydrocephalus secondary to a subarachnoid hemorrhage. She suffered an episode of meningitis and sepsis 8 months after the shunt operation. After recovering from the meningitis, she complained of a loss of cognitive function. An enhancing mass was found in the frontal lobe, around the frontal horn of the lateral ventricle, and the ventricular catheter was embedded inside the mass. The ventricular catheter and cerebral abscess were removed using neuroendoscopy. We present an interesting case of a shunt-related brain abscess which illustrates the usefulness of neuroendoscopy.

• Journal of Korean Neurosurgical Society
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• 제43권1호
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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.

• Journal of Korean Neurosurgical Society
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• 제43권4호
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• pp.201-204
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• 2008

Angiosarcoma of the brain, either primary or metastatic is extremely rare. Moreover, angiosarcoma metastazing to the brain is also highly unlike to occur when comparing with metastases to the other organs. Thus, an ideal treatment strategy has not been established. A 67-year-old man with past surgical history of a scalp angiosarcoma underwent surgical resection of intracranial invasion. Because of wide scalp flap excision and resultant poor vascularity of the scalp flap, additional radiation was not provided. Because adjuvant therapy is impossible due to poor scalp condition, more careful but ample resection of the primary lesion is essential to conduct initial operation.

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.197-200
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• 2013

Diagnosis of cerebral syphilitic gumma is frequently determined at the time of surgery, because imaging and laboratory findings demonstrate the elusive results. A 59-year-old woman presenting dysarthria showed a mass on her brain computed tomography. She was first suspected of brain tumor, but histological results from surgical resection revealed cerebral gumma due to neurosyphilis. After operation, she presented fever and rash with an infiltration on a chest X-ray. Histological assessment of skin was consistent with syphilis. Fluorescent treponemal antibody absorbed test IgG in cerebrospinal fluid was positive. She was successfully treated with ceftriaxone for 14 days.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.381-383
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• 2006

Spinal extradural arachnoid cyst is uncommon and rarely cause neural compression. We report a rare case of severe cord compression due to septated spinal extradural arachnoid cyst. A 35-year-old woman has developed back pain 3 months prior to her visit, but recently motor weakness and urinary incontinence occurred. Magnetic resonance images showed an extradural cyst posterior to the cord, which was flattened and displaced from T12 to L2. Urgent decompressive laminectomy and cyst removal was performed. Histopathological examination confirmed that cyst wall was formed by nonspecific fibrous connective tissue without a single-cell layer of inner arachnoid lining. Motor weakness and voiding difficulty were recovered completely after operation.

• 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.

• Journal of Korean Neurosurgical Society
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• 제40권1호
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• pp.35-37
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• 2006

We present a case of acute spinal epidural hematoma[EDH] following unilateral laminectomy for bilateral decompression[ULBD]. A 45-year-old male presented with severe multi-level spinal stenosis underwent ULBD on the left side at the L2-3 and L3-4 level. Five hours after operation, paraparesis developed along with severe bilateral buttock pain. The CT scan showed an acute spinal EDH at the L2-3 level. The acute spinal EDH was successfully decompressed after emergency decompressive surgery with performing an additional laminectomy on the contralateral side at the L2-3 level. Although ULBD is an effective minimally invasive surgical technique for treating spinal stenosis, the possibility of acute spinal EDH should be kept in mind, as happened in our case.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.400-403
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• 2001

Extradural meningiomas are relatively rare and those arising from spinal root are even rarer. Recently, a case of extradural meningioma arising from a spinal nerve root was surgically treated in our institution. This patient was a 19-year-old female presented with paraparesis and paresthesia. The mass was compressing the spinal cord at the level of fourth thoracic spine, and it was extended to the nerve root. At operation it was found to be originated from the fourth thoracic spinal nerve root. After removal of the tumor, the neurologic symptom and sign were recovered completely. Histoligic examination of tumor revealed as transitional type of meningioma.