• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.58-60
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• 2014

Spinal meningiomas typically adhere to the dura matter. Non-dural based spinal meningiomas are rare and most are clear cell meningiomas. We report here the first case of a fibrous meningioma with non-dural attachment. The patient was a 49-year-old female, who complained of numbness in the legs and a gait disturbance. Magnetic resonance imaging revealed a $1.7{\times}1.4-cm$ mass in the C7-T1 intra-dural extramedullary space, showing peripheral gadolinium enhancement without a "dural tail sign". A complete microsurgical resection was performed. The mass was covered with a white membrane but was not adhered to the dura, and its appearance was consistent with a neurilemmoma. The histopathological diagnosis was fibrous-type meningioma. The recovery of the patient was uneventful. No surgical complications and no recurrence of the tumor had occurred at the 6-month follow-up.

• Journal of Korean Neurosurgical Society
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• 제56권4호
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• pp.348-352
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• 2014

High-flow vertebral arteriovenous fistulas (VAVF) are rare complications of cervical spine surgery and characterized by iatrogenic direct-communication of the extracranial vertebral artery (VA) to the surrounding venous plexuses. The authors describe two patients with VAVF presenting with ischemic presentation after C1 pedicle screw insertion for a treatment of C2 fracture and nontraumatic atlatoaxial subluxation. The first patient presented with drowsy consciousness with blurred vision. The diffusion MRI showed an acute infarction on bilateral cerebellum and occipital lobes. The second patient presented with pulsatile tinnitus, dysarthria and a subjective weakness and numbness of extremities. In both cases, digital subtraction angiography demonstrated high-flow direct VAVFs adjacent to C1 screws. The VAVF of the second case occurred near the left posterior inferior cerebellar artery originated from the persistent first intersegmental artery of the left VA. Both cases were successfully treated by complete occlusion of the fistulous portion and the involved segment of the left VA using endovascular coil embolization. The authors reviewed the VAVFs after the upper-cervical spine surgery including C1 screw insertion and the feasibility with the attention notes of its endovascular treatment.

• The Korean Journal of Pain
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• 제9권1호
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• pp.279-282
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• 1996

A 45-year-old male received cervical continuous epidural block for posterior neck pain radiating to right upper extremity secondary to cervical herniated nucleus pulposus. Three days after epidural catheterization, fever, radicular pain and weakness of both upper extremities were developed. On admission, his temperature was $38.3^{\circ}C$ and showed progressive weakness and numbness in both upper and lower extremities. Cervical epidural abscess was suspected; MRI showed an epidural abscess from C4 to C7 level. Within 24 hours of admission, surgical decompression and drainage was effected. Culture of pus obtained at the lesion yielded Staphylococcus aureus. He was treated with intravenous antibiotics for 7 weeks resulting marked improvement of neurologic signs and symptoms.

• The Korean Journal of Pain
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• 제9권1호
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• pp.256-259
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• 1996

Epidural adhesiolysis is a convenient and safe method for the management of back pain. However, we experienced a case where a patient developed sensory change to S2 area after epidural adhesiolysis. Male patient, 43 years old, was admitted to our pain clinic for epidural adhesiolysis for back pain. Patient was experiencing pain radiating to left thigh, and sensory change and motor disturbance to the S1 area. Patient's symptoms and signs were much improved on the first day of epidural adhesiolysis. Patient, however, complained of numbness of perineal and S2 areas after the next day of injections. We postulated the cause of this complication was due to: compression of nerve root by the large volume of injectate and hematoma, and the side effect of local anesthetic, hypertonic saline and steroid.

• The Korean Journal of Pain
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• 제19권2호
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• pp.282-284
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• 2006

Percutaneous radiofrequency thermocoagulation has been applied in patients with various forms of chronic pain, such as facet joint pain, cancer pain and trigeminal neuralgia. A major portion of the hip joint is innervated by the articular branches of the femoral and obturator nerves. Radiofrequency thermocoagulation of the articular branches of the obturator and femoral nerves can be a good alternative treatment for patients with hip joint pain, especially in those where surgery is not applicable. A patient suffering hip joint pain due to metastatic cancer underwent multiple radiofrequency lesioning of the femoral and obturator nerves at $80^{\circ}C$ for 120 seconds, using a Racz-Finch Kit. The patient experienced about a 50% reduction in the pain, without any numbness or other side effects.

• The Korean Journal of Pain
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• 제22권1호
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• pp.92-95
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• 2009

Transverse myelitis is a focal inflammatory disorder of the spinal cord characterized by motor, sensory, and autonomic dysfunction. A 41-year-old man with transverse myelitis and no pre-existing neurologic disease presented with hypesthesia, numbness, weakness in the both lower extremities, back pain, decreased libido, constipation, and dysuria. A MRI test showed intramedullary high signal intensity between T4 and T8 on a T2-weighted image. After high-dose intravenous methylprednisolone and oral prednisolone therapy, he showed facial swelling and acneiform eruption. Therefore, we injected 40 mg methylprednisolone via an epidural route. A 7-dose serial treatment improved most symptoms. A follow up MRI showed radiological improvement. We report a case of transverse myelitis treated by epidural steroids.

• The Korean Journal of Pain
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• 제22권1호
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• pp.65-67
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• 2009

Tarsal tunnel syndrome is often misdiagnosed it shares clinical features with other diseases of the lower extremity such as lumbar radiculopathy and arthritis. Failure to diagnose and treat neuropathies effectively can cause permanent neuropathic pain. We report a case of a ganglion cyst detected early using ultrasonography and MRI in a 51-year-old man who complained of rapidly aggravating pain, numbness and paresthesia on the great toe and the first metatarsal area in the sole, symptoms that resembled tarsal tunnel syndrome. Surgical treatment could be performed early with no permanent sequelae. We could also avoid repeated steroid injections or prescription medications.

• 동의신경정신과학회지
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• 제14권2호
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• pp.155-167
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• 2003

Objective : The aims of this study were to show the clinical aspects and to investigate psychiatric traits by SCL-90-R in patients who visited Oriental Medicine Hospital Emergency Room. Method : We studied twenty patients who visited Daejeon University Oriental Medicine Hospital from May, 2003 to September, 2003. Results : 1. The ratio of male to female patients was 1:3 and age distribution was most frequent in 30s&40s. 2. The most frequent cause of illness was stress in occupation and overwork. The greater part of patients came to hospital in 12hours after an attack. 3. In chief problem, somatic symptoms such as headache, dizziness, numbness and chest discomfort were most frequent. In diagnosis, somatization disorder was most frequent. 4. After treatment, most of symptoms were improved. 5. Psychiatric traits by SCL-90-R correlated with somatization and anxiety.

• 동의생리병리학회지
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• 제19권3호
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• pp.573-579
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• 2005

The followings are the conclusions drawn from the clinical cases of apoplexy; The main cause of apoplexy is the deficiency of both Jung and Ki. dam typed persons are stricken with paralyses because of the insufficiency of the kidney water. On the other hand, bangkwang typed persons' apoplexy comes from the deficiency of Ki and dump-phlegm. The prevention of apoplexy is very important so that porpe medical care should be taken at the appearance of premonitory symptoms like vertigo, dim sight tinnitus, stiff neck, numbness and others. It appears very reasonable both clinically and pathologically that Li dongyuen classified the apoplexy in to three groups : the first group is apoplexy involving meridians ; the second. involving Bu ; the third, involving Jang. The accurate diagnosis of apoplexy regulates com prehension consideration of four factors configuration color, pulse and symptoms and distinction from the similar diseases. Apoplexy is the up wand floating of Yaug in deficiency due to the deficiency of genuine Yim. In its early stages it should be treated by eliminating the excess in the upper pant. In the lower pant becomes the fundamental treatment.

• 동의생리병리학회지
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• 제24권3호
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• pp.512-518
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• 2010

The purpose of this paper is to report the patient with lateral medullary syndrome due to occlusion of vertebral artery who was improved by oriental medical treatment. The patient was admitted on May 15, 2009 and remained until May 29, 2009. He was treated with herbal medicine, acupuncture, moxibustion, cupping and physical therapy. After the treatment, the symptoms(vertigo, diplopia, gait ataxia, sensory loss numbness, Horner's syndrome, etc) improved. This result suggests that oriental medicine can be an effective treatment for a patient with lateral medullary syndrome due to occlusion of vertebral artery. But more clinical case reports are needed.