• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.383-387
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• 2010

Complete removal of three-compartment trigeminal schwannomas is a challenge to neurosurgeons. To expand exposure of each compartment, the combination and modification of skull base approaches are necessary. The 61-year-old woman was admitted with chronic headache. Preoperative magnetic resonance imaging showed $47{\times}50{\times}40\;mm$-sized tumor originating primarily in the middle cranial fossa extended to the posterior and the infratemporal fossa. We performed operation in five stage; 1. Zygomatic osteotomy, 2. Inferior temporal fossa plate removal and foramen ovale opening, 3. Cavernous sinus opening, 4. Tailored anterior petrosectomy, 5. Meckel's cave opening. Combination of skull base surgery should be concerned according to the patient. In this study, extradural basal extension with zygomatic osteotomy, interdural posterior extension with tailored anterior petrosectomy, and intracavemous exploration are reasonable options for remodeling three-compartment lesion into a single compartment. Tailoring of bone resection and exploring through natural pathway between meningeal layers accomplish single-stage operation for complete removal of tumors.

• Journal of Korean Neurosurgical Society
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• 제49권1호
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• pp.53-57
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• 2011

We reported a unique case of posttraumatic giant infratentorial extradural intradiploic epidermoid cyst. A 54-year-old male, with a previous history of an open scalp injury and underlying linear skull fracture in the left occipital region in childhood, presented with a painful subcutaneous swelling, which had been developed gradually in the same region and moderate headache, nausea, vomiting and cerebellar ataxia. The duration of symptoms on admission was 3 months. Imaging studies revealed occipital bone destruction and giant extradural intradiploic lesion. The preoperative diagnosis was giant infratentorial extradural intradiploic epidermoid cyst. Surgery achieved total removal of the lesion, which was histologically confirmed and the postoperative course was uneventful. To our knowledge, this is the first case of giant infratentorial extradural intradiploic epidermoid cyst with a traumatic etiology described in the literature.

• Journal of Korean Neurosurgical Society
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• 제54권1호
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• pp.47-49
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• 2013

As a rare cerebrovascular disease, cerebral venous thrombosis (CVT) is caused by various conditions including trauma, infection, oral contraceptive, cancer and hematologic disorders. However, iron deficiency anemia is not a common cause for CVT in adult. Posterior fossa infarction following CVT is not well demonstrated because posterior fossa has abundant collateral vessels. Here, we report a case of a 55-year-old man who was admitted with complaints of headache, nausea, and mild dizziness. The patient was diagnosed with isolated lateral sinus thrombosis presenting as cerebellar infarction. Laboratory findings revealed normocytic normochromic anemia due to iron deficiency, and the patient's symptoms were improved after iron supplementation.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.464-466
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• 2010

A 59-year-old female presented with headache and dizziness for one year. Magnetic resonance imaging revealed a $52{\times}28$ mm, wellcircumscribed, homogenously enhancing mass lesion without dural attachment located in the left lateral cerebellomedullary cistern. The tumor was excised, and a histological diagnosis was a mixed pattern meningioma of meningothelial and fibroblastic type. A meningioma in the posterior fossa without dural attachment is quite rare. We report a rare case of lateral cerebellomedullary cistern meningioma without dural attachment with literature review.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.477-479
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• 2010

A case of delayed progressive extradural pneumatocele after microvascular decompression (MVD) is presented. A 60-year-old male underwent MVD for hemifacial spasm; the mastoid air cell was opened and sealed with bone wax during surgery. One month after surgery, the patient complained of tinnitus, and progressive extradural pneumatoceles without cerebrospinal fluid (CSF) leakage was observed. Revision surgery was performed and the opened mastoid air cell was completely sealed with muscle patch and glue. The patient's symptoms were resolved, with no recurrence of pneumatoceles at 6 month follow up. Progressive extradural pneumatocele without CSF leakage after posterior fossa surgery is a very rare complication. Previous reports and surgical management of this rare complication are discussed.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.303-305
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• 2006

Rosai-Dorfman Disease[RDD] is an idiopathic histiocytic proliferation affecting lymph nodes. Although extranodal involvement has been reported in the skin, orbit, upper respiratory tract, of testes, the isolated intracranical involvement without associated lymphadenopathy is extremely rare. We report our experience with 1 case of an isolated intracranial RDD without associated lymphadenopathy and any other organ involvement. A 61-year-old male presented with an isolated well-circumscribed brain mass in the posterior fossa, preoperatively thought to be a meningioma. But histology and Immunohistochemistry confirmed that the lesion was RDD.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.407-410
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• 2000

The traumatically induced mass lesions of the posterior cranial fossa are unusual. Various types of traumatic posterior fossa hematoma have been described ; the most common forms is epidural hematomas, and frequently traumatic intracerebellar hemorrhage is encountered. A sixty-six-old male patient was initially presented with the occipital skull fracture and contusional hemorrhage on the both frontal lobe, a developed delayed cerebellar hemorrhage. The patient was operated for hematoma removal with good postoperative recovery. We advise a consideration for delayed intracerebellar hematoma in patients with cerebellar contusion following trauma.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.256-259
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• 2020

Although traumatic posterior fossa subdural hematoma (TPFSH) in neonates immediately after birth is extremely rare, it can pose a serious clinical problem in the neonatal period. Here, the author presents the case of a 3-day-old male infant who underwent emergency surgical treatment of TPFSH with a favorable outcome. Debate continues about surgical versus conservative treatment of TPFSH in neonates. The clinical symptoms, extent of hemorrhage, early diagnosis, and prompt and appropriate surgery are the most important factors in the treatment of TPFSH in neonates. Therefore, neurosurgeons should establish treatment strategies based on the newborn's clinical condition, the size and location of the TPFSH, and the potential of the hematoma to cause long-term complications.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.221-223
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• 2010

C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2P fixation for stabilization of type II odontoid process fracture described by Harms. The patient recovered without a major complication. Twenty months after operation, brain computed tomogram performed at psychology department for disability evaluation showed rod migration into the right cerebellar hemisphere. The patient had mild occipital headache and dizziness only regarding the misplaced rod. He refused further operation for rod removal. To our knowledge, this complication is the first report regarding rod migration after Harms method. We should be kept in mind the possibility of rod migration, and C1LM-C2P fixation should be performed with meticulous technique and long-term follow-up.

• Korean Journal of Head & Neck Oncology
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• 제15권1호
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• pp.40-45
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• 1999

Objectives: Maxillary cancer is notorious for its poor prognosis because it is usually detected lately and the majority of patients have advanced disease. Especially when the cancer extended to infratemporal fossa or pterygopalatine fossa it is very difficult to remove all the involved structure by conventional maxillectomy. In these cases we have used radical maxillectomy through lateral approach. We tried to figure out the clinical significance of this procedure. Material and Methods: This study retrospectively analyzed 23 patients with squamous cell carcinoma of the maxillary sinus who underwent surgical treatment for cure. Among them 17 patients(group A) were treated with initial surgery and 6 patients(group B) underwent salvage surgery after radiotherpy. Radical maxillectomy was performed in 12 patients and conventional total maxillectomy in 11 patients. Results: In group A, 3 out of 9 total maxillectomy case and none of 8 radical maxillectomy case were recurred. In group B one patient died of postoperative complication and among the other 5 patients only one out of 3 radical maxillectomy was salvaged and 2 total maxillectomy cases were died of intercurrent disease. Conclusion: Wide surgical dissection of pterygopalatine fossa and infratemporal fossa may improve the survival rate in patients with posterior wall invasion of maxillary sinus.