• Journal of Korean Neurosurgical Society
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• 제29권5호
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• pp.640-643
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• 2000

Objective : In neurosurgical practice, it has been generally accepted that when the dura is opened, it should be watertightly closed, and traditionally non-watertight closure has not been performed. We clinically tried non-watertight closure, analyzed the frequency of CSF leakage and evaluated the possible clinical application of non-watertight closure. Methods : After classifying our cases with supratentorial and infratentorial approach, we tried non-watertight and watertight closures and compared the results. We also analyzed the cases with or without dural graft. Results : In supratentorial approach, the rate of cerebrospinal fluid leakage noted in non-watertight closure was similar to that of watertight closure. In infratentorial approach, except microvascular decompression(MVD), the rate of cerebrospinal fluid leakage in non-watertight closure was higher than that of watertight closure. Dura graft application did not seemed to influence the cerebrospinal fluid leakage. Conclusion : Since the frequency of cerebrospinal fluid leakage was not higher in non-watertight closure than that of watertight closure, non-watertight closure can be applied in supratentorial approach. In infratentorial approach, non-watertight closure may be applied in surgery with relatively short dural incision, such as MVD. However, non-watertight closure doesn't seem to be appropriate in surgery that requires wide dural incision, such as skull base surgery.

• Journal of Korean Neurosurgical Society
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• 제41권5호
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• pp.343-346
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• 2007

Hypoplasia of the internal carotid artery is a rare congenital anomaly. Agenesis, aplasia, and hypoplasia of the internal carotid artery [ICA] are frequently associated with cerebral aneurysms in the circle of Willis. Authors report two cases with congenital hypoplasia of the ICA accompanying with the aneurysms. Transfemoral cerebral angiography [TFCA] in one patient identified nonvisualization of the left ICA. Bilateral anterior cerebral artery [ACA] and middle cerebral artery [MCA] were supplied from the right ICA accompanying with two aneurysms at anterior communicating artery [AcoA] and A1 portion of the left ACA. TFCA in another patient demonstrated hypoplastic left ICA and left ACA filled from the right ICA accompanying with AcoA aneurysm. Left MCA was filled from basilar artery via posterior communicating artery [PcoA]. Skull base computed tomography [CT] in two patients showed hypoplastic carotid canal. Authors performed direct aneurysmal neck clipping. Follow up CT angiography [CTA] at one year after surgery did not show regrowth or new development of the aneurysm. In patients with hypoplastic ICA, neurosurgeons should be aware of the possibility of development of the aneurysms, presumably because of hemodynamic process. Direct aneurysmal neck clipping is a good treatment modality. After operation, regular CTA, magnetic resonance angiography [MRA] or TFCA is needed to find progressive lesion and to prevent cerebrovascular attack [CVA].

• 한국어병학회지
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• 제7권2호
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• pp.105-112
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• 1994

1993년 전북도 관내에서 순환여과식으로 사육중인 한국산 메기에 세균성 질병이 발생하여, 이 질병에 의한 폐사율이 4개월 동안에 30%에 달하였다. 병어는 양어지의 가장자리에서 두부를 위로 한채 힘없이 물표면을 헤엄치거나 때로는 회전 발광유영을 하는 개체가 많았다. 외견상 특정적인 증상은 두부와 가슴지느러미의 기부에 궤양 병소가 형성되거나 아랫턱 주변의 출혈을 주증상으로 하고 있었다. 병어의 뇌, 신장, 비장 및 간장으로부터 원인균을 분리하여 생화학적 특성과 생물학적 특성을 조사한 바, Edwardsiella ictaluri로 동정되었다. 분리균을 한국산 메기, 차넬메기 및 잉어에 복강주사하여 병원성을 조사한 결과 한국산 메기와 차넬메기에는 병원성이 있었지만, 잉어에 대한 병원성은 없었다.

• 대한골관절종양학회지
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• 제11권1호
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• pp.94-99
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• 2005

부신경절종은, 신경외배엽 기원의 교감신경 신경내분비 세포로 이루어져 있는, 부신 이외의 부신경절에서 생긴 종양으로, 주로 갑상선, 목동맥체, 종격동, 폐, 십이지장, 대동맥 주변 부위와 후복막 부위에 잘 생긴다. 악성도는 조직학적인 진단에 의한 것이 아니라, 국소 림프절 재발과 원격 전이에 의하여 판별되며, 골 전이가 드물지만 전이가 일어나면 주로 두개골 기저, 척추에 생기며, 드물게 골반골, 대퇴골로 전이한다. 저자들은 대퇴부 피하층에 발생하여 혈관 기원성의 종양과 감별되었던 부신경절종과 조기 골 전이를 보인 후복막에 발생한 부신경 절종을 경험하여 문헌고찰과 함께 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.405-410
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• 2013

Objective : The objective of this study was to investigate changes in the posterior cranial fossa in patients with symptomatic Chiari malformation type I (CMI) compared to a control group. Methods : We retrospectively reviewed clinical and radiological data from 12 symptomatic patients with CMI and 24 healthy control subjects. The structures of the brain and skull base were investigated using magnetic resonance imaging. Results : The length of the clivus had significantly decreased in the CMI group than in the control group (p=0.000). The angle between the clivus and the McRae line (p<0.024), as the angle between the supraocciput and the McRae line (p<0.021), and the angle between the tentorium and a line connecting the internal occipital protuberance to the opisthion (p<0.009) were significantly larger in the CMI group than in the control group. The mean vertical length of the cerebellar hemisphere (p<0.003) and the mean length of the coronal and sagittal superoinferior aspects of the cerebellum (p<0.05) were longer in the CMI group than in the control group, while the mean length of the axial anteroposterior aspect of the cerebellum (p<0.001) was significantly shorter in the CMI group relative to control subjects. Conclusion : We elucidate the transformation of the posterior cranial fossa into the narrow funnel shape. The sufficient cephalocaudal extension of the craniectomy of the posterior cranial fossa has more decompression effect than other type extension of the craniectomy in CMI patients.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.100-106
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• 2013

Objective : To investigate the cases of intracranial abnormal brain MRI findings even in the negative brain CT scan after mild head injury. Methods : During a 2-year period (January 2009-December 2010), we prospectively evaluated both brain CT and brain MRI of 180 patients with mild head injury. Patients were classified into two groups according to presence or absence of abnormal brain MRI finding even in the negative brain CT scan after mild head injury. Two neurosurgeons and one neuroradiologist validated the images from both brain CT scan and brain MRI double blindly. Results : Intracranial injury with negative brain CT scan after mild head injury occurred in 18 patients (10.0%). Headache (51.7%) without neurologic signs was the most common symptom. Locations of intracranial lesions showing abnormal brain MRI were as follows; temporal base (n=8), frontal pole (n=5), falx cerebri (n=2), basal ganglia (n=1), tentorium (n=1), and sylvian fissure (n=1). Intracranial injury was common in patients with a loss of consciousness, symptom duration >2 weeks, or in cases of patients with linear skull fracture (p=0.00013), and also more frequent in multiple associated injury than simple one (35.7%>8.6%) (p=0.105). Conclusion : Our investigation showed that patients with mild head injury even in the negative brain CT scan had a few cases of intracranial injury. These findings indicate that even though the brain CT does not show abnormal findings, they should be thoroughly watched in further study including brain MRI in cases of multiple injuries and when their complaints are sustained.

• Investigative Magnetic Resonance Imaging
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• 제14권1호
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• pp.74-77
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• 2010

과립세포육종은 골수성 백혈병의 발현 형태의 하나로써, 과립세포들의 원시 전구체가 골수가 아닌 연조직에 침착하여 생긴 고형 종괴를 지칭한다. 저자들은 다른 전신 증상 없이 양쪽 안구의 돌출을 주소로 내원하여 광범위한 양쪽 안와-부비동 과립세포육종으로 진단된 22개월 남아의 CT 및 MR 소견을 보고한다. 종괴는 양측 안와 외하벽을 침범하여 양쪽 안구를 돌출시켰으며, 부비동, 상악골, 측두골, 광대뼈, 나비뼈, 벌집뼈, 입천장뼈를 포함한 거의 모든 머리뼈바닥의 골수에 침윤하고 주변에 연부 조직 종괴를 형성하였고, 해면정맥동의 아래 1/2을 침범하고 측두골 안쪽의 경질막이 비후된 소견을 동반하였다. 환아는 골수를 이용한 염색체 검사를 통해 8번과 21번 염색체의 상호전좌 t(8;21) (q22;q22)를 동반한 급성 골수성 백혈병으로 진단되었다.

• Clinical and Experimental Pediatrics
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• 제58권9호
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• pp.354-357
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• 2015

Parry-Romberg syndrome (PRS) is a rare, acquired disorder characterized by progressive unilateral facial atrophy of the skin, soft tissue, muscles, and underlying bony structures that may be preceded by cutaneous induration. It is sometimes accompanied by ipsilateral brain lesions and neurological symptoms. Here we present the case of a 10-year-old girl with right-sided PRS and recurrent monoplegic ataxia of the left leg. At 4 years of age, she presented with localized scleroderma over the right parietal region of her scalp; her face gradually became asymmetric as her right cheek atrophied. Brain magnetic resonance imaging revealed hemiatrophy of the face and skull base, and T2-weighted images showed increased signal in the right hemipons and hemicerebellar peduncle. Magnetic resonance angiography findings were unremarkable. She was treated with oral prednisolone, and her recurrent gait ataxia diminished within 2 months of the follow-up period. To the best of our knowledge, this is only the second case of PRS presenting with an abnormal involvement of the ipsilateral hemipons.

• Archives of Plastic Surgery
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• 제32권1호
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• pp.29-36
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• 2005

Craniosynostosis is the premature fusion of one or more sutures of either cranial vault or base. Fused sutures may impede normal growth of the calvaria, leading to characteristic skull deformities; Morphological craniosynostosis is classified descriptively. Being craniosynostosis uncorrected the deformity progresses continuously and causes an increase of intracranial pressure. The surgical involvement aims at the expansion of intracranial space as well as satisfactory achievement of craniofacial shape. Early surgical correction in infancy prevents the deformity from the further progression and possible associated complication of high intracranial pressure. A long period of follow-up is essential to asses the outcome of an effectiveness of the surgery. measurement of intracranial volume has been concerned in medical personnel and anthropologists for many years. A reliable and accurate measurements of the intracranial volume facilitates to make a diagnosis and treatment of craniosynostosis. Pre-and postoperative change of intracranial volume was evaluated with 3D CT scanning in 12 cases of craniosynostosis who underwent frontal advancement and total cranial vault remodeling. Increased intracranial volume is attributed to surgical release of craniosynostosis and natural growth. We conceive that the intracranial volume is significantly increased after surgical correction of fused cranial sutures and along with natural growing. A procedure of frontal advancement and total cranial vault remodeling is very useful to correct such a deformity as craniosynostosis. And also 2 cases out of five mentally retarded patients improved remarkably and Forehead retrusion or temporal depression followed in another two cases.

• 대한두경부종양학회지
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• 제3권1호
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• pp.97-105
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• 1987

Chondrosarcoma of the head and neck is very rare tumor and this incidence was reported to be about 10% of all chondrosarcomas. Maxilla is the most common site of involvement and mandible, paransal sinus, nasal cavity and base of skull in that order. In general, chondrosarcoma has been known to be radioresistant, however since the Princess Margaret Hospital reported that it was radioresponsive tumor in 1980, the role of radiotherapy has been emphasized in terms of local control, especially in head and neck regions where complete excion is often difficult to achieve. The authors experienced 4 cases of chondrosarcoma of head and neck among all 29 chondrosarcoma patients from 1971 to 1985. The clinical and pathologic feature of this disease, it's treatment and prognosis were reviewed along with the literatures.