• Journal of Korean Neurosurgical Society
• /
• 제30권7호
• /
• pp.947-950
• /
• 2001

Cavernous angiomas are being increasingly well recognized throughout the central nervous system due to the widespread use of magnetic resonance imaging(MRI). However, these malformations are uncommon in the spinal column and rarely occur in the spinal cord. Here, we report a case of a cervical cord intramedullary cavernous angioma in a 49-year-old man. The patient had complained of left upper extremity paresthesia and weakness in the left hand for 5 days prior to admission. A neurological examination showed a left C-6 dermatome paresthesia and a weakness in the left hand grasping power. A MRI demonstrated a mixed signal intensity core at the C-5 level and a surrounding edema on the T-2 weighted image. Conservatively, a laminectomy was performed and slightly hard and well demarcated intramedullary mass was removed. A histological examination confirmed the diagnosis of a cavernous angioma.

• 한국임상수의학회지
• /
• 제36권3호
• /
• pp.180-183
• /
• 2019

A 7-year-old, male Maltese dog with a body weight of 2.8 kg was presented with a history of hind limbs ataxia that progressed to tetraparesis over a one-month period. Based on physical and neurological examinations, tetraparesis with concomitant UMN signs, kyphosis and severe neck pain were identified. On MRI scan, we tentatively diagnosed this patient as a primary intramedullary spinal cord tumor. Therapy with lomustine plus hydroxyurea and prednisolone was initiated and the clinical signs rapidly improved. The patient was regularly checked by MRI scan and the range of the mass was gradually reduced to complete remission for 11 months. About 19 months after treatment, the patient showed anemia and hematochezia which suspected as adverse effects of chemotherapy. The condition was getting worse over 2 months and the patient suddenly expired 657 days after initial presentation. On histopathological examination, the spinal cord sample was identified as a neuronal atrophy without evidence of tumor cell.

• Journal of Korean Neurosurgical Society
• /
• 제56권6호
• /
• pp.527-530
• /
• 2014

Spinal subarachnoid hemorrhages (SAH) can extend into the intracranial subarachnoid space, but, severe cerebral vasospasm is rare complication of the extension of intracranial SAH from a spinal subarachnoid hematoma. A 67-year-old woman started anticoagulant therapy for unstable angina. The next day, she developed severe back pain and paraplegia. MRI showed intradural and extramedullar low signal intensity at the T2-3, consistent with intradural hematoma. High signal intensity was also noted in the spinal cord from C5 to T4. We removed subarachnoid hematoma compressing the spinal cord. The following day, the patient complained of severe headache. Brain CT revealed SAH around both parietal lobes. Three days later, her consciousness decreased and left hemiplegia also developed. Brain MRI demonstrated multiple cerebral infarctions, mainly in the right posterior cerebral artery territory, left parietal lobe and right watershed area. Conventional cerebral angiography confirmed diffuse severe vasospasm of the cerebral arteries. After intensive care for a month, the patient was transferred to the rehabilitation department. After 6 months, neurologic deterioration improved partially. We speculate that surgeons should anticipate possible delayed neurological complications due to cerebral vasospasm if intracranial SAH is detected after spinal subarachnoid hematoma.

• Journal of Korean Neurosurgical Society
• /
• 제41권1호
• /
• pp.57-60
• /
• 2007

The incidence of diastematomyelia associated with teratoma is extremely rare. We present a case of sacrococcygeal teratoma in a neonate with split spinal cord malformation[SSCM]. Magnetic resonance imaging[MRI] showed a heterogenous mass lesion with cyst in the sacrococcygeal region and multiple spinal anormalies [diastematomyelia, tethered cord, hydromyelia, and hemivertebrae]. The mature teratoma was confirmed on histopathological examination. In SSCMs, the potential for coexisting congenital anomalies at separate levels of the spinal cord must be considered in radiological investigations.

• Journal of Korean Neurosurgical Society
• /
• 제29권4호
• /
• pp.543-549
• /
• 2000

결절종은 말초 관절이나 인대에서 비교적 흔히 발견되나 척추 내 결절종은 드물게 보고되고 있다. 저자들은 5예의 요추후종인대에서 발생한 결절종을 경험하고 이들의 임상적, 방사선학적 특징, 수술소견 등에 대하여 고찰하였다. 저자들의 예에서 요추 내 결절종은 요통 및 하지통증을 유발하여 임상적으로 요추간반탈출증과 유사한 소견을 보였다. 요추 MRI상 진단이 가능하였고 5예 모두에서 특징적으로 요추디스크의 퇴행성 변화와 연관되어 있었으며 결절종이 요추디스크와 바로 인접된 부위에 위치하였다. 본 소견으로 저자들은 요추후종인대에서 발생한 결절종은 디스크의 퇴행성 변화와 밀접한 관계가 있다고 추론하였다. 수술은 5예 모두에서 완전절제가 가능하였고 전 예에서 수술 후 증상호전을 보였다.

• Korean Journal of Radiology
• /
• 제22권10호
• /
• pp.1671-1679
• /
• 2021

Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1-S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion: Spinal FF may help assess both AS disease activity and chronicity.

• 대한영상의학회지
• /
• 제83권4호
• /
• pp.938-944
• /
• 2022

표피양 낭종은 척수에 매우 드물게 발생하는 양성 병변이다. 선천적 또는 후천적으로 생길 수 있는데, 후천적 표피양 낭종은 주로 요천추부 높이에서 발생한다. 척수 자극기 삽입과 관련하여 표피양 낭종이 생긴 증례는 보고된 바 없다. 저자들은 척수 자극기 삽입술을 받았던 50세 여자 환자에서 표피양 낭종이 척수 자극기 끝의 위치와 인접한 흉추부 경막 내에 발생한 드문 증례를 경험하였기에 MRI 소견 및 문헌 고찰과 함께 보고하고자 한다.

• Journal of Trauma and Injury
• /
• 제23권2호
• /
• pp.163-169
• /
• 2010

Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

• Journal of Korean Neurosurgical Society
• /
• 제48권2호
• /
• pp.157-161
• /
• 2010

Primary central nervous system (CNS) melanoma is a rare condition that accounts for only 1% of all melanomas. A 34-year-old Korean female presented with a two-month history of progressive weakness in both legs. Spinal magnetic resonance image (MRI) revealed a spinal cord tumor at the level of T4, which was hyperintense on T1-weighted imaging and hypointense on T2-weighted imaging. The intradural and extramedullary tumor was completely resected and diagnosed as melanoma. There were no metastatic lesions. At three years after surgery, the patient is still alive, with no evidence of tumor recurrence. We present the details of this case along with a comprehensive review of spinal cord melanoma.

• Journal of Korean Neurosurgical Society
• /
• 제29권11호
• /
• pp.1523-1526
• /
• 2000

It has been known that hemangioblastoma of spinal cord occurs about 4% of all the spinal tumors. The authors present a rare case of intradural extramedullary(IDEM) hemangioblastoma of distal spinal cord in 41-year-old male patient. This IDEM mass at the level of conus medullaris showed iso-signal intensities on T1-weighted image(T1-WI) and high-signal intensities on T2-WI, and was enhanced homogeneously on MRI. At surgery, T12- L1 total laminectomy and enbloc mass removal were performed. This IDEM hemangioblastoma was confirmed by histopathologic findings. For less postoperative complication in IDEM tumors, we suggest that precise preoperative evaluation and complete excision via proper surgical approach to distal conus should be reemphasized.