• Childhood Kidney Diseases
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• v.10 no.2
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• pp.213-218
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• 2006

Purpose : Nutcracker syndrome refers to compression of the left renal vein(LRV) between the aorta and superior mesenteric artery(SMA) that results in elevation of pressure in the LRV and development of collateral veins. It must be considered as a possible factor when hematuria or proteinuria occurs in a healthy child. The purpose of this study is to determine the time to spontaneous resolution in childhood nutcracker syndrome, and to observe whether this is affected by sex, age, proteinuria or initial ratio of peak velocity of LRV. Methods : We investigated 26 patients who were found to have spontaneous resolution by follow-up Doppler ultrasonography among 117 patients diagnosed with nutcracker syndrome by renal Doppler ultrasonography from May 2001 to December 2005. We determined the time to spontaneous resolution in childhood nutcracker syndrome, and observed whether the duration was affected by sex, age, proteinuria or initial ratio of peak velocity. Results : 26 patients(59%) achieved spontaneous resolution by 1.2 years(mean). The time to spontaneous resolution of childhood nutcracker syndrome in 26 patients was $16.71{\pm}9.99$ months(range 6.0-49.2). The time to spontaneous resolution was not affected by sex, age, proteinuria nor initial ratio of peak velocity of LRV. Conclusion : More than half of the patients who were diagnosed by renal Doppler ultrasonography achieved spontaneous resolution. The time to spontaneous resolution was not affected by sex, age, proteinuria nor initial ratio of peak velocity of LRV.

• Journal of Trauma and Injury
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• v.28 no.1
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• pp.43-46
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• 2015

Although spontaneous resolution of chronic subdural hematoma (C-SDH) in the elderly has rarely been reported, spontaneous resolution of bilateral C-SDH is very rare. Here, we report the case of a 73-year-old female patient with no significant head trauma history who had a bilateral C-SDH spontaneously resolve despite receiving only conservative treatment. However, because of a lack of detailed knowledge about the mechanisms of resolution, treatment is often limited to surgical interventions that are generally successful, but invasive and prone to recurrence. We review the literature and discuss the possible relation of C-SDH's spontaneous resolution with its clinical and radiological characteristics.

• Journal of Korean Neurosurgical Society
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• v.45 no.4
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• pp.253-255
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• 2009

Spontaneous spinal subarachnoid hematoma (SSH) is a rare entity to cause spinal cord or nerve root compression and is usually managed as surgical emergencies. We report a case of spontaneous SSH manifesting as severe lumbago, which demonstrated nearly complete clinical resolution with conservative treatment A 58-year-old female patient developed a large SSH, which was not related to blood dyscrasia, anticoagulation, lumbar puncture. or trauma. Patient had severe lumbago but no neurologic deficits. Because of absence of neurologic deficits, she was treated conservatively. Follow-up magnetic resonance (MR) image showed complete resolution. Conservative treatment of SSH may be considered if the patient with spontaneous SSH has no neurologic deficits.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.119-123
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• 2018

Background: Since the first report of a rapidly resolved subdural hemorrhage (SDH) in 1986, few additional case reports have been presented in the literature. Case Report: An 82-year-old female patient presented with a SDH over the left convexity. The SDH was removed via catheter drainage through a burr hole trephination. Post-operative computed tomography (CT) following 300 mL drainage from the chronic SDH demonstrated a newly developed SDH along the right convexity. A follow-up CT performed 2 hours later revealed an unexpected significant resolution of the acute SDH. Conclusion: The spontaneous resolution of acute SDH is believed to result from redistribution by washout of the hematoma by cerebrospinal fluid dilution. However, its exact pathophysiology is not well understood. When surgical evacuation is considered in acute SDH, conservative management should also be considered because spontaneous resolution of hemorrhage remains a possibility.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.301-303
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• 2015

We report on a case of an 87-year-old woman who showed spontaneous resolution of a large chronic subdural hematoma which required surgical decompression. She had suffered from confused mentality and right side weakness of motor grade II for 10 days. The initial brain CT scan showed a 22 mm thick low density lesion located in the left fronto-temporo-parietal region with midline shift (12 mm) which required emergency decompression. However, because she and her family did not want surgery, she was followed up in the outpatient clinic. Five months later, follow up brain CT showed that the CSDH had disappeared and the patient became neurologically normal. The reasons for spontaneous resolution of CSDH remain unclear. We discuss the possible relation between mechanisms of physio-pathogenesis and spontaneous resolution of a large chronic subdural hematoma (CSH) in an elderly patient.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.63-65
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• 2001

Pituitary apoplexy resulting from hemorrhage or necrosis of a pituitary tumor with subsequent compression of the optic nerves and cavernous sinuses is a life-threatening condition. The diagnosis is made clinically by the sudden onset of headache, meningismus, visual impairment, and ocular abnormalities, Modern surgical techniques seem to have reduced morbidity. Nevertheless, it is evident that not every patient requires surgical decompression after pituitary apoplexy because of spontaneous resolution after hormonal replacement therapy. We report an 84-year-old man who had pituitary apoplexy presenting with headache, ptosis and eyelid swelling. A good result has been achieved with immediate replacement of steroid.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.563-565
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• 2015

Juxtafacet cysts are implicated in neural compression. Thus far, it is known that surgical removal is the definitive treatment for symptomatic juxtafacet cyst because spontaneous regression is rare, and the failure rate of conservative treatment is high. We have reported a rare case of right-sided juxtafacet cyst development after the spontaneous resolution of contralateral left-sided facet cyst. The left-sided facet cyst resolved spontaneously without surgical treatment, but a juxtacyst developed on the contralateral facet on the right side, as illustrated on 4-year follow-up magnetic resonance images. To the best of our knowledge, this is the first report of newly developed contralateral juxtafacet cyst after spontaneous regression. Herein, we have discussed the natural history and the management of this rare case.

• Childhood Kidney Diseases
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• v.11 no.1
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• pp.83-91
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• 2007

Purpose : Childhood primary VUR is generally diagnosed after urinary tract infection, is more prevalent among girls and has a low spontaneous resolution rate in cases of severe VUR. The aim of the present study is to examine the age and gender-related characteristics and the spontaneous resolution rate of infantile primary VUR. Methods : The medical records of 96 infants with primary VUR, diagnosed after their first UTI, were retrospectively reviewed(1995-2004). The clinical characteristics including gender, the degree of VUR and presence of renal scars were evaluated. The spontaneous resolution rate and contributing factors were also analyzed Results : Infantile primary VUR was more prevalent in males than females. The percentage of atrophic scarred kidney was significantly higher in males than females(17.2% vs 3.4%) (P<0.05). The cumulative spontaneous resolution rate in 3 years was very high(89.1%), and was not significantly different between gender and among VUR grades. But in the first year, the spontaneous resolution rate of severe refluxing ureters was significantly higher in males than in females(46.2% vs 7.1%)(P<0.05) and the spontaneous resolution rate of refluxing ureters with no scarred kidneys was significantly higher than those associated with atrophic scarred kidneys(76.6% vs 20%)(P<0.05). Conclusion : Infantile Primary VUR was more prevalent among males and tends to be associated with atrophic scarred kidneys In male infants. The cumulative spontaneous resolution rate in 3 years was very high, even in high-grade VUR and associated atrophic scarred kidneys. In infantile primary VUR, surgery should be withheld even in infants with high-grade VUR with atrophic scarred kidneys.

• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.628-636
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• 2016

Objective : Chronic subdural hematoma (cSDH) is common condition in neurosurgical field. It is difficult to select the treatment modality between the surgical method and the conservative method when patients have no or mild symptoms. The purpose of this study is to provide a suggestion that the patients could be cured with conservative treatment modality. Methods : We enrolled 16 patients who had received conservative treatment for cSDH without special medications which could affect hematoma resolution such as mannitol, steroids, tranexamic acid and angiotensin converting enzyme inhibitors. The patients were classified according to the Markwalder's Grading Scale. Results : Among these 16 patients, 13 (81.3%) patients showed spontaneously resolved cSDH and 3 (18.7%) patients received surgery due to symptom aggravation and growing hematoma. They were categorized into two groups based on whether they were cured with conservative treatment or not. The first group was the spontaneous resolution group. The second group was the progression-surgery group. The mean hematoma volume in the spontaneous resolution group was 43.1 mL. The mean degree of midline shift in the spontaneous resolution group was 5.3 mm. The mean hematoma volume in the progression-surgery group was 62.0 mL. The mean degree of midline shift in the second group was 6 mm. Conclusion : We suggest that the treatment modality should be determined according to the patient's symptoms and clinical condition and close observation could be performed in patients who do not have any symptoms or in patients who have mild to moderate headache without neurological deterioration.

• Childhood Kidney Diseases
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• v.20 no.1
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• pp.18-22
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• 2016

Purpose: The previous reports regarding VUR resolution were not precise due to early frequent surgical intervention. We evaluated the spontaneous resolution (SR) rate and the incidence of new renal scars in primary VUR, focusing on severe reflux. Methods: Medical records of 334 patients with primary VUR who were on medical prophylaxis without surgery for 1 to 9 years, were retrospectively reviewed. Medical prophylaxis was initiated with low-dose antibiotic prophylaxis or probiotics. Radioisotope cystourethrography was performed every 1 to 3 years until SR of reflux. New renal scar was evaluated with follow-up $^{99m}Tc$ DMSA renal scan. Results: The SR rates decreased as VUR grades were getting higher (P=0.00). The overall and annual SR were 58.4% and 14.9%/yr in grade IV reflux and 37.5% and 9.3%/yr in grade V reflux. The median times of SR were 38 months in grade IV reflux and 66 months in grade V reflux. The probable SR rates in grade IV and V reflux were 7.8% and 8.9% in the 1st year, 46.0% and 30.8% in the 3rd year and 74.4% and 64.4% in the 5th year. The incidences of new renal scars between low to moderate reflux and severe reflux showed no significant difference (P=0.32). Conclusion: The SR rates of severe primary VUR were higher than previously reported and most new renal scars were focal and mild.