• Title/Summary/Keyword: Subdural

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Epidural Hematomas due to Occipital Artery Injury Following Ventriculoperitoneal Shunt and Extraventricular Drainage

  • Choi, Jeong-Hoon;Moon, Jae-Gon;Hwang, Do-Yun;Choi, Jong-Hun
    • Journal of Korean Neurosurgical Society
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    • v.41 no.5
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    • pp.314-317
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    • 2007
  • Ventriculoperitoneal [VP] shunt is a common treatment for hydrocephalic patients. However, complications, such as shunt tube occlusion, infection, intracranial hemorrhage, seizure can occur. Of these, intracranial hemorrhage may occur due to intracranial vascular injury or a rapid decrease of intracranial pressure [ICP]. Most of these hemorrhages are subdural hematomas [SDH] while a few are epidural hematomas [EDH]. It is extremely rare for an intracranial hemorrhage to occur due to an extension of the bleeding from an injured extracranial vessel. We report two cases of EDH due to occipital artery injury following VP shunt and extraventricular drainage [EVD].

Postcontrast Brain MR Imaging in Children: Various Pulse Sequences and Imaging Strategies

  • 이충욱;구현우
    • Proceedings of the KSMRM Conference
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    • 2003.10a
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    • pp.100-100
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    • 2003
  • In brain MR imaging, contrast-enhanced study is important in the detection and characterization of lesions. As a postcontrast brain MR imaging, conventional T1 weighted imaging has been usually used. Magnetization transfer imaging has been used to increase conspicuity of enhancing lesions. In addition, fat-suppression imaging can be used as in other parts of the body. Recently, FLAIR sequence has been reported to be useful in detecting subarachnoid, meningeal, and subdural abnormalities. In this exhibit, we demonstrate basic principles and typical appearances of various pulse sequences that can be used as a postcontrast brain MR imaging in children. Furthermore, we discuss imaging strategies to increase clinical usefulness of postcontrast brain MR imaging for specific abnormalities. The advantages and disadvantages of each pulse sequence are also discussed.

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Epilepsy Surgery of the Cerebral Paragonimiasis

  • Lee, Woo-Jong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.114-119
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    • 2006
  • Objective : The authors investigate appropriate evaluation and surgical methods in treatment of the cerebral paragonimiasis accompanying epilepsy. Methods : Thirteen patients with the cerebral paragonimiasis accompanying epilepsy were included for this study. Preoperative evaluation methods included history taking, skin and serologic tests for Paragonimus westermani, neurologic examinations, computerized tomography, magnetic resonance imaging, amytal test, PET or SPECT, and video-EEG monitoring with depth and subdural grid electrodes. Seizure outcome was evaluated according to Engel's classification. Results : Surgical methods were temporal lobectomy including lesions in six, lesionectomy in five, and temporal lobectomy plus lesionectomy in two. Postoperative neurological complications were not noticed, and seizure outcomes were class I in 12 patients [92%], class II in one [8%]. Conclusion : In patients with a cerebral paragonimiasis accompanying epilepsy, further evaluation methods must be done to define the epileptogenic zone, and complete resection of the epileptogenic zone with different surgical methods should be performed for seizure control.

A Case Report of Spontaneous Intracranial Hypotension Treated with Cervical Epidural Blood Patch -A case report- (경추부 경막외 혈액 봉합술로 치료한 자발성 두개내 저압 -증례 보고-)

  • Chung, Sung-Won;Do, Hyun-Woo;Lee, Jung-Koo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.157-161
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    • 1999
  • We report a patient with spontaneous intracranial hypotension. In addition to the cardinal feature of a postural headache and a low CSF pressure, the patient also had subdural hematoma demonstrated by brain MRI. Radionuclide cisternography revealed a CSF leakage in the intracranium. CSF leakage from spinal meningeal defects may be the most common cause of this syndrome. The headache is a consequence of the low CSF pressure producing displacement of pain-sensitive structures. Methods of treatment are identical to those for post-dural puncture headaches. We experienced a patient with spontaneous intracranial hypotension developed in the intracranium who was successfully managed with a cervical blood patch.

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A Rare Case of Diffuse Pachymeningeal Involvement of Multiple Myeloma

  • Yoon, Jehong;Kim, Eui Jong;Lee, Kyung Mi;Choi, Woo Suk;Park, Bong Jin
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.4
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    • pp.252-255
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    • 2015
  • Intracranial involvement in multiple myeloma patients takes up around 1%, and is usually known to be present in the parietal bone or skull base in cases of skull vault involvement, while it presents in the dura and parenchyma in cases of intracranial involvement. Primary pachymeningeal invasion is even rarer with extremely rapid progression and very poor prognosis. It is our intent to report a case in which we had to differentiate multiple myeloma with other metastatic tumors, lymphoma, and leukemia with intracranial involvement. Our patient showed an osteolytic lesion of the skull with dural involvement and subdural mass formations.

Aspergillus Brain Abcess in a "healthy" Child (건강한 소아에서의 Aspergillus 뇌농양 1례)

  • Lee, Young-Do;Son, Jin-A;Kim, Jae-Yoon;Ahn, Don-Hee
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.276-281
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    • 1997
  • A 13-year-old male with normal immunity presented with Aspergillus brain abscess manifestating as frontal headache and fever. $T_2$-weight magnetic resonance imaging revealed a hypointense lesion in the right fronto-temporo-parietal lobe 1cm thickness and left midline shifting. The hypointense appearance on $T_2$-weighted images appears to be characteristic of aspergillosis. Right decompressive craniectomy and removal of subdural empyema right. Abscess culture was Aspergillus fumigatus. Antibiotic treatment with Amphotericin B was given for 2 months postoperatively. No recurrence was identified during 5 month follow-up.

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Hemorrhagic Complications of Intracranial Arachnoid Cyst Following Minor Head Injury : Report of 5 Cases

  • Kim, Jae-Hoon;Kim, Choong-Hyun;Cheong, Jin-Hwan;Bak, Koang-Hum;Kim, Jae-Min
    • Journal of Korean Neurosurgical Society
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    • v.39 no.6
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    • pp.443-446
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    • 2006
  • Intracranial arachnoid cyst is presumed to be a developmental anomaly and its natural history is not well defined. Often it is detected incidentally in a asymptomatic patient and hemorrhagic events of arachnoid cyst following head injury are rarely reported. We report hemorrhagic complications including two intracystic hemorrhages, two subdural hematomas, and an epidural hematoma in 5 patients with intracranial arachnoid cyst after minor head injury and review pertinent literatures.

Chronic Epidural Hematoma with Ossification - A Case Report - (골화를 동반한 만성 경막외혈종 - 증례보고 -)

  • Shim, Kyu Won;Chang, Jong Hee;Chang, Jin Woo;Park, Yong Gou;Kim, Tai Seung;Chung, Sang Sup
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.943-946
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    • 2001
  • We report a case of 15 year-old female patient with a ossified chronic epidural hematoma. She had had head trauma 10 weeks previously and conservative care for delayed onset epidural hematoma at other hospital. Ossification was identified about 4 weeks after head injury and then progressed rapidly. We removed the chronic epidural hematoma with thick capsule and newly formed bone. The mechanism of the ossification associated with cephalhematoma and chronic subdural hematoma is reviewed and discussed.

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Stereoelectroencephalography in Pediatric Epilepsy Surgery

  • Tomlinson, Samuel B.;Buch, Vivek P.;Armstrong, Dallas;Kennedy, Benjamin C.
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.302-312
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    • 2019
  • Stereoelectroencephalography (SEEG) is an invasive technique used during the surgical management of medically refractory epilepsy. The utility of SEEG rests in its ability to survey the three-dimensional organization of the epileptogenic zone as well as nearby eloquent cortices. Once concentrated to specialized centers in Europe and Canada, the SEEG methodology has gained worldwide popularity due to its favorable morbidity profile, superior coverage of deep structures, and ability to perform multi-lobar explorations without the need for craniotomy. This rapid shift in practice represents both a challenge and an opportunity for pediatric neurosurgeons familiar with the subdural grid approach. The purpose of this review is to discuss the indications, technique, and safety of long-term SEEG monitoring in children. In addition to reviewing the conceptual and technical points of the diagnostic evaluation, attention will also be given to SEEG-based interventions (e.g., radiofrequency thermo-coagulation).

Chronic epidural hematoma evacuated through surgical treatment: a case report

  • Sin, Eui Gyu
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.43-45
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    • 2022
  • Epidural hematoma (EDH) can sometimes be life-threatening, although small-volume EDHs can resolve spontaneously like other intracranial hematomas. However, in rare cases, EDH can transform into a chronic form instead of disappearing. In contrast to subdural hematoma, there is no agreed-upon definition or treatment of chronic EDH. A 41-year-old male patient with acute EDH in the bilateral paravertical area due to partial rupture of the sagittal sinus was operated first, and then remnant contralateral hematoma was treated conservatively. One month after surgery, he showed hemiparesis, and brain imaging revealed chronic EDH at the location of the remnant acute hematoma. We performed surgery again to treat chronic EDH through a large craniotomy. Although many cases of EDH are self-limited, clinicians must keep in mind that some cases of EDH, especially those of venous origin and arising in young people, can become chronic and require surgical treatment.