• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.310-312
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• 2005

We report a case of endodermal cyst of the posterior fossa. A 44-year-old man presented with headache for three months. Computed tomography and magnetic resonance imaging revealed a $6{\times}2.5{\times}2cm$ sized extra-axial non-enhancing cystic lesion on the ventral aspect to brain stem. To avoid retraction injury to brain stem, far lateral transcondylar approach was selected. Right suboccipital craniotomy and partial removal of occipital condyle with resection of C-1 and C-2 hemilaminae exposed the extra-axial cyst well. The cyst has a whitish thick membrane. It was not adherent to brain stem and lower cranial nerves. Total removal of the cyst was done without difficulty. Histological analysis disclosed a layer of pseudostratified columnar epithelium with basement membrane. The result of immunohistochemical study was consistent with endodermal cyst.

• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.399-404
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• 2005

Objective: Aneurysms arising from the posterior inferior cerebellar artery(PICA) are uncommon. We review literature on that and surgical results on aneurysmal treatment by choice of surgical approach. Methods: On the basis of radiologic findings & charts, we review retrospectively the surgical results of 12 cases from Mar 1999 to Dec 2003. Results: The mean age of the 12 patients was 55.8(ranged from 36 to 71) and female was predominant (female:male = 8:4). Locations of PICA aneurysms revealed variously(vertebral artery - PICA junction: 8, lateral medullary segment: 2, PICA - anterior inferior cerebellar artery common trunk: 1, telovelomedullary : 1). Surgical approaches & treatments were attempted in 11 cases and embolization was done in 1 case(Far lateral transcondylar or supracondylar approach & clipping: 9, Far lateral transcondylar or supracondylar approach and trapping: 2, suboccipital approach & clipping: 1). The surgical result were 8 of 12 patients were good outcome, 1 of 12 was severely disabled and 3 of 12 were died. Conclusion: First, we choose surgical approach by the laterality of aneurysms and surgical or interventional treatment is attempted as soon as possible. The PICA aneurysm is regarded as having a relatively good surgical outcome without drilling of the posterior arch of the atlas.