• Journal of Magnetics
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• 제19권4호
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• pp.357-364
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• 2014

This study examined effect of a transcranial magnetic stimulation device with a commercial-frequency approach on the neuronal cell death caused ischemia. For a simple transcranial magnetic stimulation device, the experiment was conducted on an ischemia induced rat by transcranial magnetic stimulation of a commercial-frequency approach, controlling the firing angle using a Triac power device. The transcranial magnetic stimulation device was controlled at a voltage of 220 V 60 Hz and the trigger of the Triac gate was varied from $45^{\circ}$ up to $135^{\circ}$. Cerebral ischemia was caused by ligating the common carotid artery of male SD rats and reperfusion was performed again to blood after 5 minutes. Protein Expression was examined by Western blotting and the immune response cells reacting to the antibodies of Poly ADP ribose polymerase in the cerebral nerve cells. As a result, for the immune response cells of Poly ADP ribose polymerase related to necrosis, the transcranial magnetic stimulation device suppressed necrosis and had a protective effect on nerve cells. The effect was greatest within 12 hours after ischemia. Therefore, it is believed that in the case of brain damage caused by ischemia, the function of brain cells can be restored and the impairment can be improved by the application of transcranial magnetic stimulation.

• Journal of Korean Neurosurgical Society
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• 제40권4호
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• pp.285-288
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• 2006

A 63-year-old female complained of left frontal headache and swelling for several months. Physical examination revealed left supraorbital soft, nontender, nonpulsatile mass without bruit. The left eye was displaced downward with respect to the normal right globe. Based on the clinical and radiological findings, the patient was diagnosed as a mucocele arising from the left frontal sinus. The patient underwent a transcranial approach through coronal incision. In this patient, large portions of the anterior and posterior frontal sinus walls were destroyed in association with epidural spread, so we performed cranialization of the frontal sinus and removed the mucosal wall with the aid of a microscope. With a brief review we present a patient with mucocele of the frontal sinus extending into the intracranial and intraorbital region, which was successfully treated by a transcranial approach.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.457-468
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• 2022

Objective : The clinical management paradigm of skull base chordomas is still challenging. Surgical resection plays an important role of affecting the prognosis. Endonasal endoscopic approach (EEA) has gradually become the preferred surgical approach in most cases, but traditional transcranial surgery cannot be completely replaced. This study presents a comparison of the results of the two surgical strategies and a summary of the treatment algorithms for skull base chordomas. Methods : We retrospectively analyzed the surgical outcomes and follow-up data of 48 patients with skull base chordomas diagnosed pathologically who received transnasal midline approaches (TMA) and transcranial lateral approaches (TLA) from 2010 to 2020. Results : Among the 48 patients, 36 cases were adopted TMA and 12 cases were performed with TLA. In terms of gross total resection (GTR) rate, 27.8% in TMA and 16.7% in TLA and with EEA alone it was increased to 38.9%, while 29.7% in primary surgery. In TMA, the cerebrospinal fluid (CSF) leak remains the most common complication (13 cases, 36.1%), other main complications included death, cranial nerve palsy, hypopituitarism, all the comparisons were no statistical significance. The Karnofsky Performance Scale scores in TMA were all better than those in TLA at different time, and the overall survival (OS) and recurrence free survival/progression free survival was just the reverse. Conclusion : The EEA for skull base chordomas resection has improved the GTR rate, but transcranial approach is still an alternative approach. It is necessary to select an appropriate surgical approach based on the location and the pattern of tumor growth in order to obtain the best surgical outcomes.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.186-188
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• 2006

We report a case of proximal internal carotid arterial spasm following pterional removal of pituitary adenoma. We discuss the possible mechanism of vasospasm associated with tumor resection.

• The Journal of Korean Physical Therapy
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• 제22권6호
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• pp.91-98
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• 2010

Neurostimulation approaches have been developed and explored to modulate neuroplastic changes of cortical function in human brain. As one of the most primary noninvasive tools, transcranial direct current stimulation (tDCS) was extensively studied in the field of neuroscience. The alternation of cortical neurons depending on the polarity of the tDCS has been used for improving cognitive processing including working memory, learning, and language in normal individuals, as well as in patients with neurological or psychiatric diseases. In addition, tDCS has great advantages: it is a non-invasive, painless, safe, and cost-effective approach to enhance brain function in normal subjects and patients with neurological disorders. Numerous previous studies have confirmed the efficacy of tDCS. However, tDCS has not been considered for clinical applications and research in the field of physical therapy. Therefore, this review will focus on the general principles of tDCS and its related application parameters, and provide consideration of motor behavioral research and clinical applications in physical therapy.

• Journal of Magnetics
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• 제20권2호
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• pp.133-137
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• 2015

This study was conducted to determine the effects of repetitive transcranial magnetic stimulation (rTMS) integrated mirror therapy on the gait of post-stroke patients. Thirty patients who were six months post-stroke were assigned to either the experimental group (n = 15) or the control group (n = 15). Stroke patients in the experimental group underwent rTMS and mirror therapy for the lower limbs, while those in the control group underwent rTMS and sham therapy. Participants in both groups received therapy five days per week for four weeks. A significant difference in post-training gains for the single support phase, step length, stride length and velocity was observed between the experimental group and the control group (p < 0.05). The experimental group showed a significant increment in the single support phase, step length, stride length, swing phase, velocity, cadence, double support phase and step width as compared to pre-intervention (p < 0.05). The control group showed a significant increment in step length, velocity, cadence and step width compared to preintervention (p < 0.05). Further investigation of the availability and feasibility of rTMS integrated mirror therapy for post-stroke patients as a therapeutic approach for gait rehabilitation is warranted.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.146-150
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• 2008

Objective : The authors reviewed the experience of 19 patients with orbital tumors and summarize the clinical features, surgical treatment and outcomes. Methods : The authors searched the database for all patients who underwent surgery for the treatment of orbital tumors at a single institution between 1999 and 2007. Data from clinical notes, surgical reports, and radiological findings were obtained for the analysis. Results : Orbital tumors constituted a heterogenous array of histopathology. The presenting symptoms were exophthalmos (52.6%), visual disturbance (26.3%) and pain (21.1%). The surgical approaches used were transcranial in 17 patients. Tumors located in the intraconal or perioptic space were surgically excised using a frontoorbital approach (8 cases). while pterional (3 cases). orbital (2 cases) and combined approaches (6 cases) were used for tumors in other sites. Total resection of tumors was achieved in 12 of 19 patients. In 4 patients with glioma and lymphoma only diagnostic biopsy was done. Three patients experienced visual deterioration postoperatively. Two patients had temporary diplopia, and one patient had temporary ptosis. Conclusion : Surgical treatment could be the mainstay of therapy for the majority of symptomatic orbital tumors. Many orbital tumors can be treated safely via a transcranial approach. Frontoorbital approach allows the surgeon to reach both the intraorbital and intracranial structures. Knowledge of the microanatomy of the orbit and meticulous surgical skills are necessary to overcome the pitfalls of intraorbital surgery.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1361-1368
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• 2001

Objective : "Paraclinoid" aneurysms include those aneurysms arising from the internal carotid artery between the site of emergence of the carotid artery from the roof of the cavernous sinus and the origin of the posterior communicating artery. The authors reviewed and analysed the results of surgical approaches to paraclinoid aneurysms treated with transcranial surgery and endovascular surgery. Methods : Between January 1998 and May 1999, 14 patients were treated surgically through ipsilateral and contralateral pterional approaches, and anterior interhemispheric approach, and endovascular surgery for paraclinoid aneurysms. All transcranial approaches were performed by same surgeon. The medical records, neuroimaging studies and videotapes which had been recorded operations were reviewed retrospectively. Results : Twelve patients presented with subarachnoid hemorrhage and ICH. Nine of fourteen patients had multiple aneurysms. Thirteen cases were small and one was a large aneurysm. Six patients were treated through ipsilateral approaches, six contralateral pterional approaches, one anterior interhemispheric approach and one primarily by GDC embolization. All aneurysms treated through contralateral approaches were multiple aneurysms. Neck clipping was performed in 9(69.2%) of the thirteen aneurysms, wrapping in four cases, among them three cases were followed by GDC embolization. The surgical outcomes were : Glasgow Outcome Scale(GOS) I 71.4%, GOS II 21.4% and GOS V 7.1%. Conclusion : The surgical approaches to paraclinoid aneurysms should be chosen after careful anatomical evaluation of aneurysm and its neighboring structures. 3D-CT angiography and/or the raw data of MR angiography were useful. This study supports the usefulness of the contralateral approach to paraclinoid aneurysm associated with multiple aneurysms, unruptured and small aneurysms whose dome projecting medially, superiorly and dorsally. The determination of contralateral approach to small and medially projecting paraclinoid aneurysm may be stressful to operator, thus we believe anterior interhemispheric approach is better alternated. Also we recommend the endovascular surgery after reinforcement of aneurym neck and dome in the case with difficulty in clipping.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.375-377
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• 2009

A 49-year-old woman presented with headache, vomiting and visual disturbance. Neurological examination revealed bitemporal hemianopsia with poor visual acuity. Magnetic resonance imaging showed a bulky intra-suprasellar mass, which was isointense with brain parenchyma on T1-weighted images, and slightly hyperintense on T2-weighted images. After gadolinium administration, the mass was homogeneously enhanced. The mass was partially removed by the endonasal transsphenoidal approach and then the remnant mass was totally removed by the transcranial approach five months later. We found a yellowish mass which was attached to the diaphragm sellae in operation field. Histopathological examination of the tumor revealed the characteristic features of a schwannoma. We report an unusual case of an intra-suprasellar schwannoma resembling a non-functioning pituitary macroadenoma both clinically and radiologically.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.643-646
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• 2016

Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.