• Journal of Korean Neurosurgical Society
• /
• 제57권6호
• /
• pp.428-431
• /
• 2015

Various approaches have been attempted in translational moyamoya disease research. One promising material for modeling and treating this disease is vascular progenitor cells, which can be acquired and expanded from patient peripheral blood. These cells may provide a novel experimental model and enable us to obtain insights regarding moyamoya disease pathogenesis. We briefly present the recent accomplishments in regard to the studies of vascular progenitor cells in moyamoya disease.

• Journal of Korean Neurosurgical Society
• /
• 제45권3호
• /
• pp.196-198
• /
• 2009

Hemifacial spasm (HFS) is almost always induced by vascular compression but in some cases the cause of HFS are tumors at cerebellopontine angle (CPA) or vascular malformations. We present a rare case of hemifacial spasm caused by epidermoid tumors and the possible pathogenesis of HFS is discussed. A 36-year-old female patient presented with a 27-month history of progressive involuntary facial twitching and had been treated with acupuncture and herb medication. On imaging study, a mass lesion was seen at right CPA. Microvascular decompression combined with mass removal was undertaken through retrosigmoid approach. The lesion was avascular mass and diagnosed with an epidermoid tumor pathologically. Eventually, we found a offending vessel (AICA : anterior inferior cerebellar artery) compressing facial nerve root exit zone (REZ). In case of HFS caused by tumor compression on the facial nerve REZ, surgeons should try to find an offending vessel under the mass. This case supports the vascular compression theory as a pathogenesis of HFS.

• Journal of Korean Neurosurgical Society
• /
• 제42권5호
• /
• pp.413-415
• /
• 2007

A 26-year-old man was admitted to our department due to intermittent left hemiparesis for 3 months. Magnetic resonance Image showed subacute infarction in the right precentral gyrus. Digital subtraction angiography and magnetic resonance angiography revealed an aneurysmal protrusion at the right middle cerebral artery (MCA) bifurcation. It was difficult to differentiate the aneurysm from the occlusion of the middle trunk of the MCA trifurcation. Brain single photon emission computerized tomography showed a decrease in perfusion in the right posterior frontal lobe without vascular reserve. Therefore, we planned a superficial temporal artery MCA anastomosis with an exploration of the right MCA bifurcation. Intraoperatively, the aneurysmal opacification on preoperative angiography proved to be the proximal stump of the occluded middle trunk of the MCA trifurcation. An aneurysmal protrusion at the MCA bifurcation does not always indicate an aneurysm. In diagnosing protruding vascular lesions at the MCA bifurcation, the possibility of a vascular stump should be considered according to their angioanatomical appearance and the history of the patient.

• Journal of Korean Neurosurgical Society
• /
• 제45권4호
• /
• pp.249-252
• /
• 2009

We report on a case of thrombosis of the left common iliac artery following anterior lumbar interbody fusion (ALIF) of L4-5 in a 79-year-old man with no previous medical problems, including peripheral vascular disease. After completing the ALIF procedure, the surgeon could not feel the pulsation of the left dorsalis pedis artery, and the oxygen saturation ($SaO_2$) had fallen below 90% from pulse oxymetry on the left great toe. Thrombectomy was successfully performed after confirming the thrombus in the left common iliac artery using Computed Tomography (CT) angiography. Thrombosis of the common iliac artery is very rare following ALIF. However, delayed diagnosis can lead to disastrous outcome. Although elderly patients have no cardio-vascular disease or vessel calcification in pre-op evaluation, the possibility of a complication involving L4-5 should be considered.

• Journal of Korean Neurosurgical Society
• /
• 제55권2호
• /
• pp.96-98
• /
• 2014

Vascular complications after percutaneous angiography include hematoma, pseudoaneurysm, arteriovenous fistula, thromboembolism, arterial laceration and infection. Hematomas may occur in the groin, thigh, retroperitoneal, intraperitoneal, or abdominal wall. A 54-year-old female underwent percutaneous transfemoral angiography for the evaluation of cerebral aneurysm. Renal subcapsular hematoma developed 3 hours after the procedure. Renal subcapsular hematoma after percutaneous angiography is very rare. We investigated the possible causes of renal subcapsular hematoma. To avoid this rare complication, we need to perform guide-wire passage carefully from the beginning of the procedure under full visual monitoring.

• Journal of Korean Neurosurgical Society
• /
• 제55권6호
• /
• pp.353-356
• /
• 2014

The Sundt encircling clip was developed to repair defects of the vessel wall. With the advent of microvascular techniques, most parts of the damaged vessel wall during aneurysm surgery can be repaired by primary closure or by the bypass technique. However, these methods are not always successful. Here, we illustrate two cases of surgical clipping with the Sundt encircling clip in the ruptured internal carotid artery trunk aneurysm. The Sundt clip provides prompt control of unexpected tearing of the vessel wall or aneurysm and plays an important role in vascular rescue during aneurysm surgery.

• Journal of Korean Neurosurgical Society
• /
• 제30권6호
• /
• pp.683-687
• /
• 2001

Objective : Angiogenesis, the proliferation of capillary endothelial cells, is a vital component in the development, progression, and metastasis of many human tumors. Vascular endothelial growth factor(VEGF) is an endothelial cell-specific mitogen and induces angiogenesis and vascular permeability. The features of glioblastoma, distinct from low grade astrocytomas, are the presence of necroses and vascular endothelial proliferation. In this study, we investigated VEGF expression in the different grades of astrocytomas and determined whether VEGF expression correlates with development of glioblastoma and progression of astrocytomas. Patients and Methods : Forty seven patients with astrocytic tumors(24 males and 23 females), aged 3 to 65 years, were evaluated. Immunohistochemical staining was carried out using labelled streptavidin biotin method and primary antibody was a antirabbit polyclonal Ab against N-terminus region of VEGF165(Oncogene research product, MA, USA). Immunoreactivity(IR) was classified into no IR(absent or a trace of stain), moderate IR and intense IR by level of staining amount and intensity. Results : Six pilocytic astrocytomas showed 3 no IR and 3 moderate IR, 10 astrocytomas showed 2 no IR, 6 moderate IR and 2 intense IR, 12 anaplastic astrocytomas showed I no IR, 7 moderate IR and 4 intense IR and 19 glioblastomas showed 1 no IR, 11 moderate IR and 7 intense IR. Immunoreactivity was significantly different between low and high grade of tumors but there was no significant difference between anaplastic astrocytomas and glioblastomas. Gemistocytic tumor cells represented the predominent VEGF-immunoreactive cell types, as compared with compactly-arranged small tumor cells. In glioblastomas VEGF IR was observed in both perinecrotic and vital tumor areas. Conclusion : VEGF seems to be a important angiogenic factor in anaplastic astrocytomas and glioblastomas and VEGF expression may contribute to neovascularization of human astrocytomas.

• Journal of Korean Neurosurgical Society
• /
• 제38권2호
• /
• pp.147-150
• /
• 2005

Cavernous angiomas of the cranial nerves are rarely reported. We report a case of a 33-year-old man affected by a cavernous angioma originated in the oculomotor nerve with it's palsy. Preoperative radiological findings are difficult to differentiate it from meningioma or neurinoma. Postopertive pathological report discloses it as cavernous angioma. We discuss radiological, pathological features and management of this vascular lesion of the cranial nerve.

• Journal of Korean Neurosurgical Society
• /
• 제29권3호
• /
• pp.411-419
• /
• 2000

Hematomyelia is an extremely rare condition that cause severe neurological symptoms. We reported 4 cases of spontaneous hematomyelia, two cases of cavernous angioma and two cases of hematoma. In all patients, the clinical course was progressive ; motor and sensory abnormalities below the lesion and voiding difficulties were the common presenting symptom complex. The preoperative diagnosis was made by magnetic resonance imaging and the all patients underwent surgical exploration. Complete removal of hematoma was done in 3 patients and complete evacuation after aspiration of hematoma were performed in one patients. Neurological function did not worsen postoperatively in any patients. The early diagnosis with magnetic resonance imaging and immediate surgical treatment of the hematoma and the associated vascular malformation are considered to be the best way to halt the progression of the disease.

• Journal of Korean Neurosurgical Society
• /
• 제29권8호
• /
• pp.1063-1068
• /
• 2000

Objectives : To determine the contribution of cranial magnetic resonance angiography(MRA) for the evaluation of patients with ischemic cerebrovascular accident. Methods : Magnetic resonance image(MRI) and MRA studies performed on 34 patients with ischemic stroke were retrospectively reviewed with the clinical records. Results : There were 9 transient ischemic attacks and 25 completed strokes in our series. Twenty-three of 34 MRA examinations(68%) were positive for stenosis or occlusion. The distribution of stenotic or occlusive vascular lesions were correlated with the location of infarction in 22 of the 23 positive cases(96%). MRA provided additional information not obtained from the MRI in 19 cases(56%). Conclusions : Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA provided information adjunctive to conventional MRI in a majority of cases. We conclude that MRA is an important noninvasive component of the complete evaluation of ischemic stroke.