• Journal of Korean Neurosurgical Society
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• 제37권3호
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• pp.173-178
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• 2005

Objective: The goal of this study is to provide the clinical data of patients with brainstem cavernous hemangiomas after treatment with microsurgery or radiosurgery after conducting a retrospective analysis of 21 patients at one institution. Methods: Twenty one patients with brainstem cavernous hemangiomas were treated at the authors' institution between 1995 and 2004 and clinical analysis was performed by retrospective review of medical records and neuroimaging examinations. Thirteen patients underwent microsurgical resection and radiosurgery was performed as an initial treatment in 9 patients. Results: Radical excision was achieved in 12 among 13 patients and transitory neurological deterioration or new neurological deficit developed during the immediate postoperative period in 7 (54%). The final outcomes at 5 - 70 months after surgery were improved in 11 patients (85%) and worsened in 2 patients (15%) compared with the preoperative state. Radiosurgery was performed in 9 patients. During the follow up period from 5 to 70 months there was neurological improvement in 3 patients, no significant change in 3 and deterioration in 3 patients. Two patients developed rebleeding at 5 months, 60 months respectively after radiosurgery. Conclusion: Microsurgery for symptomatic cavernous hemangioma of brainstem can be performed with acceptable morbidity. Fatal complication is rare with careful selection of the optimal operative approach in well selected patients. Radiosurgery is an effective alternative for the lesions which are not accessible by surgical approach, however, there is still a possibility of rebleeding over a long period after radiosurgical treatment and microsurgery should be considered as a treatment with priority for the majority of cases.

• 대한두경부종양학회지
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• 제34권2호
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• pp.69-72
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• 2018

Cavernous lymphangioma is a rare congenital malformation that usually appears in the early childhood. The most common site is head and neck area, where approximately 75% of all lymphangiomas occur. We present a cavernous lymphangioma abutting brachial plexus and causing shoulder pain. A 28-year-old male patient presented with right shoulder pain for 2 months. Neck MRI revealed a lobulated multiseptated cystic mass at the anterior superior aspect of the right neck. Inferior, medial aspect of the mass was abutting brachial plexus. Surgical excision was performed, and pathologic result with immunohistochemical analysis confirmed the diagnosis cavernous lymphangioma.

• Journal of Korean Neurosurgical Society
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• 제45권1호
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• pp.46-49
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• 2009

Developmental venous anomalies (DVAs) are hemodynamically low flow, low resistance vascular malformations without clinical significance. Although most DVAs are asymptomatic and are found incidentally, sometimes they can be symptomatic with intracerebral hemorrhage, many of which are usually caused by associated cavernous malformations (CMs) rather than the DVAs themselves. Only a few cases have been reported in the literature where an intracerebral hemorrhage has been caused by a DVA alone. This report describes a case of an intracerebral hemorrhage due to DVA alone with review of the literature.

• Clinical and Experimental Pediatrics
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• 제51권12호
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• pp.1282-1289
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• 2008

Recently, accumulated clinical experience and advanced neuroradiological techniques have led to a better understanding of pediatric cerebrovascular disease (CVD), which was once considered rare. Approximately 10% of pediatric neurosurgical patients have CVD; therefore, it is no longer uncommon to pediatricians and pediatric neurosurgeons. Furthermore, children with CVD tend to recover better than adults after stroke because the immature brain is more plastic than the mature one. Therefore, active treatment often proves more rewarding in pediatric medicine than in adult medicine.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.244-249
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• 2001

Dural arteriovenous malformations(AVM) are not uncommon. Reports of intracranial dural AVM have been increasing but most of them deal with dural AVM in the region of the cavernous sinus, posterior fossa and tentorium, but those of the anterior cranial fossa are very rare. Recently, we experienced two cases of right frontal dural arteriovenous malformation fed mainly by both ethmoidal arteries. The angiographic appearance in these two cases is quite uniform. The nidus was located in the frontal dura, although their main feeders were dural arteries. They were drained through an intracerebral cortical vein associated with aneurysmal dilatation of proximal portion into superior sagittal sinus. Spontaneous intracerebral hematoma was the cause of the clinical symptoms. We report two cases of intracerebral hematoma, caused by dural AVM, which was successfully managed by surgical treatment.

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

• 대한영상의학회지
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• 제84권1호
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• pp.226-239
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• 2023

목적 뇌동정맥루(arteriovenous fistula; 이하 AVF), 뇌동정맥기형(arteriovenous malformation; 이하 AVM), 경동맥해면정맥동루(carotid-cavernous sinus fistula; 이하 CCF) 등 뇌동정맥단락을 진단하는 데 있어서, T2 강조영상(T2-weighted imaging; 이하 T2WI)과 자화율 강조영상(susceptibility-weighted imaging; 이하 SWI)의 민감도를 비교하고, 단일 에코(single-echo) SWI(이하 s-SWI)와 다중 에코(multi-echo) SWI (이하 m-SWI)의 전반적인 영상 질을 비교하고자 하였다. 대상과 방법 2016년부터 2021년까지 뇌혈관조영술로 입증된 뇌동정맥단락을 조사하였다. 뇌동정맥단락에 대한 T2WI와 SWI의 민감도를 McNemar's Test를 이용하여 비교하였다. s-SWI와 m-SWI의 영상 질을 나쁨, 보통, 좋음으로 분류하고 Fisher's exact test를 이용하여 그 비율을 비교하였다. 결과 총 24명의 환자(중위 연령: 61세, 여성: 12명, 남성: 12명)가 연구에 포함되었다. 그중 4명은 s-SWI와 m-SWI 두 가지의 SWI로, 나머지 20명은 이 중 한 가지의 SWI로 검사하였다. 10명은 AVF, 11명은 AVM, 3명은 CCF로 진단되었고, 이와 같은 뇌동정맥단락에 대해, SWI는 T2WI 보다 유의하게 높은 민감도를 보였다(82.1% vs. 53.6%, p = 0.013). m-SWI는 s-SWI 보다 좋은 영상 질의 비율이 유의하게 높았다(83.3% vs. 25.0%, p = 0.009). 결론 SWI는 T2WI 보다 뇌동정맥단락을 더 민감하게 진단해 낼 수 있었으며, m-SWI는 s-SWI보다 혈관질환을 평가하는데 더 좋은 영상 질을 보였다.

• Advances in pediatric surgery
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• 제7권2호
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• pp.142-146
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• 2001

Lymphangioma is a congenital malformation of the lymphatic system, commonly seen in the neck. Operation was the treatment of choice but it is difficult to resect the lymphangiomas completely. The aim of this study is to evaluate the result of intralesional injection of OK-432 as a treatment strategy of lymphangioma in children. Medical records of 51 cases of lymphangioma from March 1996 to February 2001 were reviewed retrospectively. Intralesional injection of 0.1mg OK-432 in 10ml normal saline was performed after the aspiration of as much fluid as possible. The location of the lesion was the face and neck in 26 patients, the chest wall in 14, the extremities in 9, and the abdominal wall in 2. The cystic type was present in 45 patients and the cavernous type in 6. Four postoperative recurrent cases were included. Fluid aspiration from the lesion was impossible in 5 patients. Development of fever after injection was observed in 27 patients and local inflammatory reaction was in 5 patients. There was no scar formation at injection sites. Complete shrinkage was observed in 20 patients, remarkable shrinkage in 23, slight shrinkage in 3, and no response in 5. Cystic type or aspiration-possible cases showed better outcome than cavernous type or aspiration-impossible cases. All of four recurrent cases after surgical excision showed at least remarkable shrinkage. These results indicate that intralesional injection of OK-432 is a safe and satisfactory treatment modality of lymphangiomas in children and might be considered as a treatment of choice, even in recurrent cases.

• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.215-218
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• 2015

Occasionally, unexpected neurological deficits occur after lumbar spinal surgery. We report a case of monoparesis after lumbar decompressive surgery. A 63-year-old man, who had undergone decompression of L4-5 for spinal stenosis 4 days previously in the other hospital, visted the emergency department with progressive weakness in the left leg and hypoesthesia below sensory level T7 on the right side. He had been cured of lung cancer with chemotherapy and radiation therapy 10 years previously, but detailed information of radiotherapy was not available. Whole spine magnetic resonance (MR) imaging showed fatty marrow change from T1 to T8, most likely due to previous irradiation. The T2-weighted MR image showed a high-signal T4-5 spinal cord lesion surrounded by a low signal rim, and the T1-weighted MR image showed focal high signal intensity with focal enhancement. The radiological diagnosis was vascular disorders with suspicious bleeding. Surgical removal was refused by the patient. With rehabilitation, the patient could walk independently without assistance 2 months later. Considering radiation induced change at thoracic vertebrae, vascular disorders may be induced by irradiation. If the spinal cord was previously irradiated, radiation induced vascular disorders needs to be considered.

• 대한소아치과학회지
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• 제31권4호
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• pp.680-684
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• 2004

혈관종은 혈관의 증식에 의해 발생하는 양성 종양으로 유아와 어린이에서 호발한다. 대부분 진성종양으로 보다는 과오종(hamartoma)으로 보며 구강내 호발부위는 입술 혀, 협점막, 구개부 등이다. 임상소견은 편평하거나 융기된 적청색 병소로 보통 단발성이다. 조직학적 소견을 통해 모세혈관성(capillary), 해면상(cavernous), 혼합성(mixed), 경화성(sclerosing) 등으로 분류되며 확진된다. 본 증례는 6세 남자 환아가 치은에 뭐가 났다는 것을 주소로 전남대학교 병원 소아치과에 내원하였다. 임상검사 결과 #62, 63 부위의 부착치은에 딸기모양 종물(mass)이 관찰되었다. 조직검사 시행 결과 모세혈관종으로 확진되었으며 외과적 절제로 양호한 결과를 얻었기에 보고하는 바이다. 혈관종은 재발이 드물며 악성전환이 없지만 출혈 경향이 높으므로 임상적 시술시 주의가 요구된다.