• Title/Summary/Keyword: neurological sign

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Surgical Approaches to the Middle Cranial Base Tumors (중두개와저 종양에 대한 수술적 치료)

  • Kim, Il Seub;Rha, Hyung Kyun;Lee, Kyung Jin;Cho, Kyung Keun;Park, Sung Chan;Park, Hae Kwan;Cho, Jeung Ki;Kang, Jun Ki;Choi, Chang Rhack
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1079-1085
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    • 2001
  • Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

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Intrahepatic portosystemic shunt with a second degree atrioventricular block fixed by transvenous coil embolization in a dog

  • Lee, Seung-Gon;Nam, So-Jeong;Kim, Hyun-Wook;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.48 no.4
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    • pp.493-500
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    • 2008
  • A 2-year-old female Pekingese dog was presented with primary complaints including exercise intolerance and neurological sign associated with hepatic encephalopathy. The major findings in clinical examination included an intermittent seizure, a slow heart rate with pulse deficit, leukocytosis and anemia in hemogram, elevated pre- and post-prandial serum bile acid and hepatic enzymes, hypoproteinemia, coagulopathy, ammonium urate crystaluria and bilirubinuria. Diagnostic tests revealed an intrahepatic portosystemic shunt complicated with a second degree atrioventricular block and QT prolongation. The case was successfully treated with a transvenous coil embolization. Clinical signs were gradually improved and cardiac bradyarrhythmia disappeared. This case is a rare case of intrahepatic portosystemic shunts complicated with a cardiac bradyarrhythmia in a small breed dog fixed by a transvenous coil embolization.

Neuro-Behçet disease presented diplopia with hemiparesis following minor head trauma

  • Choi, Ja-Yun;Park, Sun-Young;Hwang, In-Ok;Lee, Young-Hwan
    • Clinical and Experimental Pediatrics
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    • v.55 no.9
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    • pp.354-357
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    • 2012
  • Behçet disease (BD) is rare in childhood. We report a 9-year-old boy with neuro-Behçet disease who presented diplopia and weakness on the left side after a cerebral concussion. Brain magnetic resonance imaging (MRI) revealed hyperintensity of the right mesodiencephalic junction on T2-weighted and fluid attenuated inversion recovery images. Prednisolone administration resulted in complete remission and normalization of abnormal MRI finding. Brain MRI is a useful diagnostic tool when the neurological sign is the first symptom of subclinical BD.

A Case of Cerebral Aneurysmal Subarachnoid Hemorrhage in Fabry's Disease

  • Chang, Youn Hyuk;Hwang, Sung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.187-189
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    • 2013
  • We report an unusual case of cerebral aneurysmal subarachnoid hemorrage (SAH) with Fabry's disease. A 42-year-old woman presented with aneurysmal SAH originated from a saccular aneurysm of the right posterior communicating artery. The patient was treated by an endovascular coil embolization of aneurysm. Postoperatively the patient recovered favorably without any neurological deficit. During her admission, the patient had a sign of proteinuria in urine analysis. The pathologic findings of kidney needle biopsy implied nephrosialidosis (mucolipidosis of lysosomal stroage disease), which is consistent with a Fabry's disease. It is uncommon that Fabry's disease is presented with aneurysmal SAH, especially in middle-aged patients, but could be a clinical concern. Further investigations are needed to reveal risk factors, vascular anatomy, and causative mechanisms of Fabry's disease with aneurysmal SAH.

Nonsurgical Management of Parasagittal Epidural Hematoma Report of 4 Cases (상시정맥동 주위의 뇌경막외 혈종의 비 수술적 치료 -4례 보고-)

  • Nam, Dong-Soo;Kim, Seong-Ho;Kim, Bum-Dae;Bae, Jang-Ho;Doh, Eun-Sig;Kim, Oh-Lyong;Chi, Yong-Chul;Choi, Byung-Yearn;Cho, Soo-Ho;Ihm, Jow-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.173-179
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    • 1990
  • Nonsurgical management of four cases of the parasagittal epidural hematoma were experienced. Patients were mildly symptomatic or minimal neurological disturbances on admission. Patients were treated conservatively because of stable neurologic sign. All patients had who diastatic fracture and/or suture have become a complete neurological recovery with satisfactory absorption of EDH over a period of 5 to 12 weeks.

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Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

Clinical study on the Patients with Carpal tunnel syndrome (수근관 증후군에 대한 임상적 고찰)

  • Kim, Il-du;Oh, Hee-hong;Byun, Jae-young;Moon, Hyung-cheol;Koh, Kang-hoon;Park, So-young;Chang, Byoung-sun
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.61-66
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    • 2002
  • Objective : Carpal tunnel syndrome has gained increasing attention and acceptance as a significant cause of peripheral neuropathy, since it was first reported in 1836. The purpose of this study is to inspect the effect of oriental medical treatment on Carpal tunnel syndrome patients who is not come under surgical decompession. Methods : 20 patients who visited Won-Kwang University Hospital during the period from January 1998 to May 2000 were analysed for clinical manifestations. Results : 1. Among 20 patients, 3 were male and 17 were female. 2. The syndrome occurred on the right side in 5 patients, on the left side in 0 patients, and on both 15 patients 3. The most of causes were overwork. 4. Numbness was the most common symptom followed by night pain, paresthesis, morning stiffness, puffiness and resting pain 5. Among 20 patients, 12 were Tinel's sign positive, 16 were Phalen's test positive Conclusions : When the symptom is mild and duration is short, conservative treatment is effetive, but when neurological deficit is prominent and conservative treatment is not effective, surgical decompession is indicated. We treated 19 among 20 cases of the patients which Carpal Tunnel syndrome. We achieved effective results.

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Devastating endosulfan poisoning in Korean native cattle (한우 집단 폐사를 유발한 엔도설판 중독 사례)

  • Lee, Bo-Ram;Lee, Hyun-Kyoung;Lee, Kyung-Hyun;Yoon, Soon-Seek;Kim, Meekyung;Park, Jung-Won;Jeong, Seon-Hyang;Lee, Myoung-Heon;Bae, You-Chan
    • Korean Journal of Veterinary Research
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    • v.53 no.4
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    • pp.269-271
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    • 2013
  • Here, we report the poisoning case of 10 cows. Several distinct clinical signs such as convulsion, excessive salivation, circling, lateral recumbency, and death were observed. Necropsy and histopathological examination did not reveal any significant abnormal findings. Moreover, no bacteria or viruses were detected in tissue, blood, and feeding food. However, endosulfan was detected from the stomach contents and microbials. Our results strongly suggest that death of cows may be closely associated with endosulfan poisoning.

Effect of Intravascular Laser Irradiation on Lipoprotein(a) (저용량 He-Ne 레이저 정맥내(靜脈內) 조사(照射)가 혈중(血中) Lipoprotein(a)에 미치는 영향(影響))

  • Lee, Dong-Joon;Sun, Jung-Ki;Choi, Chang-Won;Lim, Jin-Hoon
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.839-844
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    • 2000
  • Objectives : The purpose of study was to investigate the effect of ILlB(intravascular laser irradiation of blood) on serum lipoprotein(a) Methods : The 12 case is diagnosed as cerebrovascular diseases on computed tomograghy. The 18 case is not observed abnormality on computed tomograghy but, they have neurological sign. Blood test was enforced on the first medical examination, The 15 case with plasma lipoprotein(a) greater than 30 mg/dl have been classified into abnormal group and the 15 case of less than 30 mg/dl have been classified into control group. after ten times ILlB, It was observed that the change of plasma lipoprotein(a) and a fibrinogen of blood clotting factor. Conclusions : 1. After ten times ILlB, plasma lipoprotein(a) numerical value was decreased on 13 case of abnormal group. 2. Plasma lipoprotein(a) numerical value was decreased on 5 case of control group. 3. The twenty in fifteen patient's with hyperlipoproteinemias have been fibrinogenemias and after ILIB treatment, in the all of 16 case with hyperfibrinogenemia in the first medical examination to both abnormal and control group, plasma fibrinogen numerical value was decreased.

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Postoperative Systemic Dissemination of Injected Elemental Mercury

  • Kang, Suk-Hyung;Park, Seung-Won;Moon, Kyung-Yoon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.245-247
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    • 2011
  • There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.