• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.145-148
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• 2016

Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology that affects mainly the aorta, main aortic branches, and pulmonary arteries. Diverse neurological manifestations of TA have rarely been reported in children. Posterior reversible encephalopathy syndrome (PRES) is a neuroradiological condition that presents with headache, seizure, visual disturbances, and characteristic lesions on imaging. Inflammatory condition and severe hypertension in TA can cause PRES. We report of a 5-year-old girl with presumed TA who presented with PRES and chronic total occlusion in the renal artery. The findings on magnetic resonance imaging suggested PRES. Left nephrectomy was performed for total occlusion of the left renal artery, and the confirmatory diagnosis of TA was based on the pathologic findings of the renal artery.

• Journal of Yeungnam Medical Science
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• 제39권4호
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• pp.336-340
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• 2022

Although posterior reversible encephalopathy syndrome (PRES) is induced by various causes, a few cases have occurred after severe anemia correction. In this case report, a 45-year-old female patient visited emergency department with a chief complaint of dizziness due to severe anemia related to hypermenorrhea caused by uterine myoma. Before her operation, she had an abrupt headache and seizure during anemia correction with transfusion and injection of gonadotropin-releasing hormone agonist. Immediately after the operation, she experienced visual disturbances, followed by limb weakness and tonic-clonic movements. Magnetic resonance imaging showed alterations in parietal and occipital lobes suggesting cerebrovascular edema with hypoperfusion. Here, we presented and discussed the clinical and radiologic features of PRES related to anemia correction.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.314-318
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• 2016

Posterior fossa is a site next to the middle fossa where arachnoid cyst frequently occurs. Generally, most arachnoid cysts are asymptomatic and are found incidentally in most cases. Although arachnoid cysts are benign and asymptomatic lesions, patients with posterior fossa arachnoid cysts often complain of headaches, gait disturbance, and ataxia due to the local mass effects on the cerebellum. We observed a patient with a posterior fossa arachnoid cyst who had visual symptoms and a headache, but did not have gait disturbance and ataxia. We recommended an emergency operation for decompression, but the patient refused for personal reasons. After 7 days, the patient revisited our hospital in a state of near-blindness. We suspected that the arachnoid cyst induced the hydrocephalus and thereby the enlarged third ventricle directly compressed optic nerves. Compressed optic nerves were rapidly aggravated during the critical seven days; consequently, the patient's vision was damaged despite the operation. Considering the results of our case, it is important to keep in mind that the aggravation of symptoms cannot be predicted; therefore, symptomatic arachnoid cysts should be treated without undue delay.

• Childhood Kidney Diseases
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• 제11권1호
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• pp.92-99
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• 2007

후두엽 가역성 뇌병증 증후군은 고혈압, 자간증, 신부전으로 인한 고혈압 및 면역억제약물 등 의 병력과 함께 두통, 구토, 경련, 시야장애 등 임상적 증상을 보이고 뇌 자기공명영상에서 특징적인 소견을 보이는 질환군이다. 저자들은 스테로이드 저항성 신증후군 환아에서 사이클로스포린 투여 중 발생한 후두엽 가역성 뇌병증 증후군을 경험하였기에 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.975-982
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• 2021

Objective : The occurrence of posterior fossa teratomas in adulthood is extremely rare. In this study, we aimed to report our experience with two cases of posterior fossa mature teratoma in adults who underwent surgical resection. We also performed a systematic review of published papers available to date. Methods : We retrospectively reviewed the electronic medical records of patients who had onset of posterior fossa teratomas in adulthood at our institute between 1995 and 2020. We evaluated the clinical, radiographic, and pathological features of mature teratomas at the posterior fossa in adulthood. Furthermore, we searched the PubMed, EMBASE, and Web of Science database and reviewed published articles. Results : We found 507 articles on database review; of them, 102 were duplicates and 389 were excluded based on the inclusion criteria. Finally, 16 cases of posterior fossa from the web search and related articles. Subsequently, we added two cases that underwent surgery at our institute. We analyzed a total of 18 cases of mature teratomas. Headache was the most common (55.6%) symptom. The teratomas showed heterogeneous signals on magnetic resonance imaging. Thirteen patients (72.2%) had lesion at midline, five patients (27.8%) had calcification. Surgical resection was performed in all patients. No studies reported recurrence after resection. Conclusion : The occurrence of posterior fossa teratomas in adulthood is difficult to diagnose at the initial stage. Radiographic diagnosis alone can lead to misdiagnosis. Pathological confirmation is essential. Surgical resection is a curative option for posterior fossa teratomas in adulthood.

• The Korean Journal of Pain
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• 제10권1호
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• pp.121-123
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• 1997

Stellate ganglion block(SGB) is frequently performed to relieve a patient from headache of various. We experienced a rare case of subarachnoid hemorrhage by aneurysmal rupture after SGB. A 46-year-old female patient diagnosed with tension headache, and normal MRI finding consulted our pain clinic. We performed right SGB in combination with greater occipital nerve block. The next day, we performed left SGB with 6 ml of 0.25% bupivacaine. She had no evidence of subarachnoid block or intravascular injection. 15 minutes after injection, she abruptly developed convulsion and loss of consciousness. She was given artificial respiration with oxygen. The diagnosis of ruptured left posterior communicating aneurysm was confirmed by 4-vessels angiography.

• The Korean Journal of Pain
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• 제26권2호
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• pp.186-190
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• 2013

A C2-3 zygapophygeal joint is a major source of cervicogenic headache. Radiofrequency (RF) neurotomy is preformed widely for zygapophygeal joint pain. Conventional RF denervation technique is generally performed under fluoroscopic control. Recently, ultrasound-guided radiofrequency on zygapophygeal joint has emerged as an alternative method. We report our experiences of two successful ultrasound-guided pulsed radiofrequencies on 39-year-old and 42-year-old males, who complained occipital headache and posterior neck pain.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.66-72
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• 2001

Apatient with multiple dissecting aneurysms of a posterior inferior cerebellar artery trunk who presented with SAH is reported. A 58-year-old woman presented with sudden occipital headache, dizziness and vomiting. The intial vertebral angiography revealed a suspicious pearl and string sign at the proximal posterior inferior cerebellar artery(PICA) segment. After 2 weeks, follow up angiography showed a progression of the proximal PICA dissection and newly developed dissecting aneurysm of the distal PICA segment. A far lateral suboccipital transcondylar appoach confirmed two dissecting aneurysms at distant sites of the PICA trunk. The dissection segments were wrapped with muslin wrap, which preserved the flow through the PICA and brain stem perforators. The angiographys at 3 weeks and 6 months after operation revealed serial disappearance of the dissecting aneurysms which is distal to proximal. The diagnosis, course and treatment of the dissecting aneurysms of the PICA are discussed with literature review.

• Journal of Chest Surgery
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• 제46권1호
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• pp.88-91
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• 2013

A 36-year-old man visited Yeungnam University Hospital with a sudden onset of palpitation, headache, and was found to be hypertensive. Chest radiography showed a 6 cm sized mass lesion on the posterior mediastinum. A biochemical study showed elevated levels of catecholamines. An I-123 metaiodobenzylguanidine scan revealed a hot uptake lesion on the posterior mediastinum. The patient was prepared for surgery with ${\alpha}$ and ${\beta}$ blocking agents. Two months later, we removed the tumor successfully. A histological study proved that the resected tumor was mediastinal pheochromocytoma. Functional mediastinal pheochromocytomas are rare. Therefore, we reported the case with a literature review.

• Journal of Korean Neurosurgical Society
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• 제49권1호
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• pp.53-57
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• 2011

We reported a unique case of posttraumatic giant infratentorial extradural intradiploic epidermoid cyst. A 54-year-old male, with a previous history of an open scalp injury and underlying linear skull fracture in the left occipital region in childhood, presented with a painful subcutaneous swelling, which had been developed gradually in the same region and moderate headache, nausea, vomiting and cerebellar ataxia. The duration of symptoms on admission was 3 months. Imaging studies revealed occipital bone destruction and giant extradural intradiploic lesion. The preoperative diagnosis was giant infratentorial extradural intradiploic epidermoid cyst. Surgery achieved total removal of the lesion, which was histologically confirmed and the postoperative course was uneventful. To our knowledge, this is the first case of giant infratentorial extradural intradiploic epidermoid cyst with a traumatic etiology described in the literature.