1.The Efficacy of Microvascular Decompression in Hemifacial Spasm over the Course of Time.
Young Soo KANG ; Hyuk Gee LEE ; Kee Young RYU ; Jae Hoon CHO ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 2006;39(4):265-270
OBJECTIVE: Microvascular decompression(MVD) at root exit zone(REZ) of the facial nerve has been largely popularized and it has become the standard treatment for patients with hemifacial spasm(HFS). This sturdy is performed to evaluate the efficacy of MVD over the course of time. METHODS: From 1994 to 2003, 50 patients with HFS who underwent MVD were followed up for more than 6 months. We retrospectively analyzed results with medical records and telephone researches. RESULTS: The mean age of patients at the time operation was 57.6 years and 84% of the patients were female. The mean duration of follow-up after operation was 3.4 years (range 0.5~7.8 years). One day after MVD, 54% of patients had complete relief of spasm immediately. Continuous improvements of HFS were observed during the follow-up period and these improvements were statistically significant with time (P<0.05). Until 6 months after operation, complete relief of spasm was observed in 84% of patients. The delayed relief of spasm was observed in 35.7% of our patients who experienced complete relief. CONCLUSION: The efficacy of MVD in HFS is improves with time. Continuous follow-up evaluations for the duration of more than at least 6 months after MVD are important for the decision of its clinical results because delayed relief of spasms occurs.
Facial Nerve
;
Female
;
Follow-Up Studies
;
Hemifacial Spasm*
;
Humans
;
Medical Records
;
Microvascular Decompression Surgery*
;
Retrospective Studies
;
Spasm
;
Telephone
2.Recurrent Hypertensive Intracerebral Hemorrhage.
Sang Ick PARK ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 1993;22(11):1213-1219
Thirty six conseutive patients with recurrent hypertensive intracerebral hemorrhage were identified in a retrospective review of 307 cases of hypertensive intracerebral hemorrhage(HICH) treated at the Fatima hospital between September, 1989, and August, 1992. The recurrence rate was 1.7%. There were 14 males and 22 females, aged 38 to 83 years. Only one patient had recieved regular antihypertensive therapy after initial hemorrhage. The mean volume of hemorrhage was 21.7cc at first attack and 19.5cc at recurrent attack. The site of recurrent hemorrhage was putamen in 18 cases, thalamus in 12 cases, cerebellum in 8 cases and lobar in 3 cases. The most common pattern of recurrence was "Ganglionic-Ganglionic"(10 cases). Recurrent hemorrhage occurred at the same side in 54.8% and same side & same wite in 16.7% of recurrent hemorrhage. Mean interval between the hemorrhage was 17.4 months and 55.8% of recurrent hemorrhage occurred within 1 year. Initial condition was worse at recurrent hemorrhage and outcome also was worse regardless of treatment methods. We concluded that recurrent intracerebral hemorrhage in HICH patients was not a rare condition and regular follow up and antihypertensive therapy was important in prevention of recurrent hypertensive intracerebral hemorrhage.
Cerebellum
;
Cerebral Hemorrhage
;
Female
;
Follow-Up Studies
;
Hemorrhage
;
Humans
;
Hypertension
;
Intracranial Hemorrhage, Hypertensive*
;
Male
;
Putamen
;
Recurrence
;
Retrospective Studies
;
Thalamus
3.Subdural Empyema Concomitant with Bilateral Subdural Effusion in Infant after Meningitis.
Kyung Sik SUK ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 1995;24(1):97-103
Subdural empyema is a fulminating, purulent, bacterial infection located between the dura and arachnoidal membrane. Early diagnosis, adequate antibiotic therapy and surgical treatment played important roles in the successful management of subdural empyema. Subdural empyema can develop secondary to sinusitis, otitis media, meningitis, trauma or craniotomy. Subdural empyema in infants commonly develops secondary to infected subdural effusion associated with purulent meningitis. The incidence of this complication of meningitis in infants is approximately 2%. We report a case of subdural empyema concomitant with bilateral subdural effusion, which was successfully treated with surgical intervention and antibiotic therapy.
Arachnoid
;
Bacterial Infections
;
Craniotomy
;
Early Diagnosis
;
Empyema, Subdural*
;
Humans
;
Incidence
;
Infant*
;
Membranes
;
Meningitis*
;
Otitis Media
;
Sinusitis
;
Subdural Effusion*
4.Usefulness of Computed Tomographic Angiography in the Detection and Evaluation of Aneurysms of the Circle of Willis.
Hyuk Gi LEE ; Jae Hoon CHO ; Sung Lak LEE ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 2000;29(3):345-352
No abstract available.
Aneurysm*
;
Angiography*
;
Circle of Willis*
5.Odontoid Process Fracture in a 18-Month-Old Child.
Sang Ick PARK ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 1993;22(10):1124-1128
A 18-month-old child admitted with neck pain, spasm and neck motion limitation after traffic accident. On C-spine lateral view, there was anterior angulation of odontoid process with anterior displacement of atlas. Neurologic examination showed no specific focal deficits. The patient was treated with Gardner-Wells tongs traction, skeletal traction with wiring, Halo vest for 2 months, Minerva cast for 2 months and cervical collar brace. Eight months after the trauma, follow-up dynamic C-spine lateral view showed bone fusion without false movement or growth retardation.
Accidents, Traffic
;
Braces
;
Child*
;
Follow-Up Studies
;
Humans
;
Infant*
;
Neck
;
Neck Pain
;
Neurologic Examination
;
Odontoid Process*
;
Spasm
;
Traction
6.A Case of Patient with Common Variable Immunodeficiency.
Keun Cheon KIM ; Chang Gee KANG ; Chang Hyun YANG ; Dong Soo KIM ; Kir Young KIM
Journal of the Korean Pediatric Society 1989;32(8):1123-1127
No abstract available.
Common Variable Immunodeficiency*
;
Humans
7.Stereotactic Aspiration of HICH by CT-Guided U-Loop and Leksell System.
Kyung Sik SUK ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 1995;24(2):165-173
We reviewed 178 patients with hypertensive intracerebral hematoma(HICH), which were treated with computed tomography(CT) guided stereotactic aspiration from Aug. 1986 to Dec. 1993(166 CT guided U-loop and 12 Leksell system). Our series consisted of 82 males and 96 females. The hemorrhages were located in putamen in 67.4%, thalamus in 20.2%, subcortex in 9% and cerebellum in 3.4%. Mean removal rate of hematoma was 55.3%. The results for the 178 cases who underwent stereotactic aspiration were good recovery in 45.5%, moderate disability in 28.0%, severe disability in 9.0% and vegetative state in 4.0%. The infection rate and rebleeding rate of all cases were 1.7% and 6.8% respectively. The mortality rate of all cases was 13.5%. We analysed the factors affecting the prognosis in 178 patients. Factors affecting good prognosis were high initial GCS, less amount of initial hematoma and no presence of intraventricular hemorrhage. Stereotactic aspiration by CT-guided U-loop and Leksell system is simple, safe and can minimize the brain damage. This method can e performed under local anesthesia.
Anesthesia, Local
;
Brain
;
Cerebellum
;
Female
;
Hematoma
;
Hemorrhage
;
Humans
;
Male
;
Mortality
;
Persistent Vegetative State
;
Prognosis
;
Putamen
;
Thalamus
;
Urokinase-Type Plasminogen Activator
8.Efficacy and Safety of Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Body Compression Fractures: Compared with Vertebroplasty.
Won Jae YI ; Jung Ho LEE ; Hyuk Gee LEE ; Kee Young RYU ; Dong Gee KANG ; Sang Chul KIM
Journal of Korean Neurosurgical Society 2007;42(2):112-117
OBJECTIVE: Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. METHODS: Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. RESULTS: The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. CONCLUSION: Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.
Body Height
;
Follow-Up Studies
;
Fractures, Compression*
;
Humans
;
Incidence
;
Kyphoplasty*
;
Kyphosis
;
Osteoporosis
;
Paraparesis
;
Retrospective Studies
;
Spine
;
Vertebroplasty*
;
Visual Analog Scale
9.Clinical and Angiographic Results after Treatment with Combined Clipping and Wrapping Technique for Intracranial Aneurysm.
Sang Jun SUH ; Sang Chul KIM ; Dong Gee KANG ; Kee Young RYU ; Hyuk Gee LEE ; Jae Hoon CHO
Journal of Korean Neurosurgical Society 2008;44(4):190-195
OBJECTIVE: There have been numerous follow-up studies of patients who had ruptured or unruptured intracranial aneurysms treated by wrapping technique using various materials have been reported. Our objective was to ascertain whether our particular wrapping technique using the temporalis muscle provides protection from rebleeding and any aneurysm configuration changes in follow-up studies. METHODS: Clinical presentation, the location and shape of the aneurysm, outcomes at discharge and last follow-up, and any aneurysm configuration changes on last angiographic study were analyzed retrospectively in 21 patients. Reinforcement was acquired by clipping the wrapped temporalis muscle. Wrapping and clipping after incomplete clipping was also done. Follow-up loss and non-angiographic follow-up patient groups were excluded in this study. RESULTS: The mean age was 53 years (range 29-67), and 15 patients were female. Among 21 patients, 10 patients had ruptured aneurysms (48%). Aneurysms in 21 patients were located in the anterior circulation. Aneurysm shapes were broad neck form (14 cases), fusiform (1 case), and bleb to adjacent vessel (6 cases). Five patients were treated by clipping the wrapped temporalis, and 16 patients by wrapping after partial clipping. The mean Glasgow coma scale (GCS) at admission was 14.2. The mean Glasgow outcome scale (GOS) at discharge was 4.8, and 18 patients were grade 5. The mean period between initial angiography and last angiography was 18.5 months (range 8-44). Aneurysm size was not increased in any of these patients and configuration also did not change. There was no evidence of rebleeding in any of these treated aneurysms. CONCLUSION: Our study results show that wrapping technique, using the temporalis muscle and aneurysm clip(s), for intracranial aneurysm treatment provides protection from rebleeding or regrowth.
Aneurysm
;
Aneurysm, Ruptured
;
Angiography
;
Blister
;
Female
;
Follow-Up Studies
;
Glasgow Coma Scale
;
Glasgow Outcome Scale
;
Glycosaminoglycans
;
Humans
;
Intracranial Aneurysm
;
Muscles
;
Neck
;
Reinforcement (Psychology)
;
Retrospective Studies
;
Temporal Muscle
10.Mechanical Thrombolysis Using Coil in Acute Occlusion of Fenestrate M1 Segment.
Byung Sun SEO ; Yoon Soo LEE ; Jeong Ho LEE ; Hyuk Gee LEE ; Kee Young RYU ; Dong Gee KANG
Journal of Cerebrovascular and Endovascular Neurosurgery 2012;14(2):108-112
A fenestrated middle cerebral artery (MCA) is a rare congenital anomaly, and is related to interference in the normal embryonic development of the MCA. Fenestrated MCA has been regarded to have no clinical significance other than a rare event of hemorrhage from associated aneurysm. However, the fenestration within the arterial trunk can be an obstacle against thrombus migration and may be associated with a major cerebral infarction. Moreover, the presence of this anomaly can be hardly detected prior to thrombolytic procedures, and emergent treatments are proceeded without any information of anatomical configurations. Therefore, the recanalization procedures would carry a high risk of intraprocedural complications. We report a rare case of MCA territory infarction from occlusion of fenestrated M1 segment, and also introduce a safe method of mechanical thrombolysis using coil.
Aneurysm
;
Cerebral Infarction
;
Embryonic Development
;
Female
;
Hemorrhage
;
Infarction
;
Mechanical Thrombolysis
;
Middle Cerebral Artery
;
Pregnancy
;
Thrombosis