Traumatic subdural hygroma has received little attention in the literature, the authors experienced 17 cases of traumatic subdural hygroma after introduction of Computerized Tomography(CT) since October 1977 in Kyung Hee University Hospital. Characteristics in CT of our experienced traumatic subdural hygromas were almostly bilateral and located on the anterior aspect of the interhemispheric fissure, frontal and frontotemporal side with decrease density as like cerebrospinal fluid. Subdural hygroma easily differentiated with subdural hematoma by use of the CT scan. Subdural hygroma usually respond readily to evacuation of watery yellowish or cerebrospinal fluid-like fluid through simple burr hole, conservative treatment effected only 3 cases out of 17 subdural hygromas.
Cerebrospinal Fluid ; Hematoma, Subdural ; Subdural Effusion* ; Tomography, X-Ray Computed

Extradural hematomas are usually acute and rapidly progressing and the lucid intervals generally varies from a few moments to several hours. However, not uncommonly, an epidural hematoma may have a lucid interval lasting weeks, months or even years, which may present as a chronic epidural hematoma. Two cases have recently come under our care, demonstrating a paucity of objective neurologic abnormalities, but with extensive compressive extradural hemorrhage, which were found incidentally during the screening examination with the CT scanning.
Hematoma* ; Hemorrhage ; Mass Screening ; Tomography, X-Ray Computed

PURPOSE: To evaluate the diagnostic efficacy of three-dimensional(3D) short-range MR angiography(MRA) andmultiplanar reconstruction(MPR) imaging in hemifacial spasm(HS). MATERIALS AND METHODS: Two hundreds patientswith HS were studied using a 1.5T MRI system with a 3D time-of-flight(TOF) MRA sequence. To reconstructshort-range MRA, 6-10 source images near the 7-8th cranial nerve complex were processed using a maximum-intensityprojection technique. In addition, an MPR technique was used to investigate neurovascular compression. We observedthe relationship between the root-exit zone(REZ) of the 7th cranial nerve and compressive vessel, and identifiedthe compressive vessels on symptomatic sides. To investigate neurovascular contact, asymptomatic contralateralsides were also evaluated. RESULTS: MRI showed that in 197 of 200 patients there was vascular compression orcontact with the facial nerve REZ on symptomatic sides. One of the three remaining patients was suffering fromacoustic neurinoma on the symptomatic side, while in two patients there were no definite abnormal findings. Compressive vessels were demonstrated in all 197 patients; 80 cases involved the anterior inferior cerebellarartery(AICA), 74 the posterior cerebellar artery(PICA), 13 the vertebral artery(VA), 16 the VA and AICA, eight theVA and PICA, and six the AICA and PICA. In all 197 patients, compressive vessels were reconstructed on one 3Dshort-range MRA image without discontinuation from vertebral or basilar arteries. 3D MPR studies providedadditional information such as the direction of compression and course of the compressive vessel. In 31 patientsthere was neurovascular contact on the contralateral side at the 7-8th cranial nerve complex. CONCLUSION: Inpatients with HS, 3D short-range MRA and MPR images are excellent and very helpful for the investigation ofneurovascular compression and the identification of compressive vessels.
Angiography* ; Basilar Artery ; Cranial Nerves ; Facial Nerve ; Hemifacial Spasm* ; Humans ; Inpatients ; Magnetic Resonance Imaging ; Neurilemmoma ; Pica

Hypertensive intracerebral hemorrhage is one of the important diseases in Korea, sociomedically, in view of high incidence and mortality rate of the disease, severity of its sequelae and the affected productive age-group of 40 to 50 years old. The indications for surgery in hypertensive intracerebral hemorrhage are still controversial. The reason for this may be : 1) lack of adequate and comparable data in conservative and surgical therapy from the same institution : 2) lack of adequate close follow-up monitoring over an extended period of time ; or 3) lack of proper classification of hematomas for comparison of results from different institutions. The authors analysed 1009 cases of hypertensive intracerebral hemorrhage admitted to the Department of Neurosurgery, Kyung-Hee University Medical center for five years from January 1983 to December 1987. The site of hemorrhage have classified according to their anatomical site on computerized tomography. The long term outcome was analysed with reference to comparison between surgical treatment and conservative treatment. The results were as follows : 1) The incidence was high in the age-group of 50 years old and the sex ration was 1.23 : 1.0. 2) There was no seasonal variation in the incidence. 3) The occurrence of putamino-thalamic hemorrhage(38.7%) was most frequent, and then followed by putaminal(17.9%), thalamic(17.9%), subcortical(13.6%), pontine(7.5%), cerebellar(4.4%) hemorrhage in order. 4) The outcome was satisfactory in the cases of subcortical hemorrhage and cerebellar hemorrhage. The outcome was poorest in the cases of pontine hemorrhage. Both putamen and thalamic hemorrhage had brought about a high licidence of severe sequelae. 5) In correlation between the therapeutic modality and the outcome, surgical treatment increased the frequency of improvement towards Grade I-II, and also decreased the frequency of Grade III, but brought about the increase of the mortality rate. In general this results failed to support the view that the surgical treatment is superior to the conservative one in the management of hypertensive intracerebral hemorrhage. But, in the subcortical and cerebellar hemorrhage, surgical treatment showed better outcome than conservative treatment. 6) The outcome was poor in large sized hemorrhage than small one. In cases with large sized subcortical and cerebellar hemorrhage, surgical treatment had low mortality rate. 7) The level of consciousness at attack had closely related to the outcome. 8) In correlation between the time interval from ictus till operation and outcome, generally speaking, the outcome of delayed operation was slightly better than early operation. But, when the level of consciousness was good, the outcome of early operation was satisfactory. 9) Intraventricular hemorrhage occurred in 38.9% of all cases, and most frequently associated with thalamic hemorrhage. In the case of association with intraventricular hemorrhage, the mortality rate was greatly increased than in cases without intraventricular hemorrhage. 10) As far as the causes of death were concerned, cerebral swelling was most frequent and overall mortality rate was 22%.
Academic Medical Centers ; Blood Loss, Surgical ; Cause of Death ; Classification ; Consciousness ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Hypertensive* ; Korea ; Middle Aged ; Mortality ; Neurosurgery ; Putamen ; Seasons

We were recently encountered a cases of newborn infant with a congenital lumbar mass with associated anomalies which proved to be quite bizarre. This case if presented with review of the literatures because we were seldom able to find a cases of myelomeningocele as usual, interesting as this. A 15 day-old infant, the product of full term, was admitted to Busan National University Hospital on May 26th, 1972, because of a large pedunculated lumbar mass without any neurologic deficits. The tumor mass was translucent, flabby, infected and increased in tension when the infant cried. Chest film showed the underdeveloped with agenesis and fork rib in right upper 5 ribs and narrowed intercostal spaces between right 5,6,7 and 8th ribs. Right scapula was higher in position of axis. Total spine films showed non-fusion pattern of 3rd and 4rh thoracic vertebral bodies with cleft vertebrae, scoliosis in upper thoracic region, widening of lumbar canal, a large soft tissue mass overlying the abdominal region and hypoplasia of the spinous process at 4th lumbar vertebra. The sac of myelomeningocele was repaired successfully. He has regularly been followed up in the out-patient after discharge and has remained well. Repeated neurologic examination performed after discharge showed no neurologic deficits. We feel our present case will be of added interest.
Axis, Cervical Vertebra ; Busan ; Humans ; Infant ; Infant, Newborn ; Meningomyelocele* ; Neurologic Examination ; Neurologic Manifestations ; Outpatients ; Ribs ; Scapula ; Scoliosis ; Spine ; Thorax

Computed tomography(CT) is a new and innovative radiologic technique, the diagnostic value of which has been well established by many reports. On account of its rapidity and non-invasiveness, CT has become the diagnostic precedure of choice for the initial evaluation of head trauma patients. The authors have performed CT scan using EMI-5005 on 5 cases of subdural hematoma during the period of 8 months from October 1977 to May 1978 at the Department of Neurosurgery, Kyung Hee University Hospital. Various attenuation coefficients of hematoma such as hyperdense, hypodense, isodense and of mixed density were observed by the CT images. One case of isodensity hematoma were clearly identifiable by delayed enhancement technique, which had been confused by ordinary, noninfused method.
Brain* ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural* ; Humans ; Neurosurgery ; Tomography, X-Ray Computed

We have seen a case of oligodendroglioma arising in the left frontal lobe of 64-year-old woman. She had complained of longstanding headache with occasional seizures and episodic dysarthrias for six years before admission. On admission there were drowsy mentality and bilateral papilledema of 3 diopters without other neurological abnormality. The tumor was showed as a calcified mass of an egg size in the left frontal lobe even on the plain skull X-ray films. The tumor was totally removed by surgery and measured 4(5(4cm. On microscopic examination it was a typical oligodendroglioma. The patient was discharged in good condition on the twelfth postoperative day. Many authors reported that the incidence of oligodendrogliomas in all glioma group was relatively rare. In Korea there was no clinical report of oligodendroglioma except only two cases reported by Dr. Lee et al. in 1966. So we present this case, though it was typical and classical in pathological nature and clinical process.
Dysarthria ; Female ; Frontal Lobe ; Glioma ; Headache ; Humans ; Incidence ; Korea ; Middle Aged ; Oligodendroglioma* ; Ovum ; Papilledema ; Seizures ; Skull ; X-Ray Film

Posterior fossa injury is a relatively infrequent in all craniocerebral injuries, which may be a rapidly fatal disease unless the diagnosis and prompt treatment are made. Delay in operation or failure to make the diagnosis early may result in death from medullary decompensation. An injury to the occipital region, followed by signs and symptoms of cerebellar or medullary nerve dysfunction, should cause one to suspect the existence of this lesion. It is well to remember that neither the surgically demonstrated presence of a supratentorial clot nor the roentgenological failure to demonstrate an occipital fracure excludes the presence of a mass lesion in the posterior fossa. Authors studied 104 cases of posterior fossa injury admitted at Department of Neurosurgery, Kyung Hee Medical Center from October 5 th, 1971 to August 30 th, 1974. The results were as follows: 1) The incidence of posterior fossa injury was 5.7% of all craniocerebral injuries. 2) The age incidence was greatest in the age group between 10 and 20. 27.9% of all cases were belonged in this group. 3) Common causes were traffic accident(82 cases:78.8%), falls from(14 cases:13.5%) and direct blow(6 cases:5.8%). 4) Male outnumbered female by almost 2 to 1. 5) Common symptoms were disturbance of consciousness(67 cases:64.4%), headache(43 cases:41.3%) and vomiting(24 cases:21.3%). 6) Scalp injuries were demonstrated in 95 cases and occipital, bone fracture in 58 cases under gross and radiological examination of posterior fossa. 7) Time interval between injury and operation was greatest at 3 to 6 hours. 8) In 30 cases of operation, massive cerebellar contusion was 13 cases, extradural hematoma was 7 cases and subdural hematoma was 2 cases and negative exploration was 6 cases. 9) The overall mortality rate was 25%.
Contusions ; Craniocerebral Trauma ; Diagnosis ; Female ; Fractures, Bone ; Hematoma ; Hematoma, Subdural ; Humans ; Incidence ; Male ; Mortality ; Neurosurgery ; Scalp

Granular cell myoblastoma is a relatively uncommon lesion of debatable history appearing as a small, solitary but occasionally multiple neoplasm and usually benign course. Most granular cell myoblastoma have been observed tongue, skin and subcutaneous tissue and in the breast but only rarely in the orbit and we know of only 12 well-documented orbital myoblastoma at present. We have recently seen a orbital granuloma cell myoblastoma occurring in a 39 year-old woman, the tumor was firmly attached to the muscle cone and caused exophthalmos with exodeviation of the left eye and was totally removed from the transcranial-orbital unroofing procedure.
Adult ; Breast ; Exophthalmos ; Exotropia ; Female ; Granular Cell Tumor* ; Granuloma ; Humans ; Neoplasms, Muscle Tissue ; Orbit* ; Skin ; Subcutaneous Tissue ; Tongue

A case of metastatic renal cell carcinoma is reported. The tumor had imaging features of meningioma on brain computerized tomography and magnetic resonance.
Brain ; Carcinoma, Renal Cell* ; Dura Mater* ; Meningioma*