No abstract available.
Fatigue* ; Sciatica*

No abstract available.

OBJECTIVE: Morphometric data for the lumbar posterior longitudinal ligament (PLL) was investigated to identify whether there is a difference in the morphometry of the PLL of the lumbar spine at each level with respect to the pattern of intervertebral disc displacement.METHODS: In 14 formalin-fixed adult cadavers (12 males and 2 females), from L1 to L5, the authors measured the width and height of the PLL and compared them with other landmarks such as the disc and the pedicle.RESULTS: Horizontally, at the upper margin of the disc, the central portion of the superficial PLL covered 17.8–36.9% of the disc width and the fan-like portion of the PLL covered 63.9–76.7% of the disc width. At the level of the median portion of the disc, the PLL covered 69.1–74.5% of the disc width. Vertically, at the level of the medial margin of the pedicle, the fan-like portion of the PLL covered 23.5–29.9% of the disc height. In general, a significant difference in length was not found in the right-left and male-female comparisons.CONCLUSION: This study presents the morphometric data on the pattern of intervertebral disc displacement and helps to improve the knowledge of the surgical anatomy of the lumbar PLL.
Adult ; Cadaver ; Humans ; Intervertebral Disc Displacement ; Longitudinal Ligaments ; Lumbar Vertebrae ; Male ; Spine

A giant aneurysmal cerebral arteriovenous malformation in the left parieto-occipital region is described in a 4 year old child, including resolution of the alternating hemiparesis and left ventricular hypertrophy of the heart following successful removal of the malformation by microsurgical technique. This arteriovenous malformation has a large aneurysmal sac, 6x5x4cm, in size with several feeders from branches of the left middle and posterior cerebral arteries and drains directly into the straight sinus. So we have proposed to call it "a giant aneurysmal cerebral arteriovenous malformation".
Aneurysm* ; Arteriovenous Malformations ; Child ; Child, Preschool ; Heart ; Humans ; Hypertrophy, Left Ventricular ; Intracranial Arteriovenous Malformations* ; Paresis ; Posterior Cerebral Artery

Development of new surgical devices and approaches for management of injuries to the cervical spine has offered various methods of treatment available. Making it is not easy in choosing the most suitable method of treatment. We present our experience and results of 90 operations performed during the past eight-year-period(1986-1993) including 10 halo-vest applications. The timing of operation was within 7 days posttrauma in 34.2%, 8-14 days in 27.4%, 15-28 days in 1.0%, and over 28 days in 27.4%. In 18 cases of upper(C1-3) cervical spine injuries, 23 operations were performed, all approached from the posterior. In 5 cases of lower(C4-7) cervical spine injuries, 67 operations were performed, the anterior approach used in 33 patients and the posterior approach in 18 patients. Halo-vest was applied in 6 patients with upper cervical spine injuries and in 4 patients with lower cervical spine injuries. The halo-vest was inadequate in maintaining the stability of the injured spine in 5 out of 0 cases. The complication rate was 23.3% in postrior approaches and 32.4% in anterior approaches. Overall, 27 complications(0%) occurred in 90 operations, and the reoperation rate was 16.4%(85 operations for 73 patients, except for the halo-vest applications). Internal fixation with a variety of devices has become a popular procedure for ervical spine injuries. Despite the popular and wide usage of such devices, the occurrence of complications and the need to reoperate has rendered the procedure to be applied with much caution regarding its technical aspects and possible problems it may pose. In our study, the rate of reoperation and complications following such procedures were quite high. We conclude that in choosing the most proper surgical approach for ervical spine injuries with minimal occurrence of any complications, a stringent criteria should be adhered to rather then easily select the more fashionable, new of fancy devices over the traditional techniques.
Humans ; Reoperation ; Spine*

Two cases of iatrogenically induced false aneurysm of the superficial temporal artery are presented. One patient showed partially filled aneurysmal sac, 1x1 cm sized, on the main trunk of left superficial temporal artery by external carotid artery angiography. Another patient showed aneurysmal dilatation, 3x2 cm sized, of the superficial temporal artery with direct injection of Urograffin into the pulsatile mass. Aneurysm excision is indicated to reduce the risk of hemorrhage from the subsequent head trauma, to relieve headache, and for any cosmetic defect. The authors have reviewed the literature and discussed the incidence, classification, pathogenesis, clinical and angiographic diagnosis, differential diagnosis, and treatment.
Aneurysm ; Aneurysm, False* ; Angiography ; Carotid Artery, External ; Classification ; Craniocerebral Trauma ; Diagnosis ; Diagnosis, Differential ; Dilatation ; Headache ; Hemorrhage ; Humans ; Incidence ; Temporal Arteries*

OBJECTIVES: The purpose of this study is to review our experience with spontaneous thalamic hemorrhage. Clinical outcome of patients was brought about by comparing stereotactic aspiration and conservative medical therapy. METHODS: The study consists of seventy-three cases with spontaneous thalamic hemorrhage which were treated from the period of Jan. 1993 to Dec. 1999. Thirty-eighty patients were treated with computed tomography (CT) guided stereotactic aspiration and thirty-five patients were treated conservatively. We compared the factors affecting treatment and the factors are as follows: age and sex, conscious level on admission, hematoma volume, hematoma sites, presence of ventricular penetration. RESULTS: The results in the thirty eight stereotactic aspirated cases for the 6 months from oneset are as follows: good recovery or moderate disability in 43%, severe disability in 32%, vegitative state in 11%, dead in 13% respectively. The clinical result was more favorable in stereotactic aspiration, with 11-30cc hematoma volume, extend to internal capsule of hematoma, poor conscious level on admission than conservative medical therapy. But age and sex, conscious level on admission, presence of ventricular penetration were not influential in the statistical outcome between stereotactic aspiration and conservative medical therapy. CONCLUSION: Treatment modality of spontaneous thalamic hemorrhage is still controversial. But stereotactic aspiration is more recommended for improvement therapeutic results than conservative treatment or open craniotomy in case of 11-30cc hematoma volume, extend to internal capsule of hematoma and poor conscious level on admission.
Craniotomy ; Hematoma* ; Hemorrhage ; Humans ; Internal Capsule

Although the prevalence of infectious disorders has been decreased, tuberculous infections are still common in this country. Therefore epidemiological data for the correct diagnosis of some spinal infections and proper selection of susceptible antibiotics are necessary. We presented a series of 40 patients with primary spinal infection dated from January 1990 to December 1994. Tuberculosis was the most common infection constituting 85% of this series, while pyogenic infection constituted only 10%, and primary discitis shared 5%. In a half of the tuberculous spondylitis, there were histories of previous tuberculosis except the vertebrae. We could identify the pathogenic organisms in only 47.5% o the cases(in 4 of 6 pyogenic infection and 15 of 34 tuberculous infection). Since it is difficult to differentiate the pyogenic and tuberculous infections by clinical or radiological features alone, some pyogenic infections might have been regarded as tuberculous, although the pyogenic spinal infections are rare. Nevertheless the tuberculous spinal infection outnumbered pyogenic ones in this country, which is similar to the patterns of other third-world countries. Therefore, correct identification of the microbial agent is important not only for the proper treatment but also to evaluate the patients of primary spinal infections in this country.
Anti-Bacterial Agents ; Developing Countries ; Diagnosis ; Discitis ; Epidemiology ; Humans ; Prevalence ; Spine ; Spondylitis ; Tuberculosis

Low back pain is one of the most common symptoms in medical practice. Differential diagnosis of back pain is complicated, however. Self-reported pain intensity and disability may affect on the decision for diagnosis or therapy. Exaggerated symptoms may cause unnecessary investigations or even surgical interventions. Self-reported pain intensity and disability are not in proportion to the objective physical findings. We investigated the relationship between self-reported pain intensity or disability and sleep disturbance or fatigue. The study was conducted as a survey using a questionnaire from November 1997 to March 1998. The survey included consecutive 368 patients who visited the neurosurgical out-patient department complaining of low back pain. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. By multiple regression analysis, self-reported pain intensity corresponded best with the sleep disturbance. Age and fatigue were also related to the pain intensity. There was no good agreement between pain intensity and region or duration of the pain, appetite or indigestion. Disability corresponded best with the sleep disturbance. Fatigue, appetite, and indigestion were also related to the disability. There was no good relationship between disability and region or duration of the pain, or age. Self-reported pain intensity and disability are related to the psychological distress represented as sleep disturbance, fatigue, poor appetite or indigestion. Inquiring about sleep or fatigue is important to understand the underlying psychological condition, which may exaggerate pain intensity and disability.
Appetite ; Back Pain ; Diagnosis ; Diagnosis, Differential ; Dyspepsia ; Fatigue* ; Humans ; Low Back Pain ; Outpatients ; Surveys and Questionnaires ; Spine ; Visual Analog Scale

Tables and figures are very useful tools to support the author's point or opinion. It should be made according to instructions for the authors of the given Journal. The Journal of Korean Neurosurgical Society requires simple and clear English titles and explanations for the tables, figures and photos, which should be attached at the end of the manuscript. The author examined correctness of the tables and figures in the Jormnal of Korean Neurosurgical Society Volume 26. In 1997, 240 articles published in the Journal of Korean Neurosurgical Society. All 240 articles used at least one table or a figure. Tables were used in 157 articels, of which 107 articles(68.2%) have at least one incorrect table. Blanks in the field(26.2%), omitting the column headings(25.2%), and incorrect footnotes(19.6%) were common errors in the tables. Figures were used in 208 articles, of which 31 articles(14.9%) have at least one incorrect figure. Identifiable name or hospital number(35.5%), wrong numbering(29.0%), and duplication of tables and figures (19.4%) were common errors in the figures. It is important for the contributors to keep the instruction. To improve the quality of the journal, proper education for the manuscript and meticulous review of an article are necessary. It may be useful to illustrate an example of a table in the instruction of the Jormnal of Korean Neurosurgical Society.
Education