A statistical analysis was performed with 623 intracranial tumor cases of which diagnoses were confirmed at the Department of Neurosurgery of Seoul National University Hospital from Sep. 1957 to Apr. 1981. The authors classified the intracranial tumors according to Russell and Rubinstein's classification. Epidermiological factors were analysed in general, and especially for the changes after CT introduction. The results were as follows: 1. Intracranial tumors were found most frequently in middle age group(20.9%), and the ratio of male to female was 1.8:1. 2. Among the intracranial tumors, gliomas were found most frequently(20.9%), and followed by granulomatous lesions(15.7%), pituitary adenomas(14.3%), Meningiomas(10.9%), vascular tumors(10.0%), schwannomas(5.1%). 3. The incidence of gliomas was less than that of otjer countries, especially glioblastoma multiforme. Pituitary adenomas occupied 14.3% of all intracranial tumors and as a single entity these were the highest incidence. Granulomatous lesions occupied 15.7% of all intracranial tumors. 4. Intracranial tumors occurred more frequently in supratentorial region. The most frequent location was wellar and parasellar regions(19.9%), and followed by frontal(17.2%), cerebellar(14.4%), parietal(14.0%), temporal region(9.5%). 5. Gliomas are the most frequent tumors irrespective of age group and in children then comes granulomatous lesions, medulloblastomas, vascular tumors and in adults then comes pituitary adenomas, granulomatous lesions, meningiomas in that order. 6. Since the advent of CT scan, the detection rate of intracranial tumors was increased, but there was no specific change in proportion of tumors.
Adult ; Child ; Classification ; Diagnosis ; Female ; Glioblastoma ; Glioma ; Humans ; Incidence ; Korea* ; Male ; Medulloblastoma ; Meningioma ; Middle Aged ; Neurosurgery ; Pituitary Neoplasms ; Seoul ; Tomography, X-Ray Computed

We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-hole drainage, a large hemorrhage developed in this area. The parenchymal enhancement in the CTA may reflect the pontomensencephalic perforating vessel injury, and may be a sign of impending DH of acute transtentorial downward herniation. Previous use of aspirin and warfarin might have potentiated the process of DH and increase the extent of the bleed.
Angiography ; Aspirin ; Cerebrum ; Drainage ; Glycosaminoglycans ; Hematoma, Subdural ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Warfarin

PURPOSE: Motion effects in parallel magnetic resonance imaging (MRI) are investigated. Parallel MRI is known to be robust to motion due to its reduced acquisition time. However, if there are some involuntary motions such as heart or respiratory motions involved during the acquisition of the parallel MRI, motion artifacts would be even worse than those in conventional (non-parallel) MRI. In this paper, we defined several types of motions, and their effects in parallel MRI are investigated in comparisons with conventional MRI. MATERIALS AND METHODS: In order to investigate motion effects in parallel MRI, 5 types of motions are considered. Type-1 and 2 are periodic motions with different amplitudes and periods. Type-3 and 4 are segment-based linear motions, where they are stationary during the segment. Type-5 is a uniform random motion. For the simulation, Cartesian and spiral grid based parallel and non-parallel (conventional) MRI are used. RESULTS: Based on the motions defined, moving artifacts in the parallel and non-parallel MRI are investigated. From the simulation, non-parallel MRI shows smaller root mean square error (RMSE) values than the parallel MRI for the periodic (type-1 and 2) motions. Parallel MRI shows less motion artifacts for linear (type-3 and 4) motions where motions are reduced with shorter acquisition time. Similar motion artifacts are observed for the random motion (type-5). CONCLUSION: In this paper, we simulate the motion effects in parallel MRI. Parallel MRI is effective in the reduction of motion artifacts when motion is reduced by the shorter acquisition time. However, conventional MRI shows better image quality than the parallel MRI when fast periodic motions are involved.
Artifacts ; Computer Simulation ; Heart ; Magnetic Resonance Imaging

Klinefelter' syndrome is a disorder of sexual differentiation in males, characterized by the presence of two or more X-chromosomes, hypogonadism, and lack of secondary sexual characteristics. The association between Klinefelter' syndrome and glomerulonephritis has been reported, while cases of glomerulonephritis associated with Klinefelter' syndrome are rare. We report the Korean case: a 31-year-old man with Klinefelter' syndrome who developed glomerulonephritis. The patient's urine analysis shows microscopic hematuria and the result of kidney biopsy was minimal change disease. The onset and course of his disease might have been influenced by the sex hormone imbalance.
Biopsy ; Glomerulonephritis ; Hematuria ; Humans ; Hypogonadism ; Kidney ; Male ; Nephrosis, Lipoid ; Sex Differentiation

OBJECTIVE: The current understanding reveals that chronic subdural hematoma (CSDH) is mostly the results of direct or indirect head trauma. Other factors such as alcoholism, medication (such as anticoagulants or antiplatelet agents), liver cirrhosis, chronic renal failure and hematologic disease are also well known as causes of CSDH. Of them, the authors attempted to identify the risk factors of CSDH by focusing on the age with a view point of recent increase in the elderly population. METHODS: We retrospectively reviewed 216 consecutive CSDH patients who underwent surgery at our institute between 2002 and 2011. We classified them into two groups according to the patients' age (Group A: <65 years old, Group B: > or =65 years old). Various factors were investigated for risk factor of CSDH, such as head trauma, chronic alcoholism, epilepsy, previous shunt surgery, underlying disease having bleeding tendency or medication affecting blood coagulation. And these factors were compared between the two groups for statistical significance. RESULTS: Among the 216 patients, group A included 81 patients (37.5%), group B included 135 patients (62.5%). The medication of group B had significantly more proportion than group A, comparing to the result that group B had relatively less proportion of head trauma and alcoholism (p<0.05). And medication was more associated with non-traumatic CSDH, especially in group B. CONCLUSION: As previously reported, head trauma or alcoholism are also most important causes as a risk factor of CSDH of all ages in our study. But medication is more closely related to the incidence of CSDH in group A, than group B.
Aged ; Alcoholism ; Anticoagulants ; Blood Coagulation ; Craniocerebral Trauma ; Epilepsy ; Hematologic Diseases ; Hematoma, Subdural, Chronic ; Hemorrhage ; Humans ; Incidence ; Kidney Failure, Chronic ; Liver Cirrhosis ; Retrospective Studies ; Risk Factors

Juvenile nasopharyngeal angiofibroma is a histologically benign, but clinically troublesome neoplasm occurring in adolescent males. This neoplasm is a basically otolaryngeal disease, but at times makes problem in neurosurgical department because of intracranial extension. This neoplasm is diagnosed by history, clinical feature, cerebral angiography, and C.T. scan. But at present time there remains controversy in adjunctive surgical therapy and the role of radiotherapy in the treatment of this tumor. In spite of controversy in treatment, in the case of intracranial extension, many authors agree that the treatment of choice is radiation therapy. We experienced a case of nasopharyngeal angiofiboma with intracranial extension which occurred in female patient treated with radiation therapy.
Adolescent ; Angiofibroma* ; Cerebral Angiography ; Female* ; Humans ; Male ; Radiotherapy

A case of 'primative glioma' which involved left parietal and occipital lobes of a child is reported with detailed views on the clinical and pathologic findings.
Child ; Humans ; Occipital Lobe ; Rabeprazole

Myxedema coma is a severe life-threatening form of hypothyroidism that is associated with a high mortality rate. It is known to be common in the elderly, and is mainly accompanied with cardiogenic shock, respiratory failure, central nervous system dysfunction, and body temperature regulation defects. Thus, immediate management is required in order to prevent fatal complications in myxedema coma. However, early detection is difficult and further, it is easily misdiagnosed due to its low incidence rate and nonspecific symptoms. We report a case of myxedema coma which was misdiagnosed for heart failure. The patient was successfully treated with intensive care and oral low dose levothyroxine.
Aged ; Body Temperature Regulation ; Central Nervous System ; Coma* ; Heart Failure ; Humans ; Hypothyroidism ; Hypoventilation ; Incidence ; Critical Care ; Mortality ; Myxedema* ; Respiratory Insufficiency ; Shock, Cardiogenic ; Thyroxine*

We report a rare case of Williams syndrome accompanying moyamoya disease in whom postoperative global cerebral infarction occurred unpredictably. Williams syndrome is an uncommon hereditary disorder associated with the connective tissue abnormalities and cardiovascular disease. To our knowledge, our case report is the second case of Williams syndrome accompanying moyamoya disease. A 9-year-old boy was presented with right hemiparesis after second operation for coarctation of aorta. He was diagnosed as having Williams syndrome at the age of 1 year. Brain MRI showed left cerebral cortical infarction, and angiography showed severe stenosis of bilateral internal carotid arteries and moyamoya vessels. To reduce the risk of furthermore cerebral infarction, we performed indirect anastomosis successfully. Postoperatively, the patient recovered well, but at postoperative third day, without any unusual predictive abnormal findings the patient's pupils were suddenly dilated. Brain CT showed the global cerebral infarction. Despite of vigorous treatment, the patient was not recovered and fell in brain death one week later. We suggest that in this kind of labile patient with Williams syndrome accompanying moyamoya disease, postoperative sedation should be done with more thorough strict patient monitoring than usual moyamoya patients. Also, we should decide the revascularization surgery more cautiously than usual moyamoya disease. The possibility of unpredictable postoperative ischemic complication should be kept in mind.
Angiography ; Aortic Coarctation ; Brain ; Brain Death ; Cardiovascular Diseases ; Carotid Artery, Internal ; Cerebral Infarction* ; Child ; Connective Tissue ; Constriction, Pathologic ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Monitoring, Physiologic ; Moyamoya Disease* ; Paresis ; Pupil ; Williams Syndrome*

For the experimental study of neural tube defect (NTD), a surgical model has advantages over other models in a few aspects. It causes less functional derangement of cells and the NTDs can be made selectively by surgery. The authors planned to use the surgical model for the experimental study of NTD. As the first step for the studies, the chronological changes of morphology during the early postoperative period were investigated using postincubation 3-day chick embryos. The objectives of this study are (1) the morphological evaluation of the surgical model as a method for studies of open NTD, and (2) the observation of morphological changes for the first 24 hours after surgery which include 'overgrowth' appearance and the continuity between the surface ectoderm and the neuroectoderm. The morphological changes were observed by light microscope and scanning electron microscope. Immediately after surgery, typical open NTDs were observed. Morphologically they were very similar to the appearance of spontaneous (non-surgical) open NTDs. The opened neural tubes were everted progressively and they looked rather flat at 24 hours after surgery. Cellular hyperplasia ('overgrowth' appearance) was noted within 24 hours after surgery and became more prominent during the 24 hours. There was increasing continuity between the surface ectoderm and the neural tissue until 24 hours after surgery when the continuity looked almost complete. In conclusion, surgically induced NTDs are morphologically very similar to spontaneous NTDs.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals ; Chick Embryo ; *Disease Models, Animal ; Evaluation Studies as Topic ; Neural Tube Defects/etiology/*pathology ; Postoperative Period