The reports of epidural vascular tumors are rare however dumbbell-shaped epidural cavernous hemangioma is exceedingly rare. The reported incidence of epidural hemangiom is 4%of all spinal epidural tumors and 12% of all intraspinal hemangioma. In the majority of cases, hemangiomas of spinal epidural space represent the secondary extension of a vertebral hemangioma but the occurance of pure epidural cavernous hemangioma is relatively rare. In this report, authors present two cases of epidural cavernous hemangioma including one dembbell-shaped in the thoracic spine with review of other reports.
Epidural Neoplasms ; Epidural Space ; Hemangioma ; Hemangioma, Cavernous* ; Incidence ; Spine*

The authors presented 36 cases of chronic subdural hematoma which were diagnosed by operation from Fed. 1984 to Aug. 1986 at the Dept. of Neurosurgery, Wallace Memorial Baptist Hospital. The results were summarized as the followings : 1) Males were more frequently involved than female with the ratio of 3.5 : 1, common incidence of age was between 6th decade and 7th decade. 2) Most of the cases(88.9%) had a history of craniocerebral injury and some of them had an alcoholism(38.9%). 3) Older age(more than 50 years) group had more frequent mental changes(80%), and focal neurological deficit such as headache(62.5%) and vomiting(62.5%). 4) The hematoma density of CT scan showed isodense(38.9%), mixed dense(33.3%), hypodense(16.7%), or hyperdense(11.1%) lesion, that was not correlated with duration after head trauma. 5) The hematoma shale of CT scan showed biconvex shape(80%) in older age group that did not show the relation between hematoma shape and the duration of hematoma age. 6) Of the 36 cases, 24 cases were treated with burr hole drainage and intermittent valsalva maneuver, 12 cases with craniotomy and membranectomy, but the operative method did not affect the postoperative results. 7) The analysis and pathological review of hematoma blood and membrane showed the possible role of bleeding from outer membrane to hematoma expansion.
Craniocerebral Trauma ; Craniotomy ; Drainage ; Female ; Hematoma ; Hematoma, Subdural, Chronic* ; Hemorrhage ; Humans ; Incidence ; Male ; Membranes ; Neurosurgery ; Protestantism ; Tomography, X-Ray Computed ; Valsalva Maneuver

No abstract available.

No abstract available.

No abstract available.

To clarify possible causes, pathogenesis, and appropriate prevention method of remote intracerebral hemorrhage (RICH), we analyzed the clinical findings and the possible predisposing factors of six cases who developed RICH among the 206 surgical series of cerebral aneurysm operated in our hospital over recent 5-year period. The locations of aneurysm were anterior communicating artery in three cases and internal carotid artery in three other cases. The sites of RICH were dependent regions considering the operative position in five of six cases, con-tralateral cerebellum in three cases, bilateral cerebellum in one case, and contralateral occipital area in one case. Peripheral low density around the RICH, suggesting hemorrhagic infarction, was observed on computed tomography in four cases. No patient had preoperative hypertension; however, significant elevation of blood pressure was observed intraoperatively or postoperatively in three cases. The factors which could have induced brain shift(large amount of removed or drained cerebrospinal fluid, large amount of infused mannitol, too low PaCO2) were observed in all cases except one case. There was no case with coagulopathy or underlying occult lesion. Two patients in whom detection of RICH was delayed showed poor outcomes. The possible underlying mechanisms involved in such complication seem to be shifting of brain due to sudden decreased intracranial pressure and excessive removal of cerebrospinal fluid, and subsequent injury of blood vessels such as compression or breakdown of vein. Moreover, the sudden elevation of blood pressure may have played a role as contributing factor. Therefore, consideration should be given to the maintenance of an adequate volume of intracranial cerebrospinal fluid and the appropriate blood pressure to prevent this complication. Early detection and immediate treatment with awareness of the possibility of this complication should be borne in mind when treating these patients to prevent such complications and to obtain good results.
Aneurysm* ; Arteries ; Blood Pressure ; Blood Vessels ; Brain ; Carotid Artery, Internal ; Causality ; Cerebellum ; Cerebral Hemorrhage* ; Cerebrospinal Fluid ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Intracranial Aneurysm ; Intracranial Pressure ; Mannitol ; Veins

Since introduction of magnetic resonance imaging(MRI), six cases of multiple intracranial meningiomas without signs of neurofibromatosis were found among the forty eight cases of meningiomas. The incidence of multiple intracranial meningiomas in our series was 12.5% of all meningiomas. We analyzed six cases of multiple intracranial meningiomas that were evaluated by MRI. Two tumors were found in five patients, whereas the other one patient had more than ten tumors at different sites. The tendency of unihemispheric distribution was not seen and two cases had bilaterally located tumors and other two cases had tumors above and below the tentorium without tentorial involvement. Relatively high occurrence of meningioma in posterior fossa was observed. Half of the six cases had posterior fossa tumors and 6 tumors(28.6%) of the total 21 tumors were located in the posterior fossa. All the cases were female. Mean age on admission was 61.3 years, ranged from 44 to 77 years. All six patients were treated surgically and three of them underwent multiple staged operations. Histologically, of the 12 tumors removed, 5 were transitional, 4 were fibroblastic, 3 were meningothelial. The histological subtypes of tumors in each case were different in two cases, but identical in other three cases. The surgical results, although the follow-up periods(ranged 3 months to 2.5 years) were not long enough in some cases, were favorable.
Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Incidence ; Infratentorial Neoplasms ; Magnetic Resonance Imaging ; Meningioma* ; Neurofibromatoses

No abstract available.
Diskectomy* ; Dust* ; Transplants*

The authors compared and analysed planned extracapsular cataract extraction(ECCE) and Kelman phacoemulsification(KPE) on the 1000 cases out of 1546 cases which had undergone cataract operation during the period of September, 1983 through June, 1989. The results were as follows; 1. Postoperative visual acuity of 0.5 or better was achieved in 96%(960 eyes) and 1.0 or better in 67.6%(676 eyes). Average of visual acuity was similar each other: 0.92 +/- 0.24 in planned ECCE and 1.00 +/- 0.21 in KPE. 2. The mean spherical equivalent of required spectacle lens power was similar too: -1.07D +/- 1.51 in total, -1.08D +/- 1.57 in planned ECCE and -1.05D +/- 1.42 in KPE. 3. The mean postoperative astigmatism was -0.81D +/- 1.05 in total, -0.98D +/- 1.15 in planned ECCE and -0.54D +/- 0.79 in KPE. There was significant correlation between two groups(P<0.01). 4. The difference between predicted and postoperative refraction in terms of spherical equivalent was -0.36D +/- 1.12 in total, -0.36D +/- 1.12 in planned ECCE and -0.37D +/- 1.11 in KPE with no significant different value. The difference by Binkhorst formula was -0.50D +/- 1.10, and -0.06D +/- 1.09, the significant correlative value by regression SRK formula(P<0.05). 5. Mean changes of corneal refractive power was 0.43D +/- 0.99 in horizontal meridian and -0.21D +/-1.14 in vertical meridian in planned ECCE and 0.23D +/- 0.72 in horizontal meridian and 0.01D +/- 0.90 in vertical meridian in KPE. There was significant correlation between two groups(P<0.01). 6. The correlation between postoperative corneal astigmetism and actual astigmatism by skiascopy was very close: regression coefficient was 0.64087 in total, 0.62698 in planned ECCE and 0.62026 in KPE respectively(P<0.01).
Astigmatism ; Cataract ; Retinoscopy ; Visual Acuity

No abstract available.
Ligamentum Flavum* ; Spinal Cord Diseases*