1.Experimental Brain Edema.
Jeong Wha CHU ; Ki Chan LEE ; Ki Young JANG ; Dong Whee JUN
Journal of Korean Neurosurgical Society 1976;5(2):39-46
By the expansion of stalk of laminaria inserted into the right epidural space of the rabbit head, cerebral compression and edema were produced. The studies of the occurrence and changes of experimental brain edema have been observed by weighing the wet and dry brain tissue, and by calculating the percentage of water content and that of swelling, with rate of per cent water content to that of control group. The percentage of water content and swelling of cerebral gray and white matters in the compressed site showed higher values than those in control and in non-compressed groups. As compared with normal group, the rate of per cent water content of cerebral gray matter at the site of compression showed gradually increasing tendency as time elapsed by 12 hours, while that of white matter demonstrated a increase of it by 24 hours and decreased gradually thereafter. Cerebral edema induced by laminaria compression was more evident and severe in the white matter than in the gray. Oxygen and glucose that are utilized the brain are two of the most important substances and play very important roles in the brain to form high energy bond and nucleic acid. Authors have attempted to measure oxygen consumption in normal rabbit brain and diseased brain that are produced by the expansion of stalk of laminaria in the intracranial epidural space. The value of oxygen consumption of cerebral gray and white matters in the compressed hemispheres showed higher values than those in control group, and they revealed a tendency of rather rapid increases at early experimental stages, an of gradual decrease thereafter.
Brain Edema*
;
Brain*
;
Edema
;
Epidural Space
;
Glucose
;
Head
;
Laminaria
;
Oxygen
;
Oxygen Consumption
2.Experimental Studies on Cerebrospinal: Part I: Immunological Assessment of Age of Bloody Cerebrospinal Fluid.
Dong Whee JUN ; Ki Chan LEE ; Jeong Wha CHU ; Juk Joon WHANG
Journal of Korean Neurosurgical Society 1976;5(2):21-28
Bleeding into the subarachnoid space is one of frequent complications in neurosurgical practice and most frequently caused by rupture of meningeal by trauma to the head. Hemorrhage into the subarachnoid space may occur in patient with blood dyscrasias, intracranial tumors, vascular anomalies, certain toxic or infectious disease of the nervous system, and intracerebral hemorrhages. In may be worthy academic interest and clinical practice to estimate the age of blood after hemorrhage into cerebrospinal fluid (CSF). The age was estimated and assessed by an immunological method with hemoagglutination activity using native Korean phytoagglutinin. The age of the red blood cells in RBC-CSF suspension of normal subjects was assessed and estimated by the hemoagglutination of phytoagglutinin in vitro. Vicia PHA and Clerodendron PHA chosen from among 18 different varieties of PHA are panhemoagglutinin and demonstrated the agglutination reaction most effectively. The agglutination activity of PHA with RBC-CSF suspension decreased gradually as time elapsed and activity subsided on 7~8th day. The age of RBC in CSF can be estimated by titration. The agglutination activity of PHA to RBC in CSF suspension continued for a longer period than that of PHA to either RBC in normal saline or anti-serum A and B in CSF. It would be well to say that the experimental results can be applied to clinical situations, especially subarachnoid hemorrhage.
Agglutination
;
Cerebral Hemorrhage
;
Cerebrospinal Fluid*
;
Clerodendrum
;
Communicable Diseases
;
Erythrocytes
;
Head
;
Hemorrhage
;
Humans
;
Nervous System
;
Rupture
;
Subarachnoid Hemorrhage
;
Subarachnoid Space
;
Vicia
3.A Case of Intracranial Dermoid Cyst.
Jeong Wha CHU ; Ki Chan LEE ; Dong Whee JUN ; Yong Koo RHEE
Journal of Korean Neurosurgical Society 1977;6(1):201-206
Dermoid cysts mostly occur in the posteior fossa, a mid-line position in the vermis or adjacent meninges being favoured : the cavity of the fourth ventricle may be occupied. We have reported a case of dermoid cyst in male patient aged 16 and it was located in between midbrain tectum and artial portion of the left lateral ventricle.
Dermoid Cyst*
;
Fourth Ventricle
;
Humans
;
Lateral Ventricles
;
Male
;
Meninges
;
Mesencephalon
4.A Case of Intracranial Malignant Teratoma.
Dong Whee JUN ; Jeong Wha CHU ; Ki Chan LEE ; Ho Ik CHOI
Journal of Korean Neurosurgical Society 1977;6(1):195-200
A teratoma is a true tumor or neoplasm composed of multiple tissue of kinds foreign to the part in which it arises. Predilection site of intracranial teratoma are the pineal body, the pituitary region and the posterior fossa in order of frequency. We have reported a case of teratoma experienced in a boy aged 12 who disclosed various clinical manifestations of right frontal lobe tumor. The teratoma was malignant histologically and located deeply in the white matter of the right posterior frontal lobe.
Frontal Lobe
;
Humans
;
Male
;
Pineal Gland
;
Teratoma*
5.A Case of Trigeminal Neurinoma.
Ki Chan LEE ; Jong Koo CHOI ; Dong Whee JUN ; Jong Wha CHU
Journal of Korean Neurosurgical Society 1977;6(1):169-176
Trigeminal neurinomas are relatively rare tumors that arise from the sheath of Schwann and constitute 2.9% of intracranial neurinomas and 0.26% of all brain tumors. The most cases are confined to the middle fossa and arising from the Gasserian ganglion. In slight fewer cases the tumor occupy the cerebellopontine angle. In minority it is an hourglass form both situations. By reason of their rarity, the complex clinical problems which may present and the difficult technical aspects involved in their removal, neurinomas of the Gasserian ganglion are of extreme interest. We are reporting a case of trigeminal neurinoma which was arised from the right Gasserian ganglion and located in both situations of middle and posterior cranial fossas. A 37 year-old female was admitted to our department with characteristic symptoms and signs involving many cranial nerves, cerebellum and cerebral peduncle. We chose temporal craniotomy and approached to and exposed the mass by extradural and intradural techniques. Complete removal of the tumor occupying the middle and posterior cranial fossas are accomplished satisfactorily.
Adult
;
Brain Neoplasms
;
Cerebellopontine Angle
;
Cerebellum
;
Cranial Fossa, Posterior
;
Cranial Nerves
;
Craniotomy
;
Female
;
Humans
;
Neurilemmoma*
;
Tegmentum Mesencephali
;
Trigeminal Ganglion
6.A Case of Pituitary Abscess.
Ho Ik CHOI ; Jeong Wha CHU ; Ki Chan LEE ; Dong Whee JUN
Journal of Korean Neurosurgical Society 1977;6(1):143-148
Abscess formation within the sellar turcica is a rather entity. The development of such as abscess may be due to a direct extension of adjacent infections, such as sphenoid sinusitis, osteomyelitis of the floor of the sella or infections of other sinuses, or may be transmitted through the blood stream. Several intrinsic lesions of the pituitary gland may favor the development of infections. A case of pituitary abscess is reported in which the clinical history, manifestation and laboratory data of 32 year-old Korean female showed a strong resemblance to those in pituitary adenomas. At operation a soft cystic mass was exposed and identified in the pituitary fossa of which content was yellow pus and drained. Studies of the cyst wall and content demonstrated non-specific inflammation of the pituitary gland. A brief review of abscess in the pituitary fossa is presented.
Abscess*
;
Adult
;
Female
;
Humans
;
Inflammation
;
Osteomyelitis
;
Pituitary Gland
;
Pituitary Neoplasms
;
Rivers
;
Sphenoid Sinus
;
Sphenoid Sinusitis
;
Suppuration
7.Ventriculo-peritoneal(-atrial) Shunt in Tuberculous Meningitis with Hydrocephalus.
Ki Chan LEE ; Jeong Wha CHU ; Dong Whee JUN ; Jung Keun SUH
Journal of Korean Neurosurgical Society 1977;6(2):431-434
Tuberculous meningitis, which commonly causes thick granulations over the base of the brain, is a frequent cause of post-meningitic hydrocephalus. Raised intracranial tension affects the cause of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a V-A(V-P) shunt significally alters the course of the disease. The results in 5 cases have been detailed and discussed. Operation could be performed even in an active stage of the disease without much fear of milliary dissemination.
Brain
;
Hydrocephalus*
;
Intracranial Pressure
;
Tuberculosis, Meningeal*
8.The Treatment of Anterior Communicating Artery Aneurysms by Proximal Occlusion of the Dominant Anterior Cerebral Artery.
Ki Chan LEE ; Jeong Wha CHU ; Dong Whee JUN ; Soon Sung RO
Journal of Korean Neurosurgical Society 1977;6(2):411-418
A direct intracranial operative approach that occludes the neck of the aneurysmal sac by clipping, and excludes it from the circulation without interference with the lumen of the parent vessel, is the ideal treatment of symptomatic intracranial aneurysm. With this procedure, however, there is no assurance of complete obliteration of the aneurysmal sac. Furthermore aneurysms arising from the anterior communicating artery are particularly dangerous because of the effects produced by spasm of the important neighboring perforating vessels. Since Logue published on the treatment of anterior communicating aneurysms by proximal ligation of an anterior cerebral artery in 1956, there has been by the large number of series of cases reported by other surgeons. Tindall classified three pattern of angiographic filling in patients with anterior communicating aneurysms and in type III, each anterior cerebral artery fills from its respective side, while the aneurysm fills from one side only, proximal ligation of anterior cerebral artery was performed with good effect. Five patients with anterior communicating artery aneurysm were treated by proximal occlusion of the dominant anterior cerebral artery with no mortality or morbidity. There was also instance of recurrent hemorrhage during the follow up period for 8 months to 5 years. We thought this operative procedure, therefore, can offer a highly acceptable result if the surgeon applies strict criteria to patient selection. Technically, the procedure was simple, earlier and could be performed more quickly than the direct attack.
Aneurysm
;
Anterior Cerebral Artery*
;
Arteries
;
Follow-Up Studies
;
Hemorrhage
;
Humans
;
Intracranial Aneurysm*
;
Ligation
;
Mortality
;
Neck
;
Parents
;
Patient Selection
;
Spasm
;
Surgical Procedures, Operative
9.Two Cases of Entrapment Neuropathy.
Jeong Wha CHU ; Ki Chan LEE ; Dong Whee JUN ; Kyul KIM
Journal of Korean Neurosurgical Society 1976;5(1):185-188
We presented two cases of entrapment neuropathy which were confused with herniated lumbar disc syndrome. One was "meralgia paresthetica in association with lumbar disc herniation", and "the other inguinal neuritis along with obturator neuritis". Syndromes of these entrapment neuropathies were confirmed by subcidence of pain and creation of progressively longer pain-free intervals after analgesic blocks of the corresponding nerves by infiltration of Xylocaine and prednisolone.
Lidocaine
;
Nerve Compression Syndromes
;
Neuritis
;
Prednisolone
10.Cases Simulating Cerebrovascular Accident.
Ki Chan LEE ; Jeong Wha CHU ; Dong Whee JUN ; Sung Hack KIM
Journal of Korean Neurosurgical Society 1976;5(1):163-168
Although there are differences in the mode of onset, symptomatology and clinical course in the various types of cerebrovascular lesions, the general picture may be quite similar and it is often difficult to determine the nature of the lesion in any individual case from the clinical data. In the vast majority of cases the symptoms of a cerebrovascular accident are of sudden onset and reach maximum intensity within few minutes or a few hours at the most. Locksley, et al. have reported autopsies on people who died from spontaneous intracerebral or subarachnoid hemorrhage, and they found that a primary or metastatic brain tumor was the cause of hemorrhage in only 2%~3% of their necropsy. We presented our experience with two such patient whose clinical pictures before the surgery were quite similar with those of cerebrovascular accident. Cases with a large chronic subdural hematoma and cerebral glioblastoma multiforme demonstrated a sudden and dramatic onset of coma and focal neurological symptoms immediately before admission to the hospital. The responsible mechanism or etiology for the mode of such sudden dramatic onset of symptoms may be derangement of intracranial pressure mechanism and sudden hemorrhage in the tumor.
Autopsy
;
Brain Neoplasms
;
Coma
;
Glioblastoma
;
Hematoma, Subdural, Chronic
;
Hemorrhage
;
Humans
;
Intracranial Pressure
;
Stroke*
;
Subarachnoid Hemorrhage