In order to evaluate the safe ligation time and sites of dural venous sinuses during neurosurgical operation, systemic arterial pressure(SAP), cerebral perfusion perssure(CPP), intracranial pressure (ICP) and intrasinal pressure(ISP) were measured in cats through neuromonitor before and after obstruction of anterior 1/3, middle 1/3, posterior 1/3 of the superior sagittal sinus and the results were as follows. There were no significant increases of pressures after obstruction of anterior 1/3 of the superior sagittal sinus. In the obstructed middle 1/3 of the superior sagittal sinus group, signifi6int increases were seen un the m-SAP within 2, 4 and 6 minutes, the m-ICP within 2-7 minutes, the r.i-ISP within 14 minutes after obstruction. In the -obstructed posterior 1/3 of the superior sagittal sinus group, there were significant increases of m-SAP within 2, 4 and 6 minutes, the m-ICP within 27 minutes, the m-ISP within 13 minutes. In the obstructed Torcular Herophili,group, there were significant increases of the m-SAP within 1-2 and 4-7 minutes, the m-ICP within 36 minutes and the m-ISP within 1-7 minuted and less significant dercreases of the m-CPP within 5-7 minutes after obstruction. In the obstructed right transverse sinus group, significant increases of the m-ICP and the m-ISP were seen within 1-7 minutes after obstruction. there were no remarkable changes in the obstructed left transverse sinus group.
Animals ; Arterial Pressure* ; Cats* ; Intracranial Pressure* ; Ligation ; Perfusion* ; Superior Sagittal Sinus ; United Nations

In an attempt to eliminate some negative aspects of conventional extensive laminectomy, 4 cases of multiple level of cervical compression myelopathy, 1 OPLL (ossification of posterior longitudinal ligament) and 3 cervical stenosis, were treated with a technique of expansive laminoplasty. Operative results in all patients were satisfactory without surgical complications and all patients had a neurological improvement. We suggest that our technique is more effective one for cervical canal stenosis, OPLL, and spondylosis than conventional extensive laminectomy.
Constriction, Pathologic ; Humans ; Laminectomy ; Laminoplasty* ; Spinal Cord Diseases* ; Spondylosis

The authors have been performed stereotactic endoscopy to diagnose and treat 6 cases of ventricular and juxtaventricular lesions using Brown-Wells system under the local anesthesua. We thought that stereotactic endoscopy was easier and safer than conventional surgery for these lesions.
Endoscopy*

The introduction of computed tomography in the mid 1970s radically altered the practice of both neuroradiology and steteotactic neurosurgery. Shortly after the introduction of CT, work began on a variety of methods to guide biopsy instruments to brain lesions demonstrated on CT scan. And so, a prototype Brown-Roberts-Wells(BRW) CT stereotactic system was been available to us. We report its utilization in evaluation of less accessible brain lesions using BRW system; 22 superfical lesions including the motor cortex, 3 brain stem lesions, 5 parasellar lesions, 3 pineal lesions, 3 C-p angle lesions, 3 multiple lesions. There is one complication; intratumoral bleeding. There is no mortality in this series. The diagnostic rate is 88.9%. The indications of BRW of guidance stereotactic biopsy are considered as followings; 1) Adverse medical condition. 2) Highly malignant lesions. 3) Multiple lesions. 4) Lesions near by motor cortex. 5) Brain stem lesions. 6) Deep seated lesions. 7) Small sized lesions.
Biopsy* ; Brain ; Brain Stem ; Hemorrhage ; Mortality ; Motor Cortex ; Neurosurgery ; Tomography, X-Ray Computed

Posterior stabilization of unstable cervical spine injury using metal plate and screw has been commonly used in Europe but very rarely in Korea where it has been usually achieved with wires supplemented by bone graft. We have experienced 11 patients of unstable lower cervical spine injuries which were stabilized with posterior cervical plate without bone graft. One patient was total quadriplegia and two patients showed minor motor and sensory changes and the others were neurologically intact. Operations were performed within 10 days after trauma(average 4.9 days) except 2 cases of late instability. Most of the patients could ambulate the day after operation with a Philadelphia collar which was kept for 3 months. We achieved good postoperative alignment of injured cervical spine and tolerable neck motion limitation and we experienced no surgical complication. So we suggest that posterior cervical plate fixation technique is a good method of cervical stabilization for lower cervical spine injury, especially when posterior compartment injury is predominant.
Europe ; Humans ; Korea ; Neck ; Quadriplegia ; Spine ; Transplants

To consider indications of stereotactic evacuation of spontaneous I.C.H., we reviewed 155 patients of spontaneous I.C.H. treated with B.R.W. stereotaxy in recent 2 years form Jan. 1986 to Dec. 1987. And we analysed clinical outcome according to volume of hematoma, anatomical location of hematoma, operation time from attack and initial G.C.S.. We concluded "Indications of stereotactic evacuation of spontaneous I.C.H." as followings; 1) There was no contraindication according to anatomical location of hematoma even if brain stem and posterior fossa. 2) Golden operation time seems to be as early as possible after 6-8 hours from attack. 3) There was no contraindication according to volume of hematoma but there was increased tendency of rebleeding in small thalamic hemorrhage. 4) Low initial G.C.S. was not definite contraindication but final end-result was not so satisfactory. 5) Combined I.V.H. was also good indication, because of low occurrence of postoperative hydrocephalus and early removal of ventricular hemorrhage.
Brain Stem ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus

The Brown-Robert-Wells(BRW) stereotactic system has many advantages in the supratentorial spontaneous intracerebral hemorrhage(ICH), but is has less accessibility to the spontaneous cerebellar hemorrhage by stereotactic suboccipital approach. To overcome this disadvantage, we have tried to treat stereotactically three patients of spontaneous intracerebellar hemorrhage through tentorium using BRW stereotaxis and gradual irrigation wth urokinase(UK). This new approach has been used successfully under the local anesthesia with satisfactory postoperative neurological results. We present a detailed technique of this approach.
Anesthesia, Local ; Hemorrhage* ; Humans

A total cases of 1080 inpatients of spinal disease in neurosurgical department of Yeungnam University Hospital(YUH) from May 1983 to March 1988 were analysed statistically. 1) Of the total 1080 cases, the vast majority was degenerative disease 749(69.3%), and others were trauma 265(24.5%), tumor 28(2.5%), congenital anomaly 4(0.3%), infection 22(2.0%) and miscellaneous 12(1.1%). 2) In degenerative disease, male to female ratio in disc disease was 1.7:1 and in degenerative spondylolisthesis 1:3. And frequent age group of disc disease was 20~40(50%) and other degenerative diseases were 40~60(66.6%). 3) Most frequent site of cervical disc disease was C5~6(40%) and lumbar disc disease was L4~5(79.4%). 4) There were 265 patients of trauma, among them, spinal fracture without neurological deficit was 97(36.6%), soft tissue injury was 133(50.0%) and fracture associated with cord injury was 25(13.2%). 5) In 28 cases of spinal tumors, the most frequent site was extradural space 23(82.1%).
Female ; Humans ; Inpatients ; Male ; Soft Tissue Injuries ; Spinal Diseases* ; Spinal Fractures ; Spondylolisthesis

A total cases of 1080 inpatients of spinal disease in neurosurgical department of Yeungnam University Hospital(YUH) from May 1983 to March 1988 were analysed statistically. 1) Of the total 1080 cases, the vast majority was degenerative disease 749(69.3%), and others were trauma 265(24.5%), tumor 28(2.5%), congenital anomaly 4(0.3%), infection 22(2.0%) and miscellaneous 12(1.1%). 2) In degenerative disease, male to female ratio in disc disease was 1.7:1 and in degenerative spondylolisthesis 1:3. And frequent age group of disc disease was 20~40(50%) and other degenerative diseases were 40~60(66.6%). 3) Most frequent site of cervical disc disease was C5~6(40%) and lumbar disc disease was L4~5(79.4%). 4) There were 265 patients of trauma, among them, spinal fracture without neurological deficit was 97(36.6%), soft tissue injury was 133(50.0%) and fracture associated with cord injury was 25(13.2%). 5) In 28 cases of spinal tumors, the most frequent site was extradural space 23(82.1%).
Female ; Humans ; Inpatients ; Male ; Soft Tissue Injuries ; Spinal Diseases* ; Spinal Fractures ; Spondylolisthesis

Brain Computerized Tomography(CT) and cerebral angiography were reviewed in thirty-six patients with multiple intracranial aneurysms(22.5%) among the 160 consecutive surgical cases of intracranial aneurysms. The prevalent sites of multiple aneurysms were the middle cerebral artery(37.0%), posterior communicating artery(22.2%), and internal carotid artery(14.8%) in sequence. However, the vertebrobasilar system(83.3%), anterior communicating artery(63.6%), and posterior communicating artery(50.0%) had higher probability of rupture than internal carotid artery(8.3%) or middle cerebral artery(33.3%). Based on CT and angiographic information, the site of rupture can be predicted with a high degree of reliability. These factors were the presence of localized hemorrhage on CT, focal vasospasm, size and irregularity of aneurysms, and relative hyperplasia of parent artery.
Aneurysm ; Arteries ; Brain ; Cerebral Angiography ; Hemorrhage ; Humans ; Hyperplasia ; Intracranial Aneurysm ; Parents ; Rupture