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

Astrocytoma in the thalamus in not so frequent in incidence (1%). Moreover, bilateral thalamic tumor is rare. Certain tumors of the thalamus are considered resectable but most of thalamic tumors are thought to be untouchable. Bilateral thalamic astrocytoma with hydrocephalus was diagnosed by stereotactic biopsy and ventriculoperitoneal shunt operation was done with result of improvement. We report a case of astrocytoma in the bilateral thalamus with literature review.
Astrocytoma* ; Biopsy ; Hydrocephalus ; Incidence ; Thalamus* ; Ventriculoperitoneal Shunt

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

Spontaneous hemo-pneumothorax, a hemothorax that occurs without trauma, is a very rare condition; however, as a result of excessive bleeding, it can be lethal. Also, if the bleeding is scanty, the physician might recognize hemothorax in case of performing invasive procedures, such as chest tube insertion, and may misunder stand as a complication of the procedure. For this reason, acknowledgement of the spontaneous hemo-pneumothorax in the emergency department is very important. We report on a case of a spontaneous hemo-pneumothorax in a healthy 18-year-old male presenting with chest pain who developed a spontaneous pneumothorax with a profuse amount of hemothorax.
Chest Pain ; Chest Tubes ; Emergencies ; Hemorrhage ; Hemothorax ; Humans ; Male ; Pneumothorax

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

We have treated 634 cases of cerebrovascular disease who admitted to the Yeungnam University hospital form May 1983 to march 1988. The authors analysed the clinical aspects of cerebrovascular disease, and the results are as followings. 1) The hemorrhagic stroke was 4 times more than the ischemic stroke. 2) The hemorrhagic stroke occur most frequently in fifth decade and the ischemic stroke occur in sixth decade. 3) An infarction was most common in the ischemic stroke. 4) The most common cause of intracerebral hemorrhage was hypertension. S) The most common cause of subarachnoid hemorrhage was aneurysm. 6) The intracerebral hemorrhage occur most frequently in the putamen(35.1%) followed by the thalamus(29.2%), subcortical(24.8%), brain stem(5.9%) and cerebellum(5.0%). 7) The aneurysmal sac was located most frequently in the A-com(28.3%), followed by MCA(26.4%), and P-com(25.5%). The multiple aneurysm occurred in 13% of 92 cases.
Aneurysm ; Brain ; Cerebral Hemorrhage ; Hypertension ; Infarction ; Stroke ; Subarachnoid Hemorrhage

OBJECTIVE: The purpose of the study was to evaluate the clinical and radiological results after discectomy and Lubboc bone graft in the surgical management of the cervical diseases with a new titanium interbody implant and integrated screw fixation(PCB) by anterior approach. METHODS: The authors retrospectively analyzed 28 cases of anterior cervical fusion with PCB system and Lubboc bone(xeno graft) from september 1998 to december 2000. Twenty-eight patients with cervical diseases underwent decompression cervical lesion and followed from 5 to 27 months with a mean follow-up of 14 months. There patients were evaluated with clinically and radiologically at immediate postoperative period and at 3, 6, 9, and 12 months. RESULT: The authors investigated the pre- and postoperative intervertebral disc space, clinical outcomes, radiography fusion rate, and Cobb angle in the fixed segments by anterior approach. The lordotic angles and height of disc space were increased after the operation. The clinical outcome of patients follow-up was good or excellent result based on Odom's criteria with improvement of clinical symptom in about 92.9% of the cervical diseases. Two patients showed loosening of the lower and upper cervical screw of PCB instruments, and two patients showed swallowing difficulty and wound infection. CONCLUSION: The PCB system is a new implant for anterior cervical interbody fusion in the degenerative cervical disease and disc herniations. It provides immediate stability and segment distraction. The results of this study indicate that the PCB system is safe, easy handling of hardware, less complications, high fusion rate, and has provide the keeping the intervertebral disc space height and lordotic angles.
Decompression ; Deglutition ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Postoperative Period ; Radiography ; Retrospective Studies ; Titanium ; Transplants ; Wound Infection

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

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