No abstract available.
6-Cyano-7-nitroquinoxaline-2,3-dione* ; Cycloheximide* ; Dizocilpine Maleate*

The authors describe a technique consisting of subfascial temporalis dissection and performing a pedicled bone flap in pterional craniotomy. This technique provides reliable preservation of the frontalis nerve, does not necessitate the reconstruction of the temporalis muscle at the end of the surgery, and does not compromise the operative exposure.
Craniotomy

In recent years there has been a tendency to abandon repeat cerebral angiography in patients with subarachnoid hemorrhage(SAH) if the initial angiogram is normal because prognosis is said to be excellent. Our experiences does not support such a conclusion. In 291 cases with subarachnoid hemorrhage(SAH), four vessel cerebral angiography was performed to investigate a source of the hemorrhage. The first four vessel study on admission revealed 234 cases(80.4%) of ruptured cerebral aneurysms. Fifty-five of 291 patients with primary subarachnoid hemorrhage(SAH) did not show vascular lesion in initial pan-angiography studies. In order to define the benefit of control angiography these patients were reviewed. Among 41 patients who underwent repeat angiography, a second angiography showed an aneurysm in 24(58.5%). Twelve of the twenty-four cases had aneurysms in the anterior communicating artery. But the age, sex, initial clinical grade and CT grade of patients with aneurysm in repeat angiography were indistinguishable from thoses of patients without aneurysm. Even in the patients who showed angiographic vasospasm in intial angiography, probability of revealing an aneurysm was not different from those without spasm. We conclude that repeat angiography is necessary in the cases of SAH with normal initial angiogram regardless of the CT findings and the presence of vasospasm.
Aneurysm ; Angiography* ; Arteries ; Cerebral Angiography ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Prognosis ; Spasm ; Subarachnoid Hemorrhage*

Atrial natriuretic factor(ANF) is a diuretic natriuretic peptide hormone produced by both the heart and brain. It has been postulated to play a role in the hemodynamic and sodium instability that frequently follows subaracthnoid hemorrhage(SAH). Electrocardiographic(EKG) abnormalities is known to occur frenquently after cerebrovascular accident, especially subarachnoid hemorrhage. A prospective study was undertaken to evaluate the relation between the changes of ANF and EKG findings and clinical findings. Thirty-five nonselected patients with SAH were followed with serial measurements of plasma ANF, plasma antidiuretic hormone(ADH), serum sodium, serum osmolarity, and electrocardiography(EKG) at 2nd, 5th, and 7th day after hemorrhage. Mean plasma ANF values at 2nd, 5th, and 7th day of hemorrhage were 202.3+/-109.6 pg/ml, 134.6+/-83.5 pg/ml, and 123.3+/-69.9 pg/ml, respectively. Mean plasma ADH values were within normal limits(3.2-4.4 pg/ml). At a later stage, 9 patients showed hyponatremia and hypoosmolarity, among whom 8 patients had elevated ANF and 1 patient elevated ADH. The delayed and persistent rise of plasma ANF was correlated with the development of hyponatremia. One or more EKG abnormalities were found in 13 patients. Mean ANF values of patients with normal EKG(131.8+/-48.7 pg/ml) were significantly different from those with abnormal EKG(272.2+/-107.5 pg/ml). The changes of plasma ANF appeared unrelated to age, sex, clinical grade, CT grade, and bleeding site. The results of this study indicate that elevated plasma ANF is closely related with electrophysiological changes of myocardium and that the transitory myocardial ischemia might be the source of plasma ANF sfter SAH.
Atrial Natriuretic Factor* ; Brain ; Electrocardiography* ; Heart ; Hemodynamics ; Hemorrhage ; Humans ; Hyponatremia ; Myocardial Ischemia ; Myocardium ; Osmolar Concentration ; Plasma ; Prospective Studies ; Sodium ; Stroke ; Subarachnoid Hemorrhage*

No abstract available.
Conus Snail* ; Hemangioblastoma*

No abstract available.
Conus Snail* ; Hemangioblastoma*

The author has examined the effect of cortical spreading depression(CSD) on the changes in extracellular concetration of aspartate and glutamate in the neocortex of anesthetized rats using microdialysis and high performance liquid chromatography(HPLC). The rats were prepared by halothane anesthesia and artificial ventilation. Rats were placed in a stereotaxic frame, and craniotomies were performed over the frontal and parietal cortexes on one side. The CSD was elicited by local application of KCI-soaked small pellets to the frontal cortex. The CSD was monitored by the changes of direct current(DC) potential in the parietal cortex. The microdialysis probe was implanted in the anterior part of the parietal cortex. Amino acids were analyzed by HPLC and fluorescence detection. Baseline concentration of the aspartate was 34.9+/-15.9nM and that of glutamate was 189.8+/-29.1nM(mean standard deviation). The perfusate for analysis was obtained 30 minutes after the beginning of the 300mM KCl induced CSD. Aspartate was found to increase to 146+/-55% baseline, glutamate up to 173+/-30% baseline(mean standard deviation). The increment of glutamate was statistically significant(p<0.05). Then 2M KCI-doaked pellets were applied for more frequent CSD amd the samples were collected. Aspartate increased up to 258+/-97% baseline, glutamate up to 174+/-57% baseline(mean standard deviation), The increment of glutamate and aspartate accompanying 2M KCI induced CSD were also statistically significant(p<0.05). These data suggest that the excitatory amino acids were released during the CSD and this may explain the various aspects of CSD that could contribute to the secondary neuronal damage in the compromised nerve cell.
Amino Acids ; Anesthesia ; Animals ; Aspartic Acid* ; Cerebral Cortex* ; Chromatography, High Pressure Liquid ; Cortical Spreading Depression* ; Craniotomy ; Excitatory Amino Acids ; Fluorescence ; Glutamic Acid* ; Halothane ; Microdialysis ; Neocortex ; Neurons ; Rabeprazole ; Rats* ; Ventilation

OBJECTIVE: Hemangiopericytoma is known as a malignant tumor originating from pericytes and rarely occurs in the central nervous system. We present 6 cases of pathologically confirmed meningeal hemangiopericytoma. METHODS: Retrospective study was done based on patient's recordings including radiological studies. Each case of tumors was treated surgically and postoperative radiotherapy was done. RESULTS: There were 5 cases of intracranial and 1 case of spinal hemangiopericytomas. Three of 5 intracranial hemangiopericytomas were located at tentorial region. Total tumor removal was done in 4 cases and postoperative local recurrence (or regrowth) was noted in 3 cases despite of postoperative external radiation therapy, 2 of which had died. CONCLUSION: Our cases show more frequent tentorial locations and poor clinical outcomes of hemangiopericytomas compared with meningiomas.
Central Nervous System ; Hemangiopericytoma* ; Meningioma ; Pericytes ; Radiotherapy ; Recurrence ; Retrospective Studies

OBJECTIVE: This paper describes our experience and implant technique for cranioplasty of a large cranial defects using a porous polyethylene implant(Medpor) and compares the results with polymethylmethacrylate(PMMA). METHODS: Sixteen cranioplasties were performed using Medpor(n=10) and PMMA(n=6) implants between June 2003 and January 2005. The criterion for patient enrollment was a defect larger than 10cm in diameter. This study compared the operation times and complications. RESULTS: The operation times ranged from 105 to 250minutes(Mean 180 degrees +/-44minutes) in Medpor and from 185 to 460minutes (mean 128minutes) in PMMA. The absolute operation times were shorter using the Medpor implant and the differences were statistically significant(P=0.030). Satisfactory cosmetic results were obtained in all cases using the Medpor implant and with no implant-related complications. Bone ingrowth to the medpor implant was presumed to be the result on an increase in Houndsfield units of the implant, particularly at the marginal areas in the serial follow-up brain computed tomography images. CONCLUSION: It is believed that the properties of a Medpor implant make this implant an good alternative to the existing methods of a cranial contour correction. However, a further follow-up study will be needed.
Brain ; Follow-Up Studies ; Humans ; Polyethylene* ; Polymethyl Methacrylate

A 51-year-old female patient with right lower motor weakness and left side motor weakness is presented. MRI signal revealed a butterfly brain mass. Angiography showed stenosis of left side internal carotid artery at the supraclinoid portion and Moyamoya vessel, collateral circulation to mass via posterior circulation and contralateral was observed.
Angiography ; Brain Neoplasms* ; Brain* ; Butterflies ; Carotid Artery, Internal ; Collateral Circulation ; Constriction, Pathologic ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Moyamoya Disease*