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

No abstract available.
Conus Snail* ; Hemangioblastoma*

No abstract available.
Conus Snail* ; Hemangioblastoma*

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*

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

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

The author has performed an experimental study in order to investigate the effect of nimodipine on the production of CSF in 12 cats. The cats were divided into 2 groups, one for nimodipine intravenous infusion and the other for its vehicle infusion group. Using ventriculo-cisternal perfusion method, nimodipine and its vehicle were examined for their effects on CSF formation rate respectively. Baseline CSF formation rate was 22.5+/-2.9 microliter/min(S.E.) and it gradually reduced to 17.0+/-3.4 microliter/min(S.E.) after final infusion of nimodipine at 60 microgram/kg/min. Vehicle infusion revealed no significant change in CSF formation rate. Although the nimodipine insuion revealed declining tendency in CSF formation rate along with increment of nimodipine concentration, it was not statistically different from that of vehicle infusion group. Systolic blood pressure was significantly reduced after nimodipine infusion(133+/-31.8mmHg at baseline, 93.9+/-19.1mmHg at the end of the experiment) on oneway ANOVA test and it was significantly different from that in vehicle infusion group(p<0.01).
Animals ; Blood Pressure ; Cats ; Infusions, Intravenous ; Nimodipine* ; Perfusion

About 10% of all intracranial tumors occur at the cerebellopontine angle(CPA). While the most common of these, accounting for about 75% of the total, are acoustic neurinomas, these-with widly varying histology-also comprise a significant portion. One of these is trigeminal neurinoma, which account for about 2-10% of all CPA tumors ; a cystic lesion is even rarer. The authors report a case of large cystic trigeminal neurinoma at the cerebellopontine angle and review of the pertinent literature.
Cerebellopontine Angle* ; Neurilemmoma* ; Neuroma, Acoustic ; Trigeminal Nerve

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*