Recurrent episode of meningitis in infants and children frequently constitute a frustrating and distressing, both in determination of course and treatment. The authors are reporting a infected case of congenital dermal sinus with dermoid cyst in the subarachnoid space of cauda equina and conus medullaris which was cured after complete removal of cyst and sinus tract.
Cauda Equina ; Child ; Conus Snail ; Dermoid Cyst ; Humans ; Infant ; Meningitis ; Spina Bifida Occulta* ; Subarachnoid Space

We checked and analysed the clinical and radiological status of the upper extremities of 142 baseball player in childhood and adolescence. The results of this study were as follow:1. The oreder of frequency of pain locations in the upper extremities was elbow, shoulder, and then wrist joint. 2. There was colse relationship between elbow pain and career, but not in shoulder and wrist area. 3. The characteristics of shoulder or wrist pain were diffuse and vague nature, but elbow pain was located in medial aspect. 4. The cubitus valgus and limited elbow ROM in throwing side were found in pitchers or older careers. 5. All players showed cortiocotrabecular hypertrophy of humerus, and high incidence of medial epicondylar changes were noticed with career increased. 6. Main bony changes: Shoulder
Adolescent ; Baseball ; Elbow ; Epiphyses ; Growth Plate ; Humans ; Humerus ; Hypertrophy ; Incidence ; Joints ; Shoulder ; Upper Extremity ; Wrist ; Wrist Joint

No abstract available.
Humerus*

We report a case of irreducible atlantaxial dislocation with spinal cord injury. The patient was a 36-year-old man who suffered from the sudden onset of shallow respiration and severe motor weakness after slip down. We have performed the one-stage operation, the transoral decompression, reduction and posterior interspinous wiring with bone fusion. Three weeks after surgery, the reduction state and posterior wiring procedure were failed, due to severe osteoporotic change. So, we have performed second operation, the transarticular facet screw fixation and occipito-cervical fixation with Steinmann pin, from which good postoperative stability and neurological improvements, were obtained.
Adult ; Decompression* ; Dislocations* ; Humans ; Osteoporosis ; Respiration ; Spinal Cord Injuries* ; Spinal Cord*

Study of 22 cases with the pseudospondylolisthesis established that it occurred more frequently in the older women, and far more frequently at the L4 level, as same results as reported by others. The slipping occurred as a result of degenerative disease of the articular process and facet joint, but it never exceeded 25% in this series. This study was performed to recognize the stability of the lumbosacral joint by the measurement of the anterior and posterior vertical heights(deformity) of the body of the L5 vertebra and lumbosacral angles in our cases. We also attempted to observe whether the facet angle changes at the involved level was meaningful or not. Result : lumbosacral angles in the our patients with pseudospondylolisthesis were increased greater than normal, so lumbar lordosis was less than normal. The body of the L5 vertebra was not as wedged anteroposteriorly as it normally was. The contour of the body of the L5 vertebra resembled rectangle shape. The pedicle-facet angles were increased at involved level, but this measurement was not correctly demonstrated on the plain roentgenograms. Conclusion : The stability of the lumbosacral joint in the patients with pseudospondylolisthesis was increased due to rectangle shape of the body of the L5 vertebra and less lumbar lordosis. The pedicle-facet angles at the involved level were increased, but not correct diagnostic values.
Animals ; Female ; Humans ; Joints ; Lordosis ; Spine ; Zygapophyseal Joint

The authors experience a case of juvenile type thoracic arteriovenous malformation. It is acute onset and represent spastic paraparesis, sensory Impairment and voiding difficult. Intradural spinal arteriovenous malformation is relatively rare lesion. The authors treated with total excision of A-V malformed vessel with good results.
Arteriovenous Malformations* ; Paraparesis, Spastic

In anterior communicating artery aneurysm that accounts for about 30% of intracranial aneurysms, it has been pointed out that the hemodynamic factor plays a very important role in all stages such as initiation, growth and rupture of aneurysm. Based upon the relationship between the findings of brain CT and those of cerebral angigram, the authors reviewed 96 cases of ruptured anterior communicating artery aneurysms that were operated on at the Department of Neurosurgery of Hanyang University Hospital from Jan. 1985 to June 1990, to suggest a point referred to which carotid artery should be selected first when direct carotid angiography is inevitable. The results were summarized as followings: 1) Of 96 cases, hemorrhagic evidence was observed in 92 case(95.8%) and among them, subarachnoid hemorrhage accompanying intracerebral hematoma(37 cases, 38.5%) was the most common type of hemorrhage. 2) Of 96 cases, left A1 was operated as afferent artery in 61 case(63.5%), right A1 in 23 cases(24.0%), and both A1, in 12 cases(12.5%). And the direction of aneurysm was to the right in 49 cases(51.0%), to the left in 12 cases(12.5%) and to the midline in 35 cases(36.5%). 3) Of 53 cases which had intracranial hematoma, 28 cases showed unilateral predominance. Among them the predominance of hematoma was opposite to the afferent artery in 82.1%(23/28) and was ipsilateral to the direction of aneurysm in 64.3%(18/28). 4) Of 91 cases which had subarachnoid hemorrhage, 29 cases showed unilateral predominance. Among them the predominance of hemorrhage was opposite to the afferent artery in 72.4%(21/29) and was ipsilateral to the direction of aneurysm in 58.6%(17/29). 5) Above findings suggest that in the cases with suspicious ruptured anterior communicating artery aneurysms on brain CT and direct carotid angiography is inevitable, contralateral carotid angiography should be undertaken at first when intracranial hematoma or subarachnoid hemorrhage shows unilateral predominance on brain CT, and left carotid antiography is preferable than the right one if there is no predominance of intracranial hematoma or subarachnoid hemorrhage on brain CT.
Aneurysm ; Angiography ; Arteries ; Brain ; Carotid Arteries ; Cerebral Angiography ; Hematoma ; Hemodynamics ; Hemorrhage ; Intracranial Aneurysm* ; Neurosurgery ; Rupture ; Subarachnoid Hemorrhage

A retrospective clinical study was performed in 41 patients with intracranial AVM during the period from January 1985 to December 1989. 12 patients managed conservatively and 29 patients surgically were followed for an average of 15 months. The results were as follows ; 1) The age range of presentation of intracranial AVM was 5 years to 48 years, with peak incidence from second to third decade. 2) The presenting symptoms and signs were intracranial hemorrhage(75.6%), seizure(12.5%), and headache(9.7%) in order of frequency. 3) In intracranial hemorrhage, intracerebral hematoma was the most frequent. 4) In small intracranial AVM, 84.2% was presented with hemorrhage, and large intracranial AVM, 37.5% with seizure. 5) There was a correlation between AVM grade of Spetzler & Martin and the incidence of postoperative neurological complication. 6) The clinical outcome for patients managed surgically was more favorable than that for patients managed conversatively.
Arteriovenous Malformations ; Hematoma ; Hemorrhage ; Humans ; Incidence ; Intracranial Arteriovenous Malformations* ; Intracranial Hemorrhages ; Retrospective Studies ; Seizures

The authors analysed 140 cases of subdural hygroma developed after head injury and various neurosurgical operations and was treated at Hanyang university hospital from 1983 to 1989. The results were analysed and summarized as follows. 1) The peak incidence was the age over 50 and under 10. 2) 104 cases(74.4%) were bilateral frontotemporoparietal lesions. 3) Causes were head injury(121 cases), operation for intracranial aneurysms(5 cases), ventriculoperitoneal shunt(5 cases), traumatic(2 cases), external ventricular drainage(1 case). 4) Change in mental status without focal sign of brain damage was presenting symptom. 5) Operation was underwent if 63 cases and the reaccumulation rate was high (26.8%) after trephination but outcome was favorable. 6) Mortality rate in traumatic subdural hygroma was low(5.8%) because brain CT could detect subdural hygroma easily in early stage.
Brain ; Craniocerebral Trauma ; Head ; Incidence ; Mortality ; Subdural Effusion* ; Trephining

The authors reviewed angiographic findings of 96 cases of ruptured anterior communicating artery aneurysms that were operated at the Department of Neurosurgery of Hanyang University Hospital from Jan. 1986 to June 1990. The results were summarized as follows ; 1) Asymmetricity of caliber of A1 was observed in 71.9%(69/96) and which was 3 times more frequent than that of reported incidence of control group(2~23%). 2) The incidence of predominance of left A1 was 54.2%(53/96) and that of right A1 was 17.7%(17/96). Among them, predominant A1 was operated as afferent artery of aneurysm in 94.2%(65/69). 3) Of 69 cases in which a unilateral A1 showed predominance, the direction of aneurysm was opposite to the side of predominant A1 in 66.7%(46/69) and ipsilateral to the predominant A1 in only 2.9%(2/69). 4) Above findings suggest that it is desirable to approach the anterior communicating artery aneurysm via the side of predominant A1 when the direction of aneurysm is uncertain on cerebral angiogram.
Aneurysm ; Arteries ; Cerebral Angiography ; Incidence ; Intracranial Aneurysm* ; Neurosurgery