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 present 43 cases of intracranial acute epidural hematomas(EDH's) managed by close observation. In each of 43 cases, the following criteria were met:1) the patient was conscious soon after head injury;2) the volume of hematoma was under 30ml(10ml in case of posterior fossa EDH's);3) there was no severe effacement of basal cistern or 4th ventricle;4) there was no associated intradural lesion;5) the patient showed neither cerebral herniation nor cardiorespiratory abnormalies. Of the 43 patients, 31(72%) showed no hematoma enlargement, and showed rsolution of hematoma on computerized tomography(CT) scans over a period of 4 to 11 weeks. Repeat CT scans within 24 hours of initial CT revealed enlargement of EDH in 12 of 43 patients(28%), of these 12 EDH's, 5 were reabsorbed spontaneously from 6 to 10 weeks, and 7 were evacuated surgically. All patients recovered without morbidity except one who had craniotomy during observation. There was no specific location of EDH which was indicated or contraindicated for conservative treatment. Factors that influence outcome include the age of patient, initial CT finding, cerebrospinal fluid(CSF) leakage, the use of mannitol, and recovery from shock. Hematoma enlargement did not always accompany deterioration of consciousness, therefore repeat CT scans within 24 hours is strongly recommended.
Consciousness ; Craniotomy ; Head ; Hematoma* ; Humans ; Mannitol ; Shock ; Tomography, X-Ray Computed

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

The authors operated 127 cases of the spontaneous intracerebral hematoma patients who were admitted via the emergency room during the recent two years. The location, timing of operation, method of approach, mortality etc. were analyzed. The results are as follows : 1) putaminal hemorrhage was 47.3%, thalamic hemorrhage was 23.6%, subcortical hemorrhage was 18.9%, cerebellar hemorrhage was 3.9%, pontine hemorrhage was 1.6%, and IVH only was 4.7%. 2) 77.2% was operated during the first 48 hours from the onset. 3) Almost all of the procedures were transcortical and trans-sylvian approach. 4) The mortality rate was 52.0%. 5) Microsurgical technique and external ventricular drainage(or ventriculoperitoneal shunt) played an important role for the good surgical outcome.
Emergency Service, Hospital ; Hematoma* ; Hemorrhage ; Humans ; Mortality ; Putaminal Hemorrhage ; Ventriculoperitoneal Shunt

The authors analysed 33 cases of metastatic spinal tumors admitted to the department of neurosurgery, Hanyang University Hospital from January 1983 to December 1992. During this period, we operated 12 cases of 33 cases. The results were as follows : 1) The common incidence of age was fifth decade, the most frequent primary site of metastatic tumors was lung, and the thoracic region was the most common site of metastatic tumors. 2) The most common complaints of patients were pain, weakness of extremities and sphincter disturbance in order. 3) The indication to surgical treatments comprises spinal instability, aggravation of neurologic symptom, diagnosis in doubt, known radioresistance of tumor and intractable pain. Anterior approach was used in cervical area for tumor removal and fusion and posterior approach was used in the thoracolumbar area for decompressive laminectomy. The result was better in surgery group. 4) Early identification of spinal metastasis were considered to be important for better prognosis. 5) The survival rate of the primary lesion may imfeuence on the pregnosis of metastatic spinal tumor.
Diagnosis ; Extremities ; Humans ; Incidence ; Laminectomy ; Lung ; Neoplasm Metastasis ; Neurologic Manifestations ; Neurosurgery ; Pain, Intractable ; Prognosis ; Survival Rate

The cavitron ultrasonic surgical aspirator(CUSA) has been used for the surgical removal of 26 cases of spinal intradural tumors. In 26 patients, total removal was possible in 77% and there was no neurological deterioration due to surgical removal using CUSA. 21 of 26 patients(84%) showed neurological improvement at long term follow-up examination. The cavitron ultrasonic surgical aspirator had advantages in the surgical removal of spinal intradural tumors, as follows:1) precise removal of tumor without excessive meahcnical manipulation of normal tissue;2) rapidity of action relative to the consistency of the tissue;3) direct visualization of the tissue being removed and good proprioceptive feedback for the surgeon;4) preservation of large vessel and very little bleeding;5) lack of thermal injury. The limitation of CUSA was obscuring of operation field by large and straight hand piece.
Feedback, Sensory ; Follow-Up Studies ; Hand ; Humans ; Ultrasonics*