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

No abstract available.
Humerus*

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

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 author analyzed 68 cases of the spinal cord tumors who had been operated at the Department of Neurosurgery of the Hanyang University Hospital from 1985 to 1989. The results were summerized as followings : 1) The spinal cord tumor was most common in the 5th decade of age(18 cases, 26.5%) and the ratio of male to female was 1.5 : 1, male predominant. The most common pathologic type was neurogenic tumor(29 cases, 42.6%). 2) The tumors were located most frequently in the thoracic area(35 cases, 51.5%) and in the intradural extramedullary space(30 cases, 44.1%). The most common initial presentation was pain and the paraparesis was most frequent symptom on admission. 3) The ratio of positive findings in plain radiologic study was 55.9% and all cases were shown the complete or partial blockings in myelography. 4) The computed tomographic scanning with water-soluble contrast media was useful in planning of operation to provide the exact relationship between the tumor, spinal cord and location of dura. 5) The total or gross total removal was possible in 60.3%(41 cases) and the result within postoperative one month was recovery or improvement in 73.5%(50 cases), the follow-up result was 83%(49 cases among 59 cases). 6) The most common postoperative complication was the spinal deformity in children(37.5%), and the osteoplastic laminotomy was required in prevention of this. 7) The incidence of metastatic tumor was 16.2%(11 cases), relatively high rate and the lung was most common primary focus. In plain X-ray examination, the bone destruction was most commonly found(54.5%) and the follow-up result was poor than the other tumors.
Congenital Abnormalities ; Contrast Media ; Female ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Lung ; Male ; Myelography ; Neurosurgery ; Paraparesis ; Postoperative Complications ; Spinal Cord Neoplasms* ; Spinal Cord*

In the past the patients with fracture on the occipital bone involved the lateral sinus and/or the foramen magnum, were treated with the early exploratory burr hole trephination regardless of mental state. The 64 cases occipital bone fracture were evaluated used the computed tomography of the brain scan. The fracture lines involved both the transeverse sinus and the foramen magnum were 59.4%, only the transeverse sinus were 29.7% and only the foramen magnum were 10.9%. The findings of the computed tomography of the brain scan were normal 42 cases, brain edema 13 cases. The 5 cases had large hematoma on the computed tomography of the brain scan performed emergency operation. The other 59 cases were treated with only close observation and conservative treatment. The mortality rate was 20% in operative treatment and 8.5% in conservative treatment. So we concluded that the patients with significant fracture on the occipital bone but had no surgical indication on the computed tomography of the brain scan might be treated with close observation & conservative treatment and it would not be necessary to perform the exploratory craniotomy as was done in the past.
Brain ; Brain Edema ; Craniotomy ; Emergencies ; Foramen Magnum ; Hematoma ; Humans ; Mortality ; Occipital Bone* ; Transverse Sinuses ; Trephining

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 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