No abstract available.
Glioblastoma*

With the development of devices and techniques, including complex shape coils, balloons, multiple catheter techniques, and intracranial stents, endosaccular treatment of ruptured or unruptured wide-necked cerebral aneurysms has advanced rapidly with respect to indications and outcomes. In contrast to other options, stent-assisted aneurysm embolization has a distinct feature in which the stent is permanently implanted in the cerebral vessels. Therefore, we must consider the short-term effect of stent-assisted aneurysm embolization in the prevention of coil migration and adverse thrombogenicity, but also the permanent mechanical, hemodynamic, and biological influence on the parent vessels and the aneurysm. We have reviewed the current experimental and clinical data on stent-assisted coil embolization of cerebral aneurysms.
Aneurysm ; Catheters ; Hemodynamics ; Humans ; Intracranial Aneurysm ; Parents ; Stents

The incidence of distal anterior cerebral artery(ACA) aneurysm is relatively rare, and only a few cases of bilateral symmetrical distal ACA aneurysms which were adhered together have been reported. They are also called kissing aneurysms. We treated bilateral symmetrical distal ACA kissing aneurysms in a 44-year-old woman. We successfully clipped the double aneurysmal sacs individually by interhemispheric approach in spite of intraoperative aneurysmal rupture. The patient was discharged without any neurological deficits two weeks after the operation.
Adult ; Aneurysm* ; Anterior Cerebral Artery* ; Female ; Humans ; Incidence ; Rupture

Background: and Purpose: Neural stem cells (NSCs) have the ability to regenerate, proliferate, and differentiate, enabling them to play important roles in the recovery of the damaged nervous system. However, in neurodegenerative diseases such as Alzheimer's disease (AD), the NSCs are damaged as well. Glia-like cells from human mesenchymal stem cells (ghMSCs) are functionally enhanced adult stem cells. In the present study, we investigated whether ghMSCs could protect NSCs from amyloid beta (Aβ)-mediated toxicity. Methods: Rat NSCs were obtained from E13–14 fetal rat cortices. NSCs were seeded in pre-coated plates, and the next day, cells were simultaneously treated with 20 μM Aβ and 0.4 μm pore insert well-seeded ghMSCs. After 48 hours of co-treatment, cell viability and proliferation were evaluated. After 2 hours of co-treatment, western blotting was performed to measure inflammasome-related factors, such as NOD-like receptor family pyrin domain containing 3, caspase-1, and interleukin-1β. Results: The results showed that ghMSCs increased viability and proliferation and reduced the toxicity of NSCs injured by Aβ by reducing the NRLP3 inflammasome activation of NSCs induced by Aβ. Conclusions In this study, we confirmed that ghMSCs could protect NSCs in an in vitro model of AD through the regulation of inflammatory response.

Background: and Purpose: Neural stem cells (NSCs) have the ability to regenerate, proliferate, and differentiate, enabling them to play important roles in the recovery of the damaged nervous system. However, in neurodegenerative diseases such as Alzheimer's disease (AD), the NSCs are damaged as well. Glia-like cells from human mesenchymal stem cells (ghMSCs) are functionally enhanced adult stem cells. In the present study, we investigated whether ghMSCs could protect NSCs from amyloid beta (Aβ)-mediated toxicity. Methods: Rat NSCs were obtained from E13–14 fetal rat cortices. NSCs were seeded in pre-coated plates, and the next day, cells were simultaneously treated with 20 μM Aβ and 0.4 μm pore insert well-seeded ghMSCs. After 48 hours of co-treatment, cell viability and proliferation were evaluated. After 2 hours of co-treatment, western blotting was performed to measure inflammasome-related factors, such as NOD-like receptor family pyrin domain containing 3, caspase-1, and interleukin-1β. Results: The results showed that ghMSCs increased viability and proliferation and reduced the toxicity of NSCs injured by Aβ by reducing the NRLP3 inflammasome activation of NSCs induced by Aβ. Conclusions In this study, we confirmed that ghMSCs could protect NSCs in an in vitro model of AD through the regulation of inflammatory response.

Primary oligodendroglioma of the spinal cord is very rare tumor. On searching through the literature from 1931, we could find only about 46 cases, and this tumor is almost absent in Korea on the review of the literature. The authors present a case of 8-year-old female patient with the symptoms of paraparesis, urination difficulty, diffuse back pain and hypesthesia in both lower extremities. Spine MRI revealed the mass at the level of T3-T12, with combined nature of cystic and solid portion. Decompressive laminectomy and partial mass removal was performed, and then adjunctive radiotherapy and chemotherapy was done. The patient was improved after operation with radiotherapy and chemotherapy, so she walks alone and has no voiding difficulty at present(postoperative about 20 months) .
Back Pain ; Child ; Drug Therapy ; Female ; Humans ; Hypesthesia ; Korea ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Oligodendroglioma* ; Paraparesis ; Radiotherapy ; Spinal Cord* ; Spine ; Urination

Among the four-hundred patients with cerebral aneurysms confirmed by cerebral angiography, we divided them into two age groups, one with ages 39 years or younger(young-aged group: 51 patients, 12.8%), and another with ages 65 years or older(old aged group: 45 patients, 11.3%). A comparison was undertaken in regard to clinical characteristics and overall outcome in two groups. In young-aged group, the female-to-male ratio was 2.2: 1 whereas, women was predominant by five times more in old aged group. Anterior communicating artery aneurysm was the most common site(43.1%) in young-aged group, unlike to old aged group where posterior communicating artery was the most common site(33.3%). The most common symptom was headache in both groups, and the hypertension was more frequent in young-aged group(45.5%) than old-aged group(33.3%). Surgery was performed in 43 patients(84%) in younger group, and 37 patients(82.2%) in elderly group. Young-aged group showed more favorable outcome(91%) than old-aged group(70%).
Aged ; Arteries ; Cerebral Angiography ; Female ; Headache ; Humans ; Hypertension ; Intracranial Aneurysm* ; Prognosis

This study is a retrospective clinical analysis of 134 cases of anterior communicating artery aneurysms surgically treated in the Department of Neurosurgery, Chungnam National University Hospital from January 1990 to December 1996. The results of analysis were summarized as follows; 1) Peak age incidence was in the sixth decade and male to female ratio was 1: 1.2, showing female predominancy. 2) There was no statistically significant relationship between direction of aneurysm and Fisher's grade, and occurrence of hydrocephalus, and also between the direction, size and shape of aneurysm and preoperative Hunt-Hess grade. 3) There was statistically significant relationship between the shape of aneurysm and angiographic vasospasm; there was high incidence of vasospasm in lobulated and oval shape of aneurysm. But there was no statistically significant relationship between the direction, size of aneurysm and angiographic vasospasm. 4) The correlations between outcome and preoperative Hunt-Hess grade, and occurrence of angiographic vasospasm, and temporary clipping were statistically significant; the outcome was good in cases of no vasospasm, temporay clipping and better preoperative Hunt-Hess grade. 5) The direction, shape and size of aneurysm, existence or not of abnormality in circle of willis, timing of surgery and operative procedure had no statistically significant relationship with outcome. 6) Postoperative complications were vasospasm and infarction(18.7%), brain edema, hydrocephalus, in order of frequency, and the mortality rate was 3%.
Aneurysm ; Brain Edema ; Chungcheongnam-do ; Circle of Willis ; Female ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Neurosurgery ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

One hundreds eighty cases of traumatic intracerebral hematoma(TICH) among 1,633 head injury patients diagnosed with computerized tomography in neurosurgical department from Jan. 1990 to Jun. 1996. were classified into two TICH groups; TICH group associated with other traumatic intracranial lesions and TICH group without other traumatic intracranial lesions. The incidence of TICH was 11.0% and percentage of TICH with other traumatic intracranial lesions among 180 cases of TICH was 66.7%. TICH group with other traumatic intracranial lesions showed worse initial level of consciousness, more likely to have abnormal pupillary reflex, higher incidence of delayed traumatic intracerebral hematomas(DTICH), greater amount of hematoma, increased chance of surgery and worse outcome. In TICH group with other traumatic intracranial lesions, the factors affecting prognosis were initial Glasgow coma scale(GCS) score, pupillary reflex, amount of hematoma and treatment modality. In TICH only group, the factors affecting prognosis were initial GCS score, pupillary reflex, amount of hematoma and DTICH. The patients with 12-15 of GCS score, normal pupillary reflex, absence of DTICH, and amount of hematoma below 10cc, the presence of other traumatic intracranial lesions were found to be important prognostic factor. The overall mortality was 27.7% but in TICH group with other traumatic intracranial lesions, the mortality was 35.0% compared to 13.3% in TICH only group. It is concluded from this study that in the case with other traumatic intracranial lesions, TICH showed worse initial neurological status and prognosis compared to those without other lesions. Thus, these patients, although in conditions of good general clinical index at admission, should be considered to provide intensive care and treatment because these associated lesions will play as a bad prognostic factor.
Coma ; Consciousness ; Craniocerebral Trauma ; Hematoma* ; Humans ; Incidence ; Critical Care ; Mortality ; Prognosis ; Reflex, Pupillary

OBJECTIVE: The authors analyzed the postoperative radiological changes in chronic subdural hematoma (CSDH) after operation and its relation to the recurrence. METHODS: After reviewing the postoperative imagings of CSDH patients (90 cases, 70 patients), we classified them into 4 types according to the radiological changes in the hematoma area and calculated the prevalence of recurrence respectively. We also reviewed the preoperative images of the same patients and classified them into 4 types according to hematoma density and internal structure and investigated the prevalence of recurrence after operation respectively. RESULTS: The low density area in postoperative computerized tomography (CT) showed the same Hounsfield unit and signal intensity in magnetic resonance imaging (MRI) with the CSF in ventricles. The recurrence of CSDH was lower if the hematoma was totally replaced with CSF (Type III) or the brain re-expanded completely with total hematoma drainage (Type IV) on postoperative imagings (p<0.05). The location of catheter tip can be used as a valuable indicator of the boundary of newly collected CSF and residual hematoma. CONCLUSION: The low-density area found on postoperative CT medial to the residual hematoma in CSDH is filled with CSF and it can be a helpful factor in reducing the recurrence. The catheter tip location can be used as a good index and we can remove the catheter immediately after confirming the tip location on the inner surface of the skull.
Brain ; Catheters ; Drainage ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Magnetic Resonance Imaging ; Prevalence ; Recurrence* ; Skull