No abstract available.
Magnetic Resonance Imaging* ; Tomography, Emission-Computed, Single-Photon*

Microscopic calcification within the basal ganglia was reported by Virchow and Bamberger in 1855. The description of symmetrical cerebral calcification, particularly of the basal ganglia and often of the dentate nuclei, associated with hypoparathyrodism as related by Eaton, Camp and Love(1939) was a significant development in the field of calcification. Calcification of the basal ganglia has been visualized by skull radiography and computed tomography(CT) scan, and in two-third of cases, it has been associated with metabolic and endocrine abnormalities. Computed tomography is more sensitive to detect the intracranial calcification than plain skull radiography. The purpose of our report was evaluate the significance of basal ganglia calcification as visualized by CT, discusses on pathogensis of calcification, clinical significance and management under the hypocalemia.
Basal Ganglia* ; Hypoparathyroidism* ; Radiography ; Skull

Metastatic adenocarcinoma to the brain usually appears low-to-moderate attenuation on non-enhanced computed tomography. However, metastatic mucinous adenocarcinoma shows strikingly high attenuation, even simulating hemorrhage in some cases. We present a rare case of a mucin-containing metastatic adenocarcinoma of the rectum mimicking cerebral hemorrhage.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Brain ; Cerebral Hemorrhage* ; Hemorrhage ; Mucins* ; Rectum

The authors report a case of a 24-year-old man with unilateral sphenoid dysplasia in the absence of NF-I. Preoperatively, the patient was presented with pulsating exophthalmos and headache. The patient underwent cranioorbital sphenoid wing reconstruction with split calvarial bone graft. Postoperatively, he showed relieved headache and significant reduction of exophthalmos by exophthalmometry. There were no evidence of osteomyelitis and neurologic complication.
Exophthalmos ; Headache ; Humans ; Neurofibromatoses* ; Neurofibromatosis 1* ; Osteomyelitis ; Transplants ; Young Adult

Patients with extra-axial mass lesions of the posterior fossa frequently demonstrate signs of brainstem dysfunction. These dysfunctions may be induced by the change of regional cerebral blood flow and electrophysiological status as well as mechanical compression and distortion of the brainstem. Frontal cortical regional cerebral blood flow(rCBF), pontine rCBF, brainstem autidory evoked potentials(AEPs), infratentorial intracranial pressure(infratentorial ICP) and mean arterial blood pressure(MABP) were recorded before and after expansion of an infratentorial epidural ballon in anesthetized experimental cat models. After the elevation of MABP during the increased infratentorial ICP, frontal cortical and potine rCBF, AEPs were recorded every 30 minutes. The results suggest that the elevating the MABP to improve cerebral perfusion pressure before irreversible change occurs in the brain may preserve cerebral function. We conclude that if the volume of the space in the posterior fossa that is occupied by the mass can be estimated, brain damage from low rCBF and brain compression due to intracranial hypertension can be prevented by the elevation of MABP before irreversible damage of the brain occurs.
Animals ; Blood Pressure* ; Brain ; Brain Stem ; Cats ; Evoked Potentials, Auditory* ; Humans ; Intracranial Hypertension ; Intracranial Pressure* ; Perfusion

Intracranial metastasis of hepatocellular carcinoma have been rarely reported, even in the Orient and Africa where this carcinoma is one of the relatively common malignancies. Hepatocellular carcinomas usually spread to regional lymph nodes around the porta hepatis via lymphatics. But venous metastasis of this cacinoma can occur via intrahepatic vein. The lungs are the most common distant metastatic sites followed by stomach, bones, and adrenals. Recently, we experienced a case of intracranial metastasis of hepatocellular carcinoma associated with epidural hematoma. Although the epidural hematoma and the metastatic tumor mass were totally removed, the patient died of liver complications on the 9th day of postoperative care. The clinical and radiological details of this case are presented here with a brief review of the literature.
Africa ; Carcinoma, Hepatocellular* ; Hematoma* ; Humans ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis* ; Postoperative Care ; Stomach ; Veins

PURPOSE: Although platelet-rich plasma (PRP) potentiate the wound healing activity of adipose-derived stem cells (ADSCs), its effect cannot be sustained for a prolonged period of time due to short duration of action. This led us to design and produce platelet-rich fibrin (PRF), in an effort to develop a tool which lasts longer, and apply it on wound healing. METHODS: Two symmetrical skin defects were made on the back of seven nude mice. ADSCs were applied to each wound, combined with either PRP or PRF. The wound area was measured over 14 days. By day 16, the wound was harvested and histologic analysis was performed including counting of the blood vessel. RESULTS: The healing rate was more accelerated in PRP group in the first 5 days (p<0.05). However, PRF group surpassed PRP group after 6 days (p<0.05). The average number of blood vessels observed in the PRF group was 6.53 +/- 0.51, compared with 5.68 +/- 0.71 for the PRP group. CONCLUSION: PRF exerts a slow yet pervasive influence over the two-week course of the wound healing process. Thus, PRF is probably more beneficial for promoting the activity of ADSCs for a sustained period of time.
Acceleration ; Animals ; Blood Platelets ; Blood Vessels ; Fibrin ; Mice ; Mice, Nude ; Platelet-Rich Plasma ; Skin ; Stem Cells ; Wound Healing

OBJECTIVE: The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery. MATERIALS AND METHODS: Brain perfusion SPECT images obtained at baseline and after the administration of acetazolamide were reconstructed using statistical parametric mapping in 23 patients, both before and after STA-MCA bypass surgery. The clinical outcomes of the surgery were also recorded and compared with the hemodynamic changes. A voxel with an uncorrected p-value of less than 0.001 was considered to be statistically significant. RESULTS: SPECT images of the territory supplied by the bypass graft showed an increase in both cerebrovascular flow and reserve at baseline, and the increase was significantly higher following the administration of acetazolamide. All patients showed improvement of clinical symptoms and increased blood flow to the left temporal, parietal, and frontal cortices as well as the thalamus. CONCLUSION: Brain SPECT effectively and objectively demonstrated the improved outcomes of STA-MCA bypass surgery, and thus may be used in postoperative analyses.
Acetazolamide/diagnostic use ; Adult ; Aged ; Brain/*radionuclide imaging ; Brain Mapping/methods ; Carotid Stenosis/surgery ; *Cerebral Revascularization ; *Cerebrovascular Circulation ; Cysteine/analogs & derivatives/diagnostic use ; Female ; Follow-Up Studies ; Humans ; Image Processing, Computer-Assisted ; Intracranial Arteriosclerosis/surgery ; Male ; Middle Aged ; Middle Cerebral Artery/*surgery ; Models, Statistical ; Organotechnetium Compounds/diagnostic use ; Predictive Value of Tests ; Radiopharmaceuticals/diagnostic use ; Temporal Arteries/*surgery ; Tomography, Emission-Computed, Single-Photon/*methods ; Treatment Outcome

Anterior basal meningiomas, which belong the olfactory groove and suprasellar meningioma account for 12 to 22% of all intracranial meningioma. Anterior cranial base meningioma are difficult to operate on because of their proximity to the important neurovascular structure. The authors report 25 cases of large meningiomas of the anterior. cranial base operated on during recent 5-year period. The tumor ranged from 3cm to 6.5cm in diameter. Fifteen tumors were located in the suprasellae(included tuberculum sellae, planum sphenoidale, diaphragma sellae,and anterior clinoid process), ten on olfactory groove. The mean age of 19 female and 6 male patient was 55years. The main clinical symptom were visual disturbance, anosmia, headache, and psychotic syndrome. Tumors were approached in 11 cases by pterional, in 9 cases by bifrontal, in 3 cases by transbasal, in 2 case by orbitozygomatic infratemporal and in 1 case by combined approach with tranabasal and orbitozygomatic infratemporal. Total tumor removal was performed in 80% of cases. Postoperative complication include accentuated psychotic syndrome in two cases, worsening of visual function in two, major vessel injury in one, infection in one, CSF rhinorrhea in one, and oculomotor palse in one. Postoperative death was in four(16%). Results at follow up of the 21 survivours were good in 17(68%), fair in 4(16%). Selection criteria for operative approach is discussed with review of pertinent literature.
Female ; Follow-Up Studies ; Headache ; Humans ; Male ; Meningioma* ; Olfaction Disorders ; Patient Selection ; Postoperative Complications ; Skull Base ; Temazepam

This is a report of 15 consecutive cases of petroclival lesions performed by transpetrosal approach over five years. Pathologies from these cases include 13 cases of tumors and two cases of aneurysms. All cases of tumors were over 4.5cm in size. Two cases of very low-lying basilar bifurcation aneurysms and one case of facial schwanoma extended to the petrosal tip and temporal fossa were operated with anrerior transpetrosal approach, where as nine cases of petroclival tumor which was localized in the posterior fossa were operated via posterior transpetrosal approach. Of these nine cases, one case with lower clival extension was removed totally by adding a retrosigmoid dural opening. Remaining three cases extended to the Meckel's cave or cavernous sinus were operated by combined anterior-posterior transpetrosal approach. Of the 12 cases done with posterior transpetrosal or combined approach, nine cases with preserved serviceable hearing were approached by retrolabylinthine technique and remaining three cases without preservation of serviceable hearing were operated via retrolabylinthine technique. Total removal was achieved in 9 of 13 tumor cases. Of two cases, aneurysmal neck of the first case was clipped completely but was clipped together with right posterior cerebral artery in second case. There was no operative mortality. Immediate postoperative neurological dysfunction were appered in 12 cases. These were significantly improved by the time of follow up examination. Permanent postoperative dysfunction was present in 6 cases, hemiparesis in 2, facial paralysis in 2 and hearing impairment in 2 cases. These results suggest that when selecting the surgical approach to the petroclival lesions, the size, location, extent of the lesion and preoperative status of the hearing were important factors to be considered. We recommend combined anterior-posterior transpetrosal approach for the complex lesions in the petroclival area which extends into the middle fossa(Meckel's cavum or cavernous sinus). Also, we recommend combining with retrosigmoid dural opening or a far lateral type of suboccipital exposure in cases of complex petroclival lesions involving the entire clivus or foramen magnum. In cases with brain stem invasion by tumor, vascular encasement or cavernous sinus invasion without cranial nerve involvement, we recommend subtotal resection of the tumor and radiosurgery to prevent permanent postoperative sequele.
Aneurysm ; Brain Stem ; Cavernous Sinus ; Cranial Fossa, Posterior ; Cranial Nerves ; Facial Paralysis ; Follow-Up Studies ; Foramen Magnum ; Hearing ; Hearing Loss ; Mortality ; Neck ; Paresis ; Pathology ; Posterior Cerebral Artery ; Radiosurgery