No abstract available.
Fatigue* ; Sciatica*

Recurrent alternating stroke, i.e., one time ischemic and the other hemorrhagic or vice versa, is an uncommon event. We report a series of eight patients who had recurrent alternating strokes, which were diagnosed by CT scans during the last four years. Infarcts preceded hemorrhage in six patients. In the remaining two patients, hemorrhage developed first and infarct followed. All ischemic strokes were the lacunar infarcts. The lesions of the two attacks were located in different sites in all cases except one. The mean age of the patients was 56.6 years at the time of the first attack and 57.5 years at the time of the second. The mean interval between attacks was 11.8 months. All patients were hypertensive on admission. After the first attack, the outcome was favorable in all patients. However, after the second attack the outcome deteriorated to moderate disability in three, severe disability in one and death in four. We discuss some possible reasons for the rarity of recurrent alternating stroke.
Brain Ischemia/*complications ; Cerebral Hemorrhage/*complications ; Cerebrovascular Disorders/*radionuclide imaging ; Female ; Humans ; Hypertension/complications/radionuclide imaging ; Male ; Middle Aged ; Prognosis ; Recurrence ; Tomography, X-Ray Computed

We present a study on the systemic insults in the early death(within one week) after head injury. The patient population consisted of 192 patients who were admitted to the Soonchunhyang University Chonan Hospital from August 1986 to May 1990 after head injury. We collected clinical features and systemic insults including blood pressure, arterial pH, PaO2, PaCO2, hematocrit, and serum concentration of Na, retrospectively. The most common cause of injury was road traffic accident(77.6%). More than half(57.8%) were under the age of 40 years. The interval from injury to admission was within one hour in 63.2%, and within four hours in 91.4%. The mean interval was 1.8 hours. However, in 154(80.2%) patients, we found the evidence of systemic insults on admission. We found hypotension(ststolic less than 90mmHg) in 22.9%, acidemia(pH<7.35) in 71.3%, arterial hypoxemia(PaO2<60mmHg) in 42.7%, hypercarbia(PaCO2>45mmHg) in 28.7%, anemia(hematocrit<30%) in 13.0%, hyponatremia(Na<135mEq/L) in 10.7%, and hypernatremia(Na>145mEq/L) in 11.2%. These results imply that the prehospital emergency care system useful at the scene of accident and during the transportation is more important than the simple quick-transport-system.
Arterial Pressure ; Chungcheongnam-do ; Craniocerebral Trauma* ; Emergency Medical Services ; Head* ; Hematocrit ; Humans ; Hydrogen-Ion Concentration ; Retrospective Studies ; Transportation

The cysts of the anterior third ventrilce were first described by Wallman in 1858. These cysts have been thought to originate from a paraphyseal remnant in the telencephalic portion of the third ventricle, from a diencephalic ependymal pouch, or from the epithelium of the choroid plexus. Dandy reported 31 cases in 1933 where this condition had been found at necropsy and added 5 cases of his own in which surgical excision had been achieved with but a single postoperative death. Since Wallman's appeared before the age of 10 and in only 3 before the age of 2. We report a case of colloid cyst the third ventricle in the age of 23 months and the literature of this disease has been reviewed.
Choroid Plexus ; Colloid Cysts* ; Colloids* ; Epithelium ; Third Ventricle*

No abstract available.

In 1934 Elsberg and Dyke published normal values for interpediculate distances as determined on roentgenograms of adult human spine. It has since proved invaluable in the roentgenologic diagnosis of spinal abnormalities and meningeal or cord lesion. Since 1942 the attempts at obtaining the interpediculate distances of children have been made. In 1943 Landmesser & Heublein prepared measurements of interpediculate distances using roentgenograms of selected children from the population of a home and hospital for crippled children, and in 1955 Simril and Thurston published maximum & minimum normal interpediculate distances of infants and children. But Schwarz published extreme upper limits of normal interpediculate disctances in children and adults adding measurements of the sacral spinal canal. Nagashima reported that sagittal & transverse diameters of spinal canal were measured in dried speciemens of normal adults vertebras. Many pioneer studies have established the clinical values of the interpediculated measurements in the diagnosis of intraspinal diseases at all ages. The present investigation was undertaken to provide refined maximal normal interpediculate measurements for use in diagnosis of intraspinal tumor and anomalies and minimem norms for recognition of spinal stenosis. It was also decided to show the results of normal interpediculate distances in adult Korean. The results were the followings : 1) The interpediculate distances from T1 to T12 in male were 22.6, 19.9, 18.3, 17.6, 16.9, 17.1, 17.3, 17.3, 17.3, 18.1, 19.8 and 22.7mm respectively, and in female 21.3, 18.4, 17.7, 17.4, 17.2, 17.0, 17.0, 16.9, 17.0, 17.1, 18.4, and 21.5mm. In male and female combined these were 22.3, 19.4, 18.1, 17.5, 17.0, 17.1, 17.2, 17.2, 17.4, 17.8, 19.4, and 22.3mm respectively. 2) The contour of thoracic canal was biconcave due to the fact that the interpediculate distances of T1 to T4 and T9 to T12 were generally larger than those of T5 to T8. 3) Average measurements in male were consistently larger than in female by about 1mm. 4) Compared with the measurements of Nagashima and Hinck, the IPD mean values for male were 1.1mm smaller than those of Hinck, and 0.6mm smaller than those of Nagashima, but for female 1.2mm smaller than those of Hinck, 0.3mm larger those of Nagashima. For male and female combined IPD were 0.8mm and 0.3mm smaller than those of Hinck and Nagashima respectively.
Adult* ; Child ; Diagnosis ; Female ; Humans ; Infant ; Male ; Reference Values ; Spinal Canal ; Spinal Stenosis ; Spine*

We report a case of cerebral lymphomatoid granulomatosis in a 50-year-old man. Lymphomatoid granulomatosis is an unusual condition which usually presents as a pulmonary manifestation, which occasionally affects the brain, and causes focal inflammatory lesions. Primary cerebral lymphomatoid granulomatosis is very rare. We describe a case of lymphomatoid granulomatosis in the left frontal lobe without pulmonary involvement.
Brain ; Frontal Lobe* ; Humans ; Lymphomatoid Granulomatosis* ; Middle Aged

A retrospective study of 90 cases of small-sized (less than 3 mm on the printed CT film) acute (within 24 hours) subdural hematoma (SASDH) is presented. From March 1985 to December 1986, the SASDH were immediately operated on (operation rate: 86.0%). From January 1988 to December 1989, we attempted to treat them conservatively (operation rate: 49.1%). The patient population for this study consisted of 38 surgically-treated patients in the first period (Group I), 26 surgically-treated patients in the second period (Group IIs), and 26 conservatively-treated patients in the second period (Group IIc). We compared the clinical features, radiologic findings, and outcome of these 3 groups. The clinical features of Group I, including age, sex, Glasgow Coma Scale (GCS) score on admission, pupillary status on arrival, and interval from injury to the CT, did not differ significantly from those of Group II (P greater than 0.01). The only difference was the timing of the operation. In Group I, 20 patients (52.6%) received an operation within 4 hours, while in Group IIs, only 7 patients (26.9%) underwent surgery within 4 hours (P less than 0.05). The radiologic findings of Group I, including the thickness and volume of the hematoma, the degree of midline shift, and the frequency of skull fracture, also did not differ from those of Group II (P greater than 0.1). However, the outcome of Group II strikingly differed from that of Group I. The mortality rate was 76.3% in Group I, while it was 44.2% in Group II (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
Acute Disease ; Adult ; Female ; Glasgow Coma Scale ; Hematoma, Subdural/mortality/pathology/radiography/*therapy ; Humans ; Male ; Time Factors ; Treatment Outcome

PURPOSE: Although the process by which intravitreal perfluorocarbon gas is absorbed is incompletely understood, it is known that considerable absorption of intravitreal perfluorocarbon gas occurs through the aqueous humor. The aim of the study was to evaluate experimentally the effect of topical aqueous humor suppressants on the intravitreal perfluorocarbon gas bubble duration. METHODS: After sulfur hexafluoride and perfluoropropane were injected intravitreally in ten rabbits, we measured the time of gas bubble disappearance in eyes treated with topical aqueous humor suppressants and in those not treated. RESULTS: The mean time(+/-SD) to disappearance of 0.4 cc of sulfur hexafluoride was 6.0+/-0.71 days, which was prolonged to 8.0+/-0.71 days with topical aqueous humor suppressants. The mean time(+/-SD) to disappearance of 0.2 cc perfluoropropane was 14.8+/-0.84 days, while it was prolonged to 22.0+/-1.58 days with topical aqueous humor suppressants. CONCLUSIONS: Sulfur hexafluoride and perfluoropropane intravitreal gas bubbles last longer in rabbit eyes treated with aqueous humor suppressants than in fellow control eyes.
Absorption ; Aqueous Humor* ; Rabbits* ; Sulfur Hexafluoride

Recent advances in diagnosis and therapy for head injury have brought some changes in concepts, definition of the terms, therapeutic methods and the duration of treatment. In medical certificates, the diagnosis and duration of treatment also need to be changed according to the new concepts. Mixed use of the terms according to the classic and the new concepts may cause confusion. We investigated with a questionnaire to assess the acceptability of the new concepts of head injury, and seeked for a plan to avoid possible confusion in medical certificates. We sent questionnaires for diagnosis and duration of treatment of 10 given examples of head injury to 367 neurosurgeons whose addresses could be identified. Questionnaires were answered by 52 neurosurgeons. The diagnosis described in the questionnaires showed wide variability with a range of 10 to 32 different descriptions, on average 16.8 different descriptions for each case. Duration of treatment also revealed great discrepancy. Coefficients of variation for duration of treatment varied from 33.44% to 54.37%. Cerebral contusion was the most commonly used term. It was described in every 10 given examples, and to take an average, 32.3 neurosurgeons used cerebral contusion or each case. To avoid possible confusion in medical certificates, it is necessary to make a guide for medical certificates for head injuries according to the new concepts, and a chance of training of this guide should be provided.
Contusions ; Craniocerebral Trauma* ; Diagnosis* ; Head* ; Surveys and Questionnaires*