No abstract available.
Humans ; Spondylolisthesis*

No abstract available.
Hematoma* ; Orbit*

The authors report a case of acute nontraumatic spinal epidural hematoma which extending from C4 to C6. A 70-year-old woman was presented with neck pain and left hemiparesis. T1-weighted magnetic resonance image revealed a mass isointense to the spinal cord and the mass was slightly enhanced after administration of gadolinium. T2-weighted images revealed high signal in the left posterolateral part of the spinal canal at the level of C4-C6. Evacuation of an epidural hematoma was performed with laminectomy. The pathological examination did not reveal any malformation within this hematoma. The patient showed complete recovery of the deficits. Medical investigation yielded thrombocytopenia and splenomegaly derived from liver cirrhosis. Thrombocytopenia and mechanical factor may be considered as etiologic factors in this case.
Aged ; Female ; Gadolinium ; Hematoma ; Hematoma, Epidural, Spinal* ; Humans ; Laminectomy ; Liver Cirrhosis ; Neck Pain ; Paresis ; Spinal Canal ; Spinal Cord ; Spine* ; Splenomegaly ; Thrombocytopenia

Cerebral vascular reserve capacity was evaluated by acetazolamide activated 99m Tc-HMPAO brain SPECT in 17 patients with subarachnoid hemorrhage. Abnormal reactivity of the vascular reserve capacity correlated very well with the prognosis of these patients. This study would also help to make decision of the surgical timing for the ruptured aneurysm. In patients with normal response to acetazolamide activated vascular reactivity, vasodilatory drug such as calcium channel blocker is recommaned for the treatment of vasospasm. This study should be done as early as possible during the period of vasospasm to aid in the diagnosis, and in treating the vasospasm. Although this study has a minimal transient side effect of acetazolamide such as dizziness there was no major complication.
Acetazolamide* ; Aneurysm, Ruptured ; Brain ; Calcium Channels ; Diagnosis ; Dizziness ; Humans ; Prognosis ; Subarachnoid Hemorrhage* ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon* ; Vasospasm, Intracranial

Congenital leukemia is a rare disease developing within the first 4 to 6 weeks of life, whose natural history is quite different from that of childhood and adult leukemia. Leukemia cutis occurs in 25% to 30% of infants with congenital leukemia and is more frequently associated with acute myeloid leukemia than acute lymphocytic leukemia. We report a case of congenital leukemia cutis in which a walnut-sized, slightly erythematous, dome-shaped tumor that had developed at left frontal area since birth was confirmed by skin biopsy. A review and analysis of Korean literature pertaining specially to leukemia cutis in congenital leukemia is presented along with the report of an additional case.
Adult ; Biopsy ; Humans ; Infant ; Leukemia* ; Leukemia, Myeloid, Acute ; Natural History ; Parturition ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Rare Diseases ; Skin

Superficial siderosis is a rare condition characterized by hemosiderin deposition in leptomeninges, subpial tissue, brainstem, cerebellum, spinal cord, and cranial nerves. Slowly progressive hearing loss and gait ataxia are invariable clinical manifestations. We report three patients with their clinical and radiological features. All patients presented with hearing loss and cognitive dysfunction. Two showed gait ataxia and myelopathic symptoms and signs. Decreased visual acuity, hand tremor, limb ataxia, dysarthria, and nystagmus were also present. All patients showed typical MRI findings: marked linear hypointensities around the cerebellum, brainstem, and the surface of the cerebral cortex, especially in sylvian fissures. Two patients had brain tumors : pituitary adenoma and oligodendroglioma. Another patient had no definite bleeding source. Hemosiderin deposition is caused by chronic and recurrent subarachnoid hemorrhage derived from tumor, vascular malformation, aneurysm, posthemispherectomy, and unknown bleeding sources. Diagnosis is easily made by characteristic clinical manifestations and MRI findings. The selective vulnerability of the cerebellum and the 8th cranial nerve depends upon their own histological and biochemical characteristics. Benefits of the iron chelating agents are questionable. Removal of the possible bleeding sources is the most reliable strategy to prevent the disease progression.
Adenoma ; Aneurysm ; Ataxia ; Brain Neoplasms ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Cranial Nerves ; Diagnosis ; Disease Progression ; Dysarthria ; Gait Ataxia ; Hand ; Hearing Loss ; Hemorrhage ; Hemosiderin ; Humans ; Iron Chelating Agents ; Magnetic Resonance Imaging ; Oligodendroglioma ; Pituitary Neoplasms ; Siderosis* ; Spinal Cord ; Subarachnoid Hemorrhage ; Tremor ; Vascular Malformations ; Visual Acuity

The authors report four cases of ependymal cysts. Among the benign cystic lesions of neuroepithelial origin, ependymal cysts have been reportedly located in the cerebral parenchyme. This usually become symptomatic after 40 years of age, although it is generally thought to be congenital in origin. Symptomatic cases have been treated effectively with resection of the cyst or shunting procedures. Stereotactic removal of the cyst was also a good alternative as management in the authors' cases. Differential diagnosis is mandatory with other benign intraparenchymal cystic diseases.
Diagnosis, Differential

After surgical operation in patients with arteriovenous malformation (AVM), normal pressure perfusion breakthrough (NPPB) is one of the major complications. Brain perfusion SPECT with acetazolamide stress was known to be useful to evaluate the vascular reserve in several neurological and neurosurgical conditions. The authors performed acetazolamide brain perfusion SPECT in patients with AVM and compared the brain perfusion in the post-operative clinical courses. The acetazolamide brain perfusion SPECT was helpful in defining the prognosis of the patients with AVM. We describe 4 patients with AVM who had acetazolamide brain perfusion SPECT to examine the prognosis.
Acetazolamide* ; Arteriovenous Malformations* ; Brain* ; Humans ; Perfusion* ; Prognosis* ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*

The use of steroids has long been reported many side effects. Steroid-induced mental disorder is one of many complications associated with corticosteroid therapy. Steroid psychosis is not common disease but it may be more popular due to high steroid therapy such as pulse therapy or high dose steroid therapy. Euphoria, irritability, insomnia, and hallucination are predominating symptoms. The dosage, duration of the treatment may not be correlated with the time of the onset, duration, severity, or type of mental disturbances, but the risk of developing psychosis is increased to the high dose of steroid. It is usually reversible on dose reduction or discontinuation of the drug.
Euphoria ; Hallucinations ; Mental Disorders ; Psychotic Disorders* ; Sleep Initiation and Maintenance Disorders ; Steroids

PURPOSE: The purpose of this study was to analyze the flow signal chracteristics of 3 dimensional time of flight MR angiography (3D TOF MRA) by using a flow phantom model. MATERIALS AND METHODS: Nonpulsatile flow phantom and tap water were used in this experiment. We performed FISP 3D TOF MRA with various values of parameters (repetition time ; 34-100 msec, flip angle ; 10degrees-50degrees, flow velocity ; 14.7-73.6 cm/sec, Gd-DTPA concentration ; 0.6-3.6 mmol/liter). The values of flow signal intensity (SI), signal to noise ratio (SNR) and contrast to noise ratio (CNR) were measured from base images of each MRA. The measured values were displayed graphically and analyzed statistically in relation to various parameters. RESULTS: A prolongation of repetition time resulted in a decrease of CNR of flow. As flip angles increased, SNR and CNR of flow also increased but larger flip angles of more than 40degrees rapidly saturated exit flow. As the flow velocities increased in a range of 14.7-73.6 cm/sec, SNR and CNR of flow decreased. This may be related to the phase dispersion effect of laminar flow, more dominat than the TOF effect. The addition of Gd-DTPA to water increased SNR and CNR of exit flow. There were however, no significant differences of SI, SNR or CNR of flow among the various concentrations of Gd-DTPA. CONCLUSION: An experimental MRA study using a flow phantom model was useful in understanding the flow signal characteristics of 3D TOF MRA within various MRA parameters. Our preliminary results can be used as basic data for refined flow experiments.
Angiography* ; Gadolinium DTPA ; Noise ; Signal-To-Noise Ratio ; Water