No abstract available.
Angiography* ; Intracranial Aneurysm*

No abstract available.
Lung Neoplasms* ; Lung*

Aneurysms arising from the distal basilar artery(BA) and relating to the origin of the superior cerebellar artery (SCA), posterior cerebral artery (PCA) account for more than 15% of all intracranial aneurysms and more than one-half of all aneurysms occurring in the vertebrobasilar circulation. The anatomic complexity of the interpeduncular cistern is directly related to the dangers of surgical manipulation in this region and it is undoubtedly difficult to operate on a distal basilar aneurysm which located deep in a very narrow operative field restricted by unremovable neural and vascular architectures. Although we can not choose no single operative approach suitable to this area because the indivisual patient's vascular, neural and bony anatomy is widly variable, using the modified transsylvian approach with orbitozygomatic resection the distal basilar artery aneurysms could be seen and clipped easily by upward and oblique viewing from below through the wide operative space consisting of the less retracted intracarotid artery, middle cerebral artery and oculomotor nerve. We have operated 64 distal basilar artery aneuysms. Among them, 27 patients were approached using the modified transsylvian approach with orbitozygomatic resection. The operative procedure is presented in detail and compared with other surgical approaches.
Aneurysm ; Arteries ; Basilar Artery* ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Oculomotor Nerve ; Posterior Cerebral Artery ; Surgical Procedures, Operative

No abstract available.
Cholestasis, Intrahepatic*

In many countries, the percentage of seninor citizens is expanding. Direct operation for ruptured aneurysm should be the choice of treatment in elderly patients of Hunt-Hess grade I through III, but should not be performed in cases of grade V. To evaluate the risk of early operation of elderly patients with ruptured cerebral aneurysm, conducted a retrospective analysis 464 elderly patients with ruptured aneurysms who were over aged 60 years between Jan 1980 to June 1999. Of these, 334 cases were performed early operation in which the direct intracranial operation was carried out within 3 days after last subarachnoid hemorrhage. The female: male ratio is 4.87: 1. The location of aneurysms are 144 anterior communicating artery aneurysms, 139 internal carotid artery aneurysms, 117 middle cerebral artery aneurysms, 35 multiple aneurysms, etc. Associated conditions are hypertension, diabetes mellitus, pulmonary problem, etc. Operation methods are 404 clippings, 53 coatings, 1 endovascular treatment, etc. Problems during operation are 29 broad aneurysms, 22 giant aneurysms, 21 tight brains, etc. In early operative group(within 3 days), 79% had favorable outcome, 11% unfavorable outcome and 10% died. The early operation is an effective and reliable method to reduce the occurrence of rebleeding, vasospasm, ischemic complication, medical complication and to shorten lengths of hospitalization.
Aged* ; Aneurysm ; Aneurysm, Ruptured ; Brain ; Carotid Artery, Internal ; Diabetes Mellitus ; Female ; Hospitalization ; Humans ; Hypertension ; Intracranial Aneurysm* ; Male ; Retrospective Studies ; Subarachnoid Hemorrhage

The thalamic pain is an unfamiliar, intensely disagreeable sensation and resistant to analgesics. The purpose of this study is to determine the usefulness of digital infrared thermographic imaging for objective diagnosis of thalamic pain syndrome after cerebrovascular stroke. Twenty-seven patients with thalamic pain syndrome who had mild or no disability after cerebrovascular stroke were examined. Digital Infrared thermographic imaging study of these patients revealed hypothermia on the involved trunk, upper and lower extremities. The meaningful differences of the skin temperature between painful side and contralateral side were 0.89degreesC in trunk, 1.02degreesC in upper extremity and 1.37degreesC in lower extremity. Digital infrared thermographic imaging seems to be an useful diagnostic modality in thalamic pain syndrome after cerebrovascular stroke.
Analgesics ; Diagnosis ; Humans ; Hypothermia ; Lower Extremity ; Sensation ; Skin Temperature ; Stroke* ; Upper Extremity

No abstract available.
Meningitis

Cavernous malformations are well demarcated mulberry-like lesions composed of thin-walled sinusoidal channels. Thanks to introduction of magnetic resonance imaging (MRI), vascular malformations are being diagnosed with increasing frequency. Cavernous malformations constitute about 10% of all cerebrovascular malformations and are present in about 0.5% of the population. There is no sex predominance, with the highest incidence occuring in fourth decade. The most common symptom is seizure, followed by focal neurological deficits, headache and hemorrhage. The annualized bleeding rate is 0.7%, with the significantly greater risk of overt hemorrhage in females. The lesion is asymptomatic in about 16% of patients. Cavernous malformations usually are sporadic but multiple lesions are common in the familial form (50% to 73%). Symptom presentation is strongly related to the size of lesion greater than 1 cm in diameter.
Epidemiology* ; Female ; Headache ; Hemorrhage ; Humans ; Incidence ; Magnetic Resonance Imaging ; Natural History* ; Seizures ; Vascular Malformations

No abstract available.
Aneurysm* ; Carotid Artery, External* ; Neurofibromatoses*

Hemangiopericytomas is a rare malignant tumor of the central nervous system having an incidence of 1-3.8% of all primary intracranial meningeal tumors, and the occurrence of cystic hemangiopericytomas is even rarer. We report our recent experience of a case of cerebral hemangiopericytoma associated with a large cyst in a 38 year-old man. The patient presented with 1-month history of headache. Computerized tomography(CT) and magnetic resonance image(MRI) showed a huge-sized, cystic tumor in the left frontal region. Histopathological report of the excised tumor confirmed cystic hemangiopericytoma. Over the years, the issue of classifying hemangiopericytoma as a form of meningioma has been controversial. Since hemangiopericytoma differs from that of ordinary meningiomas because of its extremely malignant behavior and different histological and ultrastructural properties, the author suggest that hemangiopericytoma classified not with meningiomas. Regardless of classification, total surgical removal of this tumor is crucial due to its tendency for local recurrence despite aggressive resection.
Adult ; Central Nervous System ; Classification ; Headache ; Hemangiopericytoma* ; Humans ; Incidence ; Meningeal Neoplasms ; Meningioma ; Recurrence