A series of 1909 computed tomography(CT) scan performed for head injury mostly after traffic accident was retrospectively reviewed. 17 patients were found to have clearly definable traumatic intraventricular hemorrhage(TIVH). TIVH was associated with various brain lesions in most cases; Intracerebral lesions with contusional hemorrhage and subdural hematoma(Glasgow Coma Scale Score) coexisted in 6 and 5 instances. The outcome(Glasgow Outcome Scale) of this series was related with initial clinical findings, and 11 patiens survived. We have designed this study to assess the occurrence of TIVH in our series of head-injured patients in Korea, and to correlate these findngs with the clinical status, the presence of associated lesions, and their relation to final outcome of these patients, and conculsions are as follows: 1) The incidence of TIVH and its associated mortality is 0.9% and 35.3%, respectively, Most of them occurs below 5 th decade(70.6%) with male predominace(88.2%). 2) Mode of injury is mainly from traffic accident(94.1%), followed by fall down(5.9%). 3) The presence of concomitant lesions has a definite influence on poor outcome(P<0.02), whereas skull fracture or multiplicity of TIVH deos not. 4) Primary impact site to induce TIVH is primarily on frontal portion(58.9%). 5) With regard to brain stem injury in TIVH, the final outcome clearly depends on pathological demonstration on CT(P<0.005%), but not on location of hemorrhage(P<0.5%).
Accidents, Traffic ; Brain ; Brain Stem ; Coma ; Contusions ; Craniocerebral Trauma ; Hemorrhage ; Humans ; Incidence ; Korea ; Male ; Mortality ; Retrospective Studies ; Skull Fractures

No abstract available.
Ependymoma*

The diagnosis and appropriate management of blunt abdominal trauma including retroperitoneal hematoma associated head injury is difficult. In our case, psoas muscle hematoma was revealed during the evaluation of fever. Psoas muscle hematoma most commonly results secondarily from coagulation defect or from retroperitoneal bleeding into the psoas sheath. The presenting signs and symptoms of this case are hypotension and anemia. Pain is also present in the back or abdomen. If it is associated with head injury and not presented massive hemorrhage, the actual diagnosis is not easy. The appropriate management depends on a careful initial evaluation including suspicion of physician, repetitive physical examination, the timely use of diagnostic procedures.
Abdomen ; Anemia ; Craniocerebral Trauma* ; Diagnosis ; Fever ; Head* ; Hematoma* ; Hemorrhage ; Hypotension ; Physical Examination ; Psoas Muscles

The tape-worm spirometra mansonoides infests man world-widely, particularly in Asian countries with rare involvement of the central nervous system. Recently, the authors have experienced 7 cases of cerebral sparganosis, and reviewed their clinical manifestation, radiographic findings, operative and pathologic findings, and follow-up results. The cerebral sparganosis manifests headache, seizure, or hemiparesis. Most of patient had episodes of eating frogs or snakes. The brain CT scan showed low density area with ipsilateral ventricular dilatation. Enzyme linked immunosorbent assay(ELISA) test showed positive response to serum and cerebrospinal fluid. The best treatment for cerebral sparganosis mansoni is surgical removal, from which we confirmed 4(17%) cases of live worms in operative and patholgic findings, and most of the seizure disappeared or decreased after operation.
Asian Continental Ancestry Group ; Brain ; Central Nervous System ; Cerebrospinal Fluid ; Dilatation ; Eating ; Follow-Up Studies ; Headache ; Humans ; Paresis ; Seizures ; Snakes ; Sparganosis* ; Spirometra ; Tomography, X-Ray Computed

The authors analyzed 9 cases of chronic subdural hematoma which had been originated from traumatic subdural hygroma patients who were admitted to our department from January, 1990 to June, 1991. The results of analysis were summarized as follows: 1) The range was from 23 to 73 years of age, and fifth and sixth decade were two-thirds of all with the sex ratio of male to female 3.5 to 1. 2) The hematoma sites were all the same as those sites of previous subdural hygroma, and all site involved frontal area. 3) It took on average 8 weeks for the hygroma to convert into hematoma. 4) The major clinical symptoms and signs were headache, alteration of consciousness, motor weakness and dysphasia. 5) The densities of hematoma revealed on brain CT at the time of conversion were all hyperdense. 6) Closed drainage through burr holes resulted in an excellent clinical outcome in all cases at the time of discharge, although still remained subdural hygroma in 3 cases on follow-up brain CT. 7) Patients with traumatic subdural hygroma, even small amount, should be followed for at least 8 weeks and carefully monitored.
Aphasia ; Brain ; Consciousness ; Drainage ; Female ; Follow-Up Studies ; Headache ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Lymphangioma, Cystic ; Male ; Sex Ratio ; Subdural Effusion*

The growing skull fracture represents a particular type of evolution of cranial fracture in young children, and has also been called leptomeningeal cyst. This rare fracture usually occurrs in the parietal region of the skull in infancy, and underlying dura tear is the single most important factor in the process. We are reporting a patient with a posttraumatic growing skull fracture that we have treated surgically.
Arachnoid Cysts ; Child ; Humans ; Rabeprazole ; Skull Fractures* ; Skull*

It is generally agreed that a small hematoma can be treated conservatively, whereas a larger one requires aggressive surgery; the surgical indication for those that are medium-sized remains controversial. To determine the criteria for conservative or surgical management, the authors analyzed 64 cases of spontaneous cerebellar hemorrhage diagnosed by CT scan between January 1990 and May 1996. An assessment was made of the relationship of initial GCS(Glasgow Coma Scale) score and GOS(Glasgow Outcome Scale) to hypertension, the location and size of the hematoma, obstructive hydrocephalus, intraventricular hemorrhage and the CT appearance of the quadrigeminal cistern. The results may be summarized as follows: 1) The incidence of spontaneous cerebellar hemorrhage was 6.37%(64/1005 spontaneous intracerebral hemorrhage). 2) The location of hematoma and hypertension did not correlated with initial GCS and GOS(p>0.05, p>0.05). 3) Obstructive hydrocephalus, intraventricular hemorrhage and obliteration of the quadrigeminal cistern correlated with intial GCS and GOS(p<0.01, p<0.001). 4) In case of spontaneous cerebellar hemorrhage, the mortality rate was 17.2%(11/64). 5) Poor prognostic factors were initial GCS score of less than 10(p<0.05), hematoma volume greater than 15 ml (p<0.01), the occurrance of intraventricular hemorrhage(p<0.05), and obliteration of the quadrigeminal cistern(p<0.001).
Coma ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hematoma ; Hemorrhage* ; Hydrocephalus ; Hypertension ; Incidence ; Mortality ; Tomography, X-Ray Computed

OBJECTIVE: The aim of this study is to evaluate of the significance of intraoperative electrophysiologic monitoring and follow up electrophysiologic study at seven days after microvascular decompression(MVD) for hemifacial spasm(HFS). METHODS: Thirty nine patients with hemifacial spasm were included in this study and were treated with MVD of the facial nerve from Jun 1990 to May 2001. The patients were divided into a monitoring group and a non-monitoring group. We compared the surgical outcomes, operation related complications between two groups. The abnormal muscle response(AMR) of preoperative electromyographic recording appeared on the mentalis muscle during stimulation of the zygomatic branch of the facial nerve was compared with those of changed during operation, immediately after operation and at postoperative 7th day(POD 7). The relationship between degree of AMR disappearance and surgical outcome was analyzed. RESULTS: There was no difference in surgical outcomes but significant difference in the incidence of operation-related complications between two groups. The results of electrophysiologic study at POD 7 were significantly correlated with surgical outcome in the monitoring group. CONCLUSION: The electrophysiologic study is helpful for identifying the offenders, determining the adequacy of vascular decompression and decrease of operation-related complications. The clinical and electrophysiologic status of HFS after MVD has continuously changed, and therefore the results of eletrophysiologic study at POD 7 are useful for predicting the surgical outcome.
Criminals ; Decompression ; Electromyography* ; Facial Nerve ; Follow-Up Studies* ; Hemifacial Spasm* ; Humans ; Incidence ; Microvascular Decompression Surgery*

Patients suffering a head-injury were often drinking alcohol shortly before the trauma, and it has been suggested that the degree of brain damage may be exacerbated due to high alcohol serum levels. To evaluate this, we assessed the level of consciousness, alcohol and creatinine kinase-bb(CK-BB) serum levels in 140 consecutive head-injured patients. Level of consciousness(GCS score) was strongly correlated to outcome(p<0.001) and serum CK-BB(P<0.05), but not to alcohol serum levels.
Brain ; Consciousness ; Craniocerebral Trauma* ; Creatine* ; Creatinine ; Drinking ; Head* ; Humans

OBJECTIVE: Our goal was to evaluate the usefulness of CT perfusion (CTP) in early detection of the post operative cerebral ischemia, alteration of treatment modality and patient prognosis in cerebral aneurysm patients. METHODS: 24 patients who underwent either surgical operation or endovascular coiling for ruptured aneurysms were selected. All patients undertook an angiogram, conventional CT, and CTP scan immediately following surgical operation or endovascular coiling. All patients performed a CT 2 weeks after treatment to evaluate possible development of a cerebral infarction. Postoperative CT results of patients with abnormal postoperative CTP scan findings were compared, and these results were compared with the CT results and clinical symptoms of patients who developed infarction or not. RESULTS: Of the 24 patients evaluated, 11 patients showed abnormal findings on CTP. 9 patients were diagnosed with cerebral infarction through a CT scan done 2 weeks after treatment; all exhibited abnormal CTP results immediately after treatment. Abnormal CTP findings were divided into two groups; patients with abnormal CBF and MTT maps, but with normal CBV maps, and patients with abnormal CBF, CBV and MTT maps. A correlation was seen between abnormality on CBV maps and cerebral infarction. Patients with abnormal CTP findings also exhibited poorer prognostic value. CONCLUSION: Postoperative CTP in ruptured aneurysm patients is a very useful and objective tool in evaluating abnormal cerebral hemodynamics. The CBV map of CTP is the most precisely predictable value of postoperative patient's status and alteration of treatement modality.
Aneurysm, Ruptured* ; Brain Ischemia ; Cerebral Infarction ; Cytidine Triphosphate ; Hemodynamics ; Humans ; Infarction ; Intracranial Aneurysm ; Perfusion* ; Prognosis ; Tomography, X-Ray Computed