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

OBJECTIVE: TA retrospective study is performed on 28 patients with primary intraventricular hemorrhage(PIVH) to examine the outcome and prognostic factors associated with this disorder. METHODS: Clinical data collected between 1998 and 2002 was used in the present study. The outcomes of these patients were compared by age, etiology, initial Glasgow Coma Score(GCS), Graeb's score, ventriculocranial ratio(VCR), hemorrhagic dilation of the third ventricle, and hemorrhagic dilation of the fourth ventricle. The Glasgow Outcome Scale(GOS) at discharge was used for the comparison of outcomes. RESULTS: The mean age of these patients was 48.4+/-17.4 years. The underlying causes of PIVH were hypertension(53.6%), moyamoya disease(17.9%), arteriovenous malformation(10.7%), cerebral aneurysm(7.1%), and unknown(10.7%). The age and etiology were not correlated with outcome. Patients with a GCS of 13-15 showed a good outcome in 90.5%(p<0.05). Those with a higher VCR(> or =0.23) showed a poor outcome in 64.3%(p<0.05). Patients with a Graeb's score of 9-12 showed a poor outcome in 87.5%(p<0.05). Those with hemorrhagic dilatation of the third ventricle showed a poor outcome in 80.0%, and those with hemorrhagic dilatation of the fourth ventricle showed a poor outcome in 85.7%(p<0.05). The overall mortality rate was 17.9%. CONCLUSION: Low initial GCS, high Graeb's score, high VCR, and hemorrhagic dilatation of the third ventricle or the fourth ventricle are correlated with poor outcome in PIVH.
Coma ; Dilatation ; Fourth Ventricle ; Hemorrhage* ; Humans ; Mortality ; Retrospective Studies ; Third Ventricle

Five separate incidences of patients with cerebrovascular disease(CVD) were revealed among 555 craniocerebral traumatic victims between 1991 and 192. The 5 cases of with cerebrovascular disease revealed included 3 aneurysm. 1 arteriovenous malformation and 1 spontaneous intracerebral hematoma caused by angiographic study. The frequent use of computerized tomographic scans in the evaluation of head-injured victims can well demonstrate an intracerebral hemorrhage, but may not ge able to detect the associated cerebrovascular disease;whereas the efficacy of angiogrphy, on the contrary, has been losing its popularity as diagnostic armamentarium. The importance of angiographic study should be considered, if clinical signs and/or brain CT ideate the possibility of cerebrovascular disease even during the course of head injury management.
Aneurysm ; Angiography ; Arteriovenous Malformations ; Brain ; Cerebral Hemorrhage ; Craniocerebral Trauma* ; Hematoma ; Humans ; Incidence

Intraventricular hemorrhage after blunt head trauma, which reflects the severity of head injury, is uncommon. A retrospective study of 109 traumatic intraventricular hemorrhage(TIVH) patients who were admitted between January 1, 1988 and December 31, 1993 was conducted. The results are as follows: 1) Incidence of TIVH and its associated mortality were 2.45% and 28.4%, respectively. 2) TIVH-associated radiological abnormalities were traumatic intracerebral hematoma(62.7%), skull fracture(42.7%), and traumatic subarachnoid hemorrhage(34.5%). 3) Amount of TIVH was related to traumatic intracerebral hematoma(p=0.0003) and traumatic subarachnod hemorrhage(p=0.0385). 4) The poorest prognostic indicator was associated abnormalities, especially corpus callosum or brainstem hemorrhage(p=0.0099). 5) TIVH-associated hydrocephalus was not related to the amount of TIVH(p=0.42), and poor prognosis(p=0.12). 6) Patients with TIVH showed better Glasgow coma scale and Glasgow outcome scale than TIVH-associated abnormalities.
Brain Stem ; Corpus Callosum ; Craniocerebral Trauma ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Mortality ; Prognosis ; Retrospective Studies ; Skull

Rosai-Dorfman Disease(RDD) is an idiopathic histiocytic proliferation affecting lymph nodes. Although extranodal involvement has been reported in the skin, orbit, upper respiratory tract, or testes, the isolated intracranial involvement without associated lymphadenopathy is extremely rare. We report our experience with 1 case of an isolated intracranial RDD without associated lymphadenopathy and any other organ involvement. A 61-year-old male presented with an isolated well-circumscribed brain mass in the posterior fossa, preoperatively thought to be a meningioma. But histology and immunohistochemistry confirmed that the lesion was RDD.
Brain ; Histiocytosis, Sinus* ; Humans ; Immunohistochemistry ; Lymph Nodes ; Lymphatic Diseases ; Male ; Meningioma ; Middle Aged ; Orbit ; Respiratory System ; Skin ; Testis

This retrospective analysis shows 87 patients who were admitted to our department of neurosurgery due to traumatic intracerebral hemorrhage(TICH) from June, 1990 to May, 1992. Our analyses were performed according to the patients's age, sex, operation, initial GCS, serum glucose level, platelet counts, mean arterial blood pressure, srterial CO2 and O2 level. Follow-up CT scans were performed post-operatively 1 day, and 2 weeks after the operation and in the cases that newly neurologic deficit were developed or developed or patients were not improved neurologically. The TICHs were located mainly on the frontal and/or temporal lobe(74%), and increased after craniotomy(68.6%). Other risk factors increasing the hematoma volume were poor neurologic status(GCS, < or = 7) at admission, low PaO2(< or = 80 mmHg) and high PaCO2(> or = 45 mmHg) level. The remaining factors, such as serum glucose level, number of platelets and mean arterial blood pressure did not influence the change of intracerebral hemorrhage.
Arterial Pressure ; Blood Glucose ; Cerebral Hemorrhage ; Cerebral Hemorrhage, Traumatic* ; Follow-Up Studies ; Hematoma ; Humans ; Neurologic Manifestations ; Neurosurgery ; Platelet Count ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed

OBJECTIVES: The aim of this study are clinical application of perfusion computed tomography (perfusion CT) in hydrocephalus and comparison its cerebral blood flow parameters with transcranial doppler (TCD) and clinical outcome. METHOD: 25 patients with hydrocephalus took pre- and postoperative perfusion CT and TCD. 15 patients without neurologic deficit were also examined with same protocol as a control. Blood flow parameters of perfusion CT, such as cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were analyzed according to clinical status and postoperative outcome. So did the TCD parameters, mean flow velocity (mFv) and pulsatility index (PI) with regard to clinical outcome. RESULTS: Perfusion CT parameters of the hydrocephalus showed decrease in CBF (gray matter P=0.035, periventricular region P=0.042) and increase in MTT (gray matter P=0.039, periventricular region P=0.045) compared to control. In postoperative improvement group, there noted reversal of perfusion parameters close to those of the control. TCD parameters showed increase in mFv (P=0.047), and decrease in PI (P=0.042) in cases with improvement. CONCLUSION: Perfusion brain CT and TCD can used as clinically useful tools to predict the postoperative outcome on hydrocephalus.
Blood Volume ; Brain ; Humans ; Hydrocephalus* ; Neurologic Manifestations ; Perfusion*

The overall incidence of multiple meningiomas has been estimated to be about 8 percent since the introduction of the computerized tomography. The authors report a rare case of multiple meningioma that was composed of two histologically separate types occurring in intimate juxtaposition with each other and not intermixed. One of the multiple miningioma located in subtemporal region was meningotheliomatous type, whereas the other located in both the subtemporal and infratentorial region was psammomatous type. The clinical, radiological, and histopathological features of these lesions are discussed together with a review of the literature.
Incidence ; Meningioma*