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

Acase of 14-year-old student is presented with the complaint of recurrent attack of transient quadriparesis during hyperextension of the neck. On 3-dimensional spinal CT and MRI, the authors confirmed intrusion of posterior tubercle of the atlas with increased signal on T1- and T2- weighted image was found. The clinical manifestations were improved without having cervical instability after a posterior laminectomy of the atlas.
Adolescent ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Neck ; Quadriplegia*

We had experienced a case of hematogenous brain abscess which occurred at the site of spontaneous intracerebral hemorrhage. The 41-year-old patient was admitted with sponetaneous intracerebral hemorrhage on left basal ganglia and sepsis. Brain abscess was incidentally detected by stereotactic aspiration of intracerebral hemorrhage, followed by the gram staining and culture of aspirated material.
Adult ; Basal Ganglia ; Brain Abscess* ; Brain* ; Cerebral Hemorrhage* ; Humans ; Sepsis

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

Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder of the lymph nodes and extranodal sites. Central nervous system involvement is extremely rare. Intracranial RDD, especially the isolated form, resembles meninigioma both clinically and radiologically. Here, we report a case of isolated, intracranial, dura-based RDD. The patient presented with headache and dizziness with no evidence of lymphadenopathy. Histologically, the lesion consisted of large histiocytes with emperipolesis and lymphoplasma cell infiltrates with a fibrotic background. We discuss the differential diagnosis of this lesion. To our knowledge, this is the first reported Korean case of intracranial RDD.
Central Nervous System ; Diagnosis, Differential ; Dizziness ; Emperipolesis ; Headache ; Histiocytes ; Histiocytosis, Sinus* ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Meninges

Dural arteriovenous malformations(AVM) are not uncommon. Reports of intracranial dural AVM have been increasing but most of them deal with dural AVM in the region of the cavernous sinus, posterior fossa and tentorium, but those of the anterior cranial fossa are very rare. Recently, we experienced two cases of right frontal dural arteriovenous malformation fed mainly by both ethmoidal arteries. The angiographic appearance in these two cases is quite uniform. The nidus was located in the frontal dura, although their main feeders were dural arteries. They were drained through an intracerebral cortical vein associated with aneurysmal dilatation of proximal portion into superior sagittal sinus. Spontaneous intracerebral hematoma was the cause of the clinical symptoms. We report two cases of intracerebral hematoma, caused by dural AVM, which was successfully managed by surgical treatment.
Aneurysm ; Arteries ; Arteriovenous Malformations* ; Cavernous Sinus ; Cranial Fossa, Anterior* ; Dilatation ; Hematoma ; Superior Sagittal Sinus ; Veins

Among 1350 craniocerebral trauma patients treated between January 1992 and December 1995. The authors analyzed 25 who had suffered combined head and spine trauma and had been subject to follow up. The ratio of males to females was 4 : 1 ; their ages ranged from less than twenty to over sixty. As clinical parameters, we use of the Glasgow Coma Scale(GCS), Revised Trauma Score(RTS) and Glasgow Outcome Scale(GOS) at discharge, and for clinical statistics, used the chi-square test. The results of the study were as follows : 1) Among craniocerebral trauma patients, the incidence of combined head and spine trauma was 2%(25/1350). 2) In cases with combined craniospinal trauma, the incidence of intracranial hemorrhage and cervical spine injury was 76% and 68%, respectively. 3) Among cases with spinal injury, head trauma combined with cervical spine injury showed the worst outcome (p<0.05). 4) Combined high cervical spine injury showed a poorer outcome than did lower cervical spine injury(p<0.05). 5) Initial GCS was significantly related to initial RTS(p<0.05). 6) At discharge, there was a very highly significant correlation between initial GCS and GOS(p<0.01), but not between initial RTS and GOS(p<0.081). 7) Especially in patients who are unconscious because of head trauma, it is important to investigate the possibility of spinal injury other than that of at cervical level.
Coma ; Craniocerebral Trauma ; Female ; Follow-Up Studies ; Head* ; Humans ; Incidence ; Intracranial Hemorrhages ; Male ; Spinal Injuries ; Spine*

A retrospective analysis of 60 patients with traumatic subdural hygroma who had been managed and followed up at least 6 months, was done in relation to time of development and associated intracranial lesion, initial Glasgow Coma Scale(GCS), sequeritial changes of subdural hygroma, and Glasgow Outcome Scale(GOS). The incidence of traumatic subdural hygroma was 8.4%, 131 cases among 1,563 head-injured cases. And most of them was subacute from(55%, 33 cases among 60 cases), complex subdural hygroma was 65%(39 cases among 60 cases). The conversion rate of traumatic subdural hygroma into chronic subdural hematoma was 15%(9 cases among 60 cases). There was no statistically significant relation between initial GCS score and time of development and also intial GCS score and development of complex subdural hygroma and time of development and GOS of 6 months follow-up(P>0.05). There noted only highly significant relation between initial GCS score and GOS of 6 months follow-up(P<0.001).
Coma ; Craniocerebral Trauma ; Hematoma, Subdural, Chronic ; Humans ; Incidence ; Retrospective Studies ; Subdural Effusion*