No abstract available.
Craniocerebral Trauma* ; Head* ; Hematoma*

No abstract available.
Frontal Bone* ; Humans

No abstract available.
Ependymoma*

Serial computed tomography(CT) was done on 168 patients suffering from craniocerebral trauma. The type of initial intracranial lesion in response to primary impact site was evaluated with special reference to the initial Glasgow Coma Scale(GCS), the number of specific CT findings on GCS outcome, and the skull fracture on resultant pathological findings. The development of delayed intracranial lesion, both intra - and extra - dural, was examined by comparing the intial scan with follow-up studies. The conclusions are as follows : 1) The initial GCS has a close relationship to outcome. 2) Initial CT findings(intraventricular hemorrhage, subdural hematoma, cerebral swelling, and subarachnoid hemorrhage) appear to be closely associated with poor outcome. 3) The more the number of intial pathological findings, the poorer the outcome. 4) The CT findings with skull fracture cause much more pathology than those without skull fracture. 5) The frontal lobe is shown to be the most vulnerable contusional site. 6) Delayed traumatic intracerebral hematoma, cerebral edema and cerebral inforction as new lesions encountered on subsequent CT scan have a bad outcome. We conclude that initial and follow-up scan help predict the outcome of patient with craniocerebral trauma, and may be very important in their examination and management.
Brain Edema ; Brain Injuries* ; Brain* ; Coma ; Contusions* ; Craniocerebral Trauma ; Follow-Up Studies ; Frontal Lobe ; Glasgow Coma Scale ; Hematoma ; Hematoma, Subdural ; Humans ; Pathology ; Skull Fractures ; Tomography, X-Ray Computed

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

OBJECTIVE: The authors analyze the incidence, etiological and prognostic factors between contralateral and ipsilateral delayed epidural hematoma after evacuation of initial hematoma and to formulate recommendations for early detection of evolving hematoma and improvement of outcome. METHODS: Between July 1997 and December 1999, 417 patients underwent craniotomy at department of neurosurgery to evacuate an acute posttraumatic intracranial hematoma. Analysis of these clinical and neuroradiologic data showed that we underwent a second operation on 24 patient(5.8%) for removal of delayed epidural hematoma. In 10(2.4%) of these patients the second operation was undertaken to evacuate a new hematoma that had developed at a contralateral side from the initial hematoma. In 14 patients(3.4%), the second operation was to remove a epidural hematoma at the same site as the first craniotomy. RESULTS: 24 patients were divided into two groups. In Group A, 10 patients who developed contralateral delayed epidural hematoma were 31.5 years(11-61) of age and had skull fracture at the site of delayed epidual hematoma formation. Two of these patients revealed severe brain swelling during the evacuation of acute subdural hematoma. Eight of them were diagnosed within 24 hours after craniotomy through immediately postoperative computed tomography scan. In Group B, 14 patients who developed ipsilateral epidural hematoma were 56.1 years(27-75) of age. Six of them had hemorrhagic tendency related to past medical history. Eleven of these patients were associated with thrombocytopenia and consumptive coagulopathy when required second operation. Twelve patients were diagnosed within 48-72 hours after craniotomy due to clinical deterioration or failure to improve. There was no significant difference in outcome between two groups. CONCLUSION: The authors sought differential factors between contralateral and ipsilateral delayed epidural hematoma. Delayed epidural hematoma after craniotomy may need an urgent operation or lead to serious complication or disability. Postoperative computed tomography scan, intracranial pressure monitoring and repeat computed tomography scan within 72 hours of injury are strongly recommended in these cases, especially after decompression of cranial cavity.
Brain Edema ; Craniotomy ; Decompression ; Hematoma* ; Hematoma, Subdural, Acute ; Humans ; Incidence ; Intracranial Pressure ; Neurosurgery ; Skull Fractures ; Thrombocytopenia

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

The authors analyzed 98 shunting procedures in 62 patients with hydrocephalus, who were managed by ventriculoperitoneal shunt. There were 48 complications among 62 hydrocephalics, and 36 more surgical procedures were performed for 18 revision patients (36.7% over 98 procedures). With regard to frequency, the major complications of the ventriculoperitoneal shunt were the blockage of the catheter (15.3%), infection (8.2%), seizure (7.1%) and the other complications related to shunt device(6.1%). The revision rate in infants with congenital hydrocephauls was not higher than that in older children and adults. There was no significant difference at the level of initial ventricular fluid protein and white blood cell count between initial success group and revision group. The occurrence of seizure after ventriculopertioneal shunt was statistically not significant(P>0.05), and causes of the hydrocephalus might be related to occurrence of seizure.
Adult ; Catheters ; Child ; Humans ; Hydrocephalus* ; Infant ; Leukocyte Count ; Seizures ; Ventriculoperitoneal Shunt*

OBJECTIVE: The purpose of this study is to evaluate complications in 70 patients who had underwent endovascular treatment to occlude cerebral aneurysms. METHODS: From May 1999 to December 2002, we treated 70 patients by endovascular treatment or by combination of endovascular treatment and surgery. Complications have been developed in fifteen patients. Twelve patients had anterior circulation aneurysms: 4 posterior commmuncating artery ; 2 anterior communicating artery ; 2 paraclinoid artery ; 2 anterior choroidal artery ; 1 distal internal carotid artery ; 1 middle cerebral artery ; 1 pericallosal artery and three patients had posterior circulation aneurysms: 3 basilar artery tip. RESULTS: The complications related to the coil embolization were the thromboembolic event in 9 cases, rupture of the aneurysm in 3 cases, coil prolapse in 3 cases and coil migration in 1 case. CONCLUSION: The coil embolization can be a alternative good modality in the treatment of cerebral aneurysms. But careful attention should be required to reduce the various complications of procedures and to improve the prognosis of aneurysmal treatment. Effort to overcome the technical problem and to develop more comfortable device are needed for the better results of endovascular treatment.
Aneurysm ; Arteries ; Basilar Artery ; Carotid Artery, Internal ; Choroid ; Embolization, Therapeutic ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prognosis ; Prolapse ; Rupture

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*