No abstract available.
Humans ; Lung Neoplasms* ; Lung*

No abstract available.
Fistula*

We report a case of herniated lumbar disc with sequestrated fragments which were located posterior and lateral to the thecal sac. A 60-year-old woman developed lumbago and sciatica one year prior to presentation and acute exacerbation occurred recently. Magnetic resonance imaging showed a mass that was located posteriorly and laterally to the dural sac at the L3-4 level. Laminectomy at L3-4 was done and several fragments were easily separated from the left posterolateral and posterior aspect of the dural sac. Microscopic evamination revealed disc fragment.
Female ; Humans ; Intervertebral Disc ; Laminectomy ; Low Back Pain ; Magnetic Resonance Imaging ; Middle Aged ; Sciatica

OBJECTIVE: This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. METHODS: From January 2004 to December 2008, 25 patients with diffuse axonal injury were treated at our hospital. We retrospectively investigated the patients' medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding : grade I, small scattered lesions on the white matter of the cerebral hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the brain stem. RESULT: Seven patients belonged to the grade I group; 10 to the grade II group; and 8 to the grade III group. The mean Glasgow Coma Scale (GCS) score of all patients at the time of admission was 7.28. Recovery of consciousness was observed in 23 of the 25 patients; the remaining two patients never regained consciousness. The time interval to recovery of consciousness (awake status) ranged from 1 day to 125 days (mean 22.1 days) : grade I group patients, within approximately 1 week (mean 3.7 days); grade II group patients, within approximately 2 weeks (mean 12.5 days); and grade III group patients, within approximately 2 months (mean 59.5 days). CONCLUSION: Our study results suggest a correlation between the mean time interval to recovery of consciousness in patients with diffuse axonal injuries and the degrees of brain injuries seen on MRI. Patients with grade I and II diffuse axonal injuries recovered consciousness within 2 weeks, while patients with grade III injuries required approximately 2 months.
Brain ; Brain Injuries ; Brain Stem ; Consciousness ; Diffuse Axonal Injury ; Glasgow Coma Scale ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Medical Records ; Retrospective Studies

Cerebral cavernous malformation with giant cysts is rare and literature descriptions of its clinical features are few. In this case study, the authors describe the clinical symptoms, radiological findings, and pathological diagnosis of cerebral cavernous malformations with giant cysts, reviewing the relevant literature to clearly differentiate this from other disease entities. The authors present a case of a 19-year-old male with a giant cystic cavernous malformation, who was referred to the division of neurosurgery due to right sided motor weakness (grade II/II). Imaging revealed a large homogenous cystic mass, 7.2x4.6x6 cm in size, in the left fronto-parietal lobe and basal ganglia. The mass had an intra-cystic lesion, abutting the basal portion of the mass. The initial diagnosis considered this mass a glioma or infection. A left frontal craniotomy was performed, followed by a transcortical approach to resect the mass. Total removal was accomplished without post-operative complications. An open biopsy and a histopathological exam diagnosed the mass as a giant cystic cavernous malformation. Imaging appearances of giant cavernous malformations may vary. The clinical features, radiological features, and management of giant cavernous malformations are described based on pertinent literature review.
Basal Ganglia ; Biopsy ; Caves ; Craniotomy ; Glioma ; Hemangioma, Cavernous, Central Nervous System ; Humans ; Male ; Neurosurgery ; Young Adult

OBJECTIVE: We investigated the clinical and radiological advantages of unilateral laminectomy in posterior lumbar interbody fusion (PLIF) procedure comparing with bilateral laminectomy, under the same procedural condition including bilateral instrumentation and insertion of two cages, in patients with degenerative lumbar disease with unilateral leg symptoms. METHODS: We retrospectively reviewed 124 consecutive cases of PLIF via unilateral or bilateral approach between January 2006 and April 2010. In 80 cases (bilateral group), two cages were inserted via bilateral laminectomy, and in 44 cases (unilateral group), via unilateral laminectomy. The average follow-up duration was 29.5 months. The clinical outcomes were evaluated with the Visual Analogue Scale (VAS) and the Oswestry disability index (ODI). The fusion rates and disc space heights were determined by dynamic standing radiographs and/or computed tomography. Operative times, intra-operative and post-operative blood losses and hospitalization periods were also evaluated. RESULTS: In clinical evaluation, the VAS and ODI scores showed excellent outcomes in both groups. There were no significant differences in term of fusion rate, but the perioperative blood loss and the operative time of the unilateral group were lower than that of the bilateral group. CONCLUSION: Unilateral laminectomy can minimize the operative time and perioperative blood loss in PLIF procedure. However, the different preoperative disc height between two groups is a limitation of this study. Despite this limitation, solid fusion and satisfactory symptomatic improvement could be achieved uniquely by our surgical method. This surgical method can be an alternative surgical technique in patients with unilateral leg pain.
Follow-Up Studies ; Hospitalization ; Humans ; Laminectomy ; Leg ; Operative Time ; Retrospective Studies

Retrograde jejunogastric intussusception defined as a segmental invagination of jejunal loop into stomach through stoma is a rare complication following partial gastric resection. Endoscopy and UGI series is very helpful in the diagnosis of this disease. Although the management of this disease is usually surgical, an endoscopic reduction can alternatively be attempted. If endoscopic reduction was failed, operation should be immediately per-formed in the acute type because of its high mortality. When anatomical reduction is done on due time, the prognosis is fairly good. We report a case of retrograde jejunogastric intussusception with a brief review of the literature. There was a 56 year old male patient who visited the hospital with chief complaints of severe epigastric pain and vomiting. He had subtotal gastrectomy for gastric carcinoma 6 years ago. On emergency endoscopy the type IIa jejunogastric intussusception was found. As the patient was suspected to be incar-cerated, surgical reduction was performed without delay. He was discharged on the 8th admission day.
Diagnosis ; Emergencies ; Endoscopy* ; Gastrectomy ; Humans ; Intussusception* ; Male ; Middle Aged ; Mortality ; Prognosis ; Stomach ; Vomiting

Arteriovenous fistula of the scalp is relatively rare disease. We report a traumatic arteriovenous fistula of the scalp treated with complete surgical excision and review the literature with regard to etiology, pathogenesis, and management of these unusual lesions.
Arteriovenous Fistula* ; Rare Diseases ; Scalp*

OBJECTIVE: The purpose of this study was to examine the efficacy and perioperative complications associated with lumbar spinal fusion surgery, focusing on geriatric patients in the Republic of Korea. METHODS: We retrospectively investigated 485 patients with degenerative spinal diseases who had lumbar spinal fusion surgeries between March 2006 and December 2010 at our institution. Age, sex, comorbidity, American Society of Anesthesiologists (ASA) class, fusion segments, perioperative complications, and outcomes were analyzed in this study. Risk factors for complications and their association with age were analyzed. RESULTS: In this study, 81 patients presented complications (16.7%). The rate of perioperative complications was significantly higher in patients 70 years or older than in other age groups (univariate analysis, p=0.015; multivariate analysis, p=0.024). The perioperative complications were not significantly associated with the other factors tested (sex, comorbidity, ASA class, and fusion segments). Post-operative outcomes of lumbar spinal fusion surgeries for the patients were determined on the basis of MacNab's criteria (average follow up period : 19.7 months), and 412 patients (85.0%) were classified as having "excellent" or "good" results. CONCLUSION: Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery, whereas other factors were not significant. However, patients' satisfaction or return to daily activities when compared with younger patients did not show much difference. We recommend good clinical judgment as well as careful selection of geriatric patients for lumbar spinal fusion surgery.
Comorbidity ; Follow-Up Studies ; General Surgery* ; Humans ; Judgment ; Multivariate Analysis ; Republic of Korea* ; Retrospective Studies ; Risk Factors ; Spinal Diseases ; Spinal Fusion*

OBJECTIVE: To determine whether the use of contrast enhancement (especially its extent) predicts malignant brain edema after intra-arterial thrombectomy (IAT) in patients with acute ischemic stroke. METHODS: We reviewed the records of patients with acute ischemic stroke who underwent IAT for occlusion of the internal carotid artery or the middle cerebral artery between January 2012 and March 2015. To estimate the extent of contrast enhancement (CE), we used the contrast enhancement area ratio (CEAR)-i.e., the ratio of the CE to the area of the hemisphere, as noted on immediate non-enhanced brain computed tomography (NECT) post-IAT. Patients were categorized into two groups based on the CEAR values being either greater than or less than 0.2. RESULTS: A total of 39 patients were included. Contrast enhancement was found in 26 patients (66.7%). In this subgroup, the CEAR was greater than 0.2 in 7 patients (18%) and less than 0.2 in the other 19 patients (48.7%). On univariate analysis, both CEAR > or =0.2 and the presence of subarachnoid hemorrhage were significantly associated with progression to malignant brain edema (p<0.001 and p=0.004), but on multivariate analysis, only CEAR > or =0.2 showed a statistically significant association (p=0.019). In the group with CEAR > or =0.2, the time to malignant brain edema was shorter (p=0.039) than in the group with CEAR <0.2. Clinical functional outcomes, based on the modified Rankin scale, were also significantly worse in patients with CEAR > or =0.2 (p=0.003) CONCLUSION: The extent of contrast enhancement as noted on NECT scans obtained immediately after IAT could be predictive of malignant brain edema and a poor clinical outcome.
Brain Edema* ; Brain* ; Carotid Artery, Internal ; Humans ; Infarction* ; Middle Cerebral Artery ; Multivariate Analysis ; Stroke ; Subarachnoid Hemorrhage ; Thrombectomy*