We report a case of 41-year-old male with pulmonary metastasis from a recurrent intracranial malignant meningioma, which had two more recurrence, multiple intracranial metastasis. Pulmonary metastasis was developed five years after resection of primary lesion. The metastatic routes and treatment of pulmonary metastatic malignant meningiomas were described.
Adult ; Humans ; Male ; Meningioma* ; Neoplasm Metastasis* ; Recurrence

Although technological advances and clinical studies on stem cells have been increasingly reported in stroke, research targeting hemorrhagic stroke is still lacking compared to that targeting ischemic stroke. Studies on hemorrhagic stroke are also being conducted, mainly in the USA and China. However, little research has been conducted in Korea. In reality, stem cell research or treatment is unfamiliar to many domestic neurosurgeons. Nevertheless, given the increased interest in regenerative medicine and the increase of life expectancy, attention should be paid to this topic. In this paper, we summarized pre-clinical rodent studies and clinical trials using stem cells for hemorrhagic stroke. In addition, we discussed results of domestic investigations and future perspectives on stem cell research for a better understanding.

OBJECTIVE: Stroke is the third leading cause of death in the Republic of Korea. Time is the most important factor in hyperacute stroke. Yet, there had been no protocol for mechanical thrombolysis. We have treated patients with hyperacute stroke by mechanical thrombolysis for 3 years. In current study, we analyzed the outcome of mechanical thrombolysis. METHODS: From March 2008 to February 2011, 36 patients were treated with mechanical thrombolysis. Initially we treated the patients by aggressive mechanical clot disruption (AMCD) who were admitted within 6 hours after the symptom onset. If revascularization was not achieved, balloon angioplasty was performed, followed by stenting or temporary endovascular bypass was performed. The result in 15 cases was not so successful. Since then, we started using the thromboaspiration method as the first line treatment of the mechanical thrombolysis. RESULTS: After using the thromboaspiration, we had better results in recanalization rate, modified Rankin Score (mRS) and reperfusion injury compared to AMCD. The recanalization rate was 80.85%, mRS is 2.85, and there was only 0.09% hemorrhagic formation. CONCLUSION: Even though thromboaspiration is not statistically significant due to the limited numbers of patients enrolled in this study, we think it is a good way in mechanical thronbolysis for hyperacute stroke.
Angioplasty, Balloon ; Cause of Death ; Humans ; Mechanical Thrombolysis ; Reperfusion Injury ; Republic of Korea ; Stents ; Stroke

OBJECTIVE: Osteoporotic compression fracture is an increasing issue in this community and its diagnosis depends on the magnetic resonance images (MRI). Although T1- and T2-weighted images (T1WI and T2WI) have high sensitivity and specificity, the fat suppression technique gives more clear delineation of this abnormalities. Accordingly, we re-evaluated its exact sensitivity and specificity for the imaging diagnosis of osteoporotic compression fractures in our cases. For additional information about the osteoporotic compression fractures, we evaluate the fracture lines, fluid sign and adjacent discs change on the MRI. METHODS: Retrospectively, total 85 patients who had been diagnosed with acute osteoporotic compression fracture were enrolled. They all had been underwent MRI including T1WI, T2WI and T2- Spectral Adiabatic Inversion Recovery (SPAIR) sequence. RESULTS: In this study, the incidence of high signal intensity on T2-SPAIR image was very high (0.9917). The fluid sign was seen in 56.7% on the SPAIR image. The fracture lines were more observed on the T2WI than T1WI (p=0.0062). The adjacent discs change on T2WI and T2-SPAIR image were higher than T1WI (p<0.001). CONCLUSION: For the acute osteoporotic compression fracture, T2-SPAIR image is the most specific sequence of the all sequences. The fluid sign is another suggestive finding when considered other studies. T2WI is more useful to find the fracture line than T1WI. Abnormal signal intensity on the adjacent discs may provide additional information for the acute osteoporotic compression fractures.
Fractures, Compression ; Humans ; Incidence ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Osteoporosis ; Retrospective Studies ; Sensitivity and Specificity

OBJECTIVE: Aneurysms arising from the posterior inferior cerebellar artery(PICA) are uncommon. We review literature on that and surgical results on aneurysmal treatment by choice of surgical approach. METHODS: On the basis of radiologic findings & charts, we review retrospectively the surgical results of 12 cases from Mar 1999 to Dec 2003. RESULTS: The mean age of the 12 patients was 55.8(ranged from 36 to 71) and female was predominant (female: male=8: 4). Locations of PICA aneurysms revealed variously(vertebral artery-PICA junction: 8, lateral medullary segment: 2, PICA-anterior inferior cerebellar artery common trunk: 1, telovelomedullary: 1). Surgical approaches & treatments were attempted in 11 cases and embolization was done in 1 case(Far lateral transcondylar or supracondylar approach & clipping: 9, Far lateral transcondylar or supracondylar approach and trapping: 2, suboccipital approach & clipping: 1). The surgical result were 8 of 12 patients were good outcome, 1 of 12 was severely disabled and 3 of 12 were died. CONCLUSION: First, we choose surgical approach by the laterality of aneurysms and surgical or interventional treatment is attempted as soon as possible. The PICA aneurysm is regarded as having a relatively good surgical outcome without drilling of the posterior arch of the atlas.
Aneurysm* ; Arteries* ; Female ; Humans ; Pica ; Retrospective Studies

Experimental subarachnoid hemorrhage(SAH) was produced in adult cats by injection of autologous blood(6ml) into prepontine cistern by tranclival approach and cisterna magna. The animals were sacrificed 1, 3, 5, 7 or 14 days later and basilar artery segments were prepared for electron microscopy. The following observations were made: 1) 1 to 7 days after SAH, electron micrograph showed round-shaped endothelial cells in tunica intima and disappearance of zonular occludens. Endothelial detachment from internal elastic membrane and intracytoplasmic vacuolation of endothelial cells as well as destruction of mitochondrial cirstae in tunica media. 2) 14 days after SAH, electron micrograph showed the normal findings in tunica intima and tunica media of the vessel walls. On the basis of the above findings, I found that the ultrastructural changes in the basilar arterial wall, which had presumably developed as a consequence of experimental SAH were reversible.
Adult ; Animals ; Basilar Artery* ; Cats ; Cisterna Magna ; Endothelial Cells ; Humans ; Membranes ; Microscopy, Electron ; Subarachnoid Hemorrhage* ; Tunica Intima ; Tunica Media

Experimental subarachnoid hemorrhage(SAH) was produced in adult cats by injection of autologous blood(6ml) into prepontine cistern by tranclival approach and cisterna magna. The animals were sacrificed 1, 3, 5, 7 or 14 days later and basilar artery segments were prepared for electron microscopy. The following observations were made: 1) 1 to 7 days after SAH, electron micrograph showed round-shaped endothelial cells in tunica intima and disappearance of zonular occludens. Endothelial detachment from internal elastic membrane and intracytoplasmic vacuolation of endothelial cells as well as destruction of mitochondrial cirstae in tunica media. 2) 14 days after SAH, electron micrograph showed the normal findings in tunica intima and tunica media of the vessel walls. On the basis of the above findings, I found that the ultrastructural changes in the basilar arterial wall, which had presumably developed as a consequence of experimental SAH were reversible.
Adult ; Animals ; Basilar Artery* ; Cats ; Cisterna Magna ; Endothelial Cells ; Humans ; Membranes ; Microscopy, Electron ; Subarachnoid Hemorrhage* ; Tunica Intima ; Tunica Media

Intracranial arachnoid cysts are uncommon congenital lesions of considerable interest and importance, the origins and exact nature of which remain uncertain. They account for about 1% of all intracranial space-occupying lesions4). Its predilection sites are in the sylvian fissure, the interhemispheral fissure, the cerebral convexity, the base of the brain, and over the midline of the cerebellum in the posterior fossa6)11). We are reporting a case of arachnoid cyst, developed in the left sylvian fissure in a ten years old male patient.
Arachnoid ; Arachnoid Cysts* ; Brain ; Cerebellum ; Humans ; Male

This is a report on the sudden onset of the Brown-Se`quard Syndrome on a patient following extradural cervical disc herniation. Earlier diagnosis and prompt surgical decompression in the lateral cord syndrome yielded a good outcome.
Decompression, Surgical ; Humans ; Spinal Cord Diseases

OBJECT: The surgical management of patients with intracranial aneurysm continues to be controversial, but the best results of treating an aneurysm can be achieved with treating it before it ruptures. The purpose of this study is to evaluate the surgical risk of treating unruptured intracranial aneurysms. METHODS: Between January 2000 to December 2007, 46 unruptured intracranial aneurysms were treated with aneurismal neck clipping. The clinical outcome was retrospectively evaluated according to the Glasgow Outcome Scale about one month after surgery. RESULTS: The patients consisted of 24 females and 22 males. The mean age was 56.6 years (range: 37-80). For the aneurysm location, 27 (58.8%) were at the middle cerebral artery, 10 (21.7%) were at the anterior communicating artery, three (6.5%) were at the posterior communication artery, two (4.3%) were at the internal carotid artery, two (4.3%) were at the anterior choroidal artery, one (2.2%) was at the anterior cerebral artery and one (2.2%) was at the vertebral artery. The size of the aneurysm was below 5mm for 6 patients (13%), 6 to 10mm for 30 patients (65.2%), 11 to 25mm for 9 patients (19.6%) and > or =25mm for 1 patient (2.2%). The clinical outcome was good for 39 patients (84.8%), moderate disability was noted for 5 patients (10.9%) and severe disability was noted for 2 patients (4.3%). CONCLUSION: In this study, the morbidity and mortality rates were favorable compared with those of the previous reports. Our results suggest that aneurysms associated with a ruptured lesion or those larger than 10mm could be considered for treatment. These results will be very helpful to determine whether or not to proceed with surgery.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Carotid Artery, Internal ; Choroid ; Female ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm ; Male ; Middle Cerebral Artery ; Neck ; Retrospective Studies ; Rupture ; Vertebral Artery