No abstract available.

No abstract available.

Osteoma is the most common benign tumor of the cranium, and the frontal sinus is its most frequent location in the cranium. A 39-year-old woman presented with left exophthalmos was found to have orbital and intracranial extension of a giant osteoma involving anterior cranial fossa. The etiology, presenting features, diagnosis and treatment of this tumor are reviewed.
Adult ; Cranial Fossa, Anterior* ; Diagnosis ; Exophthalmos ; Female ; Frontal Sinus ; Humans ; Orbit ; Osteoma* ; Skull

No abstract available.
Brain Edema* ; Brain* ; Meningioma* ; Vascular Endothelial Growth Factor A*

No abstract available.
Brain Edema* ; Brain* ; Microvessels* ; Vascular Endothelial Growth Factor A*

OBJECTIVE: The lateral extracavitary approach(LECA) to the thoracic spine is known as one of the procedure which allows direct vision of pathologic lesion, ventral decompression and dorsal fixation of the spine through the same incision. The authors present a usefulness of the LECA to the complicated unstable thoracic spine caused by trauma. METHODS: The authors performed LECA on six patients from January 1999 to June 2001. All patients were male and their age distribution was from 17 to 65 years. Perioperative neurological state, radiological image, and their changes during follow-up period were evaluated in all patients. RESULTS: After operation, neurological symptoms were improved and there were no significant post-operative complications. Among these trauma cases, three patients showed rapid recovery of their impending paraparesis. In two patients with paraplegia from severe fracture-dislocation, only one patient was minimally improved to motor grade 3. Spinal alignments were maintained in all. CONCLUSION: Lateral extracavitary approach is considered to be a alternative method for the treatment of traumatic thoracic vertebra with high grade instability. The major advantage of this approach is that circumferential decompression of the spine and rigid fixation can be obtained throurh the same incision.
Age Distribution ; Decompression ; Dislocations ; Follow-Up Studies ; Humans ; Male ; Paraparesis ; Paraplegia ; Spine*

A rare case of gliosarcoma with neurofibromatosis typeI is presented. The patient was a 33-year-old woman who had headache and vomiting for one week. Multiple neurofibromas over her whole body with many cafe-au-lait spots were present since childhood. At admission, she had no focal neurological deficit and ophthalmologic examination revealed bilateral Lisch nodules. Brain CT and MRI revealed a heterogeneously enhancing mass in the left fronto-parietal region with marked peritumoral edema and mass effect. The tumor was removed gross totally and a gliosarcoma was diagnosed histopathologically. Post operative course was uneventful with resolution of symptom, followed by radiotherapy with 60 Gy. A brief overview is given of this rare case together with the pertinent literature.
Adult ; Brain ; Cafe-au-Lait Spots ; Edema ; Female ; Gliosarcoma* ; Headache ; Humans ; Magnetic Resonance Imaging ; Neurofibromatoses* ; Neurofibromatosis 1* ; Radiotherapy ; Vomiting

OBJECTIVE: There is increasing evidence that the omega-3 polyunsaturated fatty acid, eicosapentanoic acid(EPA), induces relaxation in vessels from various animal models as cardiovascular protective nutrients. In vivo study was undertaken to investigate the potential therapeutic application of EPA to resolve vasospasm. METHODS: The basilar artery was visualized using transclival exposure, and its diameter monitored using videomicroscopy. Rabbits were divided randomly into seven groups:1) normal rabbits basilar artery treated with topical application of 100nM/L EPA only;2) normal rabbits basilar artery treated with 20nM/L phorbol dibutyrate(PDB), then 20 nM/L PDB+100nM/L EPA;3) normal rabbits basilar artery treated with 80mM/L KCL, then 80mM/L KCL+100nM/L EPA;4) normal rabbits basilar artery treated with 20nM/L endothelin 1(ET-1) only;5) normal rabbits basilar artery treated with 20nM/L ET-1, then 20nM/L ET-1+100nM/L EPA;6) subarachnoid hemorrhage(SAH) rabbits basilar artery treated with artificial CSF only;7) SAH rabbits basilar artery treated with 100nM/L EPA. RESULTS: In normal(non-SAH) rabbits, EPA:1) had no effect on basal tone;2) did not reverse KCL or PDB-induced constriction;and 3) substantially reversed ET-1-induced constriction. The diameter of normal rabbit basilar artery was 779.1+/-17.9nm(mean+/-standard error). After SAH, the mean diameter was 521.0+/-32.5nm. The addition of EPA reversed this SAH-induced constriction to 80.4% of baseline diameter. CONCLUSION: These results suggest that EPA induces relaxation in cerebrovascular arteries constricted with ET-1, and that it prevents and partially reverses SAH-induced vasoconstriction.
Arteries ; Basilar Artery ; Constriction ; Eicosapentaenoic Acid* ; Endothelins ; Microscopy, Video ; Models, Animal ; Rabbits ; Relaxation* ; Spasm* ; Subarachnoid Hemorrhage ; Vasoconstriction

Much controversies still exist with respect to the risk factors influencing symptomatic cerebral vasospasm. In our study, the patient group had some unique characteristics, ie.:42.5%(65) of the 153 patients were aged 60 years or older(mean;55.6 years) and consequently the proportion of Hunt-Hess grade 3-5 was higher than grade 1-2(57.5% vs 42.5%). The authors analyzed the relationship between vasospasm and Hunt & Hess grade, Fisher grade, hydrocehalus, age & hypertension among these 153 early operative cases after a 3 year follow up study. The incidence of vasospasm was significantly higher in the Hunt-Hess grade III, IV, V and the Fisher grade III, IV, compared to grade I & II, and also in preoperative hydrocehalus but it was insignificant in old and hypertensive patients. These results suggest initial severe direct insults and complicating preoperative hydrocephalus increase the chance of postoperative symptomatic vasospasm in this older aged, poorer grade study group.
Aneurysm* ; Follow-Up Studies ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Risk Factors ; Subarachnoid Hemorrhage* ; Vasospasm, Intracranial

The effect of lumboperitoneal(LP) shunt and the prognostic factors of 40 cases of communicating hydrocephalus confirmed by brain computerized tomography(CT) and/or magnetic resonance imaging(MRI) and radioisotope cisternography(RI) were analyzed. Possible prognostic factors such as disease entity, CT or MRI findings, and the type of radioisotope cisternography were compared to improvement of clinical status after LP shunt. The etiology of communicating hydrocephalus in the analyzed 40 cases included trauma in 13 cases(32.5%), subarachnoid hemorrhage(SAH) in 12 cases(30%), intracerebral hemorrhage(ICH) in 10 cases(25%), and idiopathic in 5 cases(12.5%). An overall clinical improvement after LP shunt was seen in 22 cases(55%). However, in 17 cases of SAH and idiopathic group, improvement after LP shunt was seen in 13 cases(75%), indicating that LP shunt is more effective in SAH/idiopathic group than trauma/ICH group(p<0.05). Many findings of brain CT/MRI such as Evan's index, periventricular low density, 3rd ventricular width, obliteration of cerebral sulci, rounding of frontal horn, and cortical atrophy were analyzed as prognostic factors. Except for the absence of cortical atrophy(p<0.05), none of the factors were related to the patient's outcome. The type of abnormal RI cisternography findings(Typ I, II, III) also did not show any relationship with the effectiveness of LP shunt. These findings suggest that SAH/idiopathic group were more favorable candidates for LP shunt than trauma/ICH group, and that there are no reliable brain CT/MRI findings indicating a good prognosis after LP shunt except for the absence of cortical atrophy. RI cisternography findings are also not a reliable diagnostic tool in evaluating the indication of LP shunt in communicating hydrocephalus.
Animals ; Atrophy ; Brain ; Horns ; Hydrocephalus* ; Magnetic Resonance Imaging ; Prognosis