Over the past 10 years, considerable advances have been made in the surgical treatment of pituitary adenomas, with a high incidence of complete tumor removal reported. Increasing use of surgical magnification for surgery of the sellar region has created a need for more detailed surgical anatomical studies of this area and for special attention to the anatomical variants important to the transfrontal and transsphenoidal surgical approaches. The author discussed the surgical problems conderning hypersecretory pituitary adenomas. Here, there is a triple objective:treatment of the tumor, treatment of the hyperhormonism and the prevention of postoperative recurrences and complications. In this paper, an attempt has been made to correlate a surgical management of pituitary tumor characteristics with 1) microsurgical anatomy of the sella region; 2) surgical approaches and indication; 3) surgical complications; 4) comparison of therapentic options between surgical and medical treatment; 5) pituitary adenoma and pregnancy; 6) management of recurrent hyperfunctional pituitary adenomas; 7) pre-and postoperative radiation therapeutic effects.
Acromegaly ; Incidence ; Pituitary Neoplasms* ; Pregnancy ; Prolactinoma ; Recurrence

No abstract available.
Head*

No abstract available.
Brain Abscess* ; Brain*

No abstract available.
Brain Abscess* ; Brain*

Spontaneous cerebellar hemorrhage is classically considered a rare and fatal disease because the early diagnosis is very rarely made during the life, and there is scant mention of the problems of spontaneous hemorrhage into the cerebellar hemisphere. However our opinions indicate that its frequency is greater than is generally thought although it is considered a rare lesion. The purpose of this paper is to record our present opinions concerning the possible early diagnosis and surgical management of the spontaneous cerebellar hemorrhage. We believe that it is possible by clinical examination alone to make or strongly suspect the diagnosis in life during the early stage before irreversible damage occurs and that emergency surgical intervention is strongly indicated. The patients is a 38 year old man admitted to the Department of Neurosurgery, Catholic Medical Center on Nov 3, 1976 with severe headache, vomiting, dysarthria and mental confusion. On examination, he was disclosed mental confusion, repeated vomiting, constricred pupil, horizontal nystagmus, inability to stand, dysarthria and neck stiffness. We confirmed the diagnosis under the cerebellar hemorrhage involving the cerebellar vermis and both cerebellar hemispheres by means of vertebral and carotid angiography, conray ventriculography, and cerebrospinal fluid examination. We underwent suboccipital craniectomy with the evacuation of hematoma at the vermis and both cerebellar hemispheres after 48 hours of onset of illness and his postoperative course was good except for mild cerebellar dysfunction signs and he was discharged on 45th hospital days.
Adult ; Angiography ; Cerebellar Diseases ; Cerebrospinal Fluid ; Diagnosis ; Dysarthria ; Early Diagnosis ; Emergencies ; Headache ; Hematoma ; Hemorrhage* ; Humans ; Neck ; Neurosurgery ; Nystagmus, Pathologic ; Pupil ; Vomiting

Between May, 1984 and October, 1986, twenty patients were treated at Han-Ra Hospital of JejuCity and Chung-Ang University Hospital of Seoul with immediate internal fixation with or without bone graft of open fractures of the long bones within three days. Fractured bones were ten tibiae, six femurs, three humeri and one radius and ulna. The injuries were classified on the basis of extent of soft tissue injury as defined by Gustilo and Anderson and consisted of four TypeI injuries, five Type II injuries and eleven Type III injuries. All wounds were closed primarily and radiological follow up was qhecked every month till union occurred. The complications included two deep infections, one non-union and one amputation. This study demonstrates that immediate internal fixation with bone graft when necessary is a beneficial method of treatment of open fractures of the long bones if copious irrigation, adequate debridement and skillful internal fixation technique are given golden period after injury. The results were related to the severity of the initial soft tissue injury and surgical technique and the period of union was not related to the individual bone. Autogenous bone grafting at the time of immediate internal fixation in comminuted or segmental fractures in which interfragmental compression cannot be obtained is recommended.
Amputation ; Bone Transplantation ; Debridement ; Femur ; Follow-Up Studies ; Fractures, Open ; Humans ; Methods ; Radius ; Seoul ; Soft Tissue Injuries ; Tibia ; Transplants ; Ulna ; Wounds and Injuries

Craniosynostosis has a varied clinical spectrum, ranging from isolated single suture involvement to multi-sutural fusions. Greater understanding of the pathogenesis of craniosynostosis has led to the development of practical treatment protocols. Three stages of growth have determined the approach to managing craniosynostosis : the early period, up to 12 months; the intermediate period, from 1 to 10 years; and the late period, beginning at 10 years. This review discusses current surgical management and future perspectives in craniosynostosis.
Clinical Protocols ; Craniosynostoses* ; Neurosurgery ; Sutures

No abstract available.
Rhizotomy* ; Trigeminal Neuralgia*

The term hydranencephaly designates the condition in which large protions of the cerebral hemispheres have been reduced to membranous sacs within a cranium of relatively normal size. Only basal ganglia and remnants of the mesencephalon are found at the base of the skull. We have experienced the 2 cases of infantile hydranencephaly. In surveying the pathogenesis of the hydranencephaly, it becomes apparent that the distribution of most of the lesions falls into certain distinct patterns, which is characterized by almost completely absent of both cerebral hemispheres and by relative gross preservation of the basal ganglia, a portion of lower temporal and occipital and contents of the posterior fossa in our experienced 2 cases. In our cases, the condition may present a defect in vascular ontogenesis or the outcome of vascular occlusion of both internal carotid arteries and their main branches on carotid angiogram and CT scan. This paper presents the essential features for the clinical diagnosis, suggesting pathogenesis in 2 cases of infantile hydranencephaly.
Basal Ganglia ; Carotid Artery, Internal ; Cerebrum ; Diagnosis ; Hydranencephaly* ; Mesencephalon ; Skull ; Tomography, X-Ray Computed

Diencephalic syndrome of infancy which is characterized by progressive and profound emaciation often with normal or accelerated skeletal growth, hyperkinesias, hypotension, and hypoglycemia. The profound emaciation so characteristic this syndrome has yet to be explained. The diencephalic syndrome is caused by low grade astrocytoma, ependymoma in the third ventricle including the hypothalamus. Authers report a case of diencephalic syndrome which was confirmed in this patient with ependymoma in the region of anterior hypothalamus by transcallosal approach.
Astrocytoma ; Emaciation ; Ependymoma ; Humans ; Hyperkinesis ; Hypoglycemia ; Hypotension ; Hypothalamus ; Hypothalamus, Anterior ; Third Ventricle