No Abstract Available.

The aim of this study was to evaluate the incidence and the management of hydrocephalus following ruptured intracranial aneurysms. The authors analyzed 223 patients with aneurysmal subarachnoid hemorrhage(SAH) during the last two years retrospectively. The results are summarized as follows. Eighty patients(35.9%) showed ventricular dilatation on a brain CT scan. Twenty-five patients(11.2%) required shunt surgery. Hydrocephalus was closely related to the amount of hemorrhage and the location of the ruptured aneurysm. Two of 9 patients with acute hydrocephalus, who were managed by extraventricular drainage(EVD) before definite aneurysm surgery. The shunt surgery was done before aneurysm surgery in 16 patients and rebleeding occurred in 3 patients. Radioactive isotope(RI) cisternography diagnosed communicating hydrocephalus in 11 patients and the lumboperitoneal shunt was performed in those cases. It is concluded that hydrocephalus following aneurysmal SAH is the communicating type, an indication for shunt surgery could be determined by RI cisternography, and lumboperitoneal shunting seems to be the best treatment of choice to avoid rapid decompression of the ventricles and to protect the already compromised cerebral hemisphere. Decompression of the ventricles before aneurysmal surgery should be avoided whenever possible.
Aneurysm ; Aneurysm, Ruptured ; Brain ; Cerebrum ; Decompression ; Dilatation ; Hemorrhage ; Humans ; Hydrocephalus* ; Incidence ; Intracranial Aneurysm* ; Retrospective Studies ; Tomography, X-Ray Computed

The effect of hyperbaric tetracaine spinal anesthesia was studied in 40 patients having genitourinary surgery in the horizontal lithotomy position. Patients were randomly assigned to one of two groups, after spinal injection, patients in one group were placed immediately in the supine and horizontal lithotomy position, and patients in the second group were placed immediatley in the supine and horizontal position for 10 minutes and then placed into the horizontal 1thotomy position. There were no statistically significant differences in anesthesia sensory level and heart rate of patients placed immediately in the horizontal lithotomy position compared to the patients kept in the supine position for the first 10 minutes after receiving the spinal anesthetic. The ranges of systolic blood pressure were all within normal limits, although systolic blood pressure showed a difference at 5,10 and 60 minute intervals after anesthesia. We conclude that immediate application of the horizontal lithotomy position can be safely practiced in the anesthesia of genitourinary surgery.
Anesthesia ; Anesthesia, Spinal* ; Blood Pressure ; Heart Rate ; Humans ; Injections, Spinal ; Supine Position ; Tetracaine*

Most trauma induced fistulas are direct communications between the intracavernous carotid artery and the cavernous sinus. Theses abnormal communications are characterized by high pressure, high blood flow and a clinically obvious constellation of symptoms and signs. We here in report a patient with traumatic carotid cavernous sinus fistula(CCSF). who developed central retinal vein occlusion(CRVO) during detachable balloon embolization. The mechanism of CRVO occurring during detachable balloon embolization. The mechanism of CRVO occurring during detachable ballon embolization for CCSF was discussed. We report this case with the review of previous reports.
Balloon Occlusion ; Carotid Arteries ; Carotid-Cavernous Sinus Fistula* ; Cavernous Sinus ; Fistula ; Humans ; Retinal Vein*

In order to compare the amount of surgically induced astigmatism among sutureless group(Group 1),10-0 nylone suture group(Group 2),and using tissue adhesive group(Group 3),we analysed a series of rabbit cataract surgery cases in these three groups. We performed cataract surgery on 30 eyes of 15 rabbits by Irrigation and aspiration technique. After cataract surgery,10 eyes by sutureless technique,10 eyes were closed by conventional 10-0 nylon suture technique, and 10 eyes by tissue adhesive(Beriplast) technique.We collected keratometric data before and after surgery(At 1,2,4,8 weeks).In postoperative astigmatic change,three groups had the distinct features in the evolution for postoperative astigmatism.The group 1 showed early against-the-rule(ATR)astigmatism,which advanced ATR and showed about 0.5D astigmatic change at 8 weeks.The group 2 showed early with-the-rule(WTR)astigmatism about 1.13D,which advanced toward ATR from 1week.The group 3 showed little ATR about 0.2D,which was minimal change in astigmatism.At 8 weeks after operation,there was no signifi-cant difference in the astigmatic change among the three groups(P>0.05), which were no complications observed. In this study,the tissue adhesive(Beriplast)seem to be a simple,effective and less induced astigmatic changing corneoscleral suture technique than other suture techniques
Astigmatism* ; Cataract* ; Nylons ; Rabbits ; Suture Techniques ; Sutures ; Tissue Adhesives*

To evaluate the cerebral blood flow in feline hydrocephalic brain, this study was designed to measure the regional cerebral blood flow(rCBF;frontal and periventricular area) by the hydrogen clearance method in different stages of the kaolin-induced hydrocephalus and the postshunt status. The results were as follows: 1) A reduction of rCBF was detected in the left periventricular area at two weeks after kaolin injection. A significant reduction of rCBF was revealed in the left periventricular area at two and four weeks after kaolin injection. However, the rCBF of the left frontal cortex was significantly decreased at four weks after kaolin injection. 2) At one week after shunt operation, the significant restroration of rCBF was found in the left frontal cortex and the left periventricular area.
Brain ; Hydrocephalus* ; Hydrogen ; Kaolin

Radiotherapy is a standard postoperative treatment for various cerebral neoplasms. Howewr, radiation has the potential to produce severe injury to normal brain tissue in and around the tumor bed. The authors encountered 7 patients with delayed cerebral necrosis. These unacceptable complication prompted us to analyze cases with such a complication particularly in regard to the differential diagnosis between the recurrence of the tumor and radiation necrosis of the brain. This article summarizes factors related to the radiation necrosis, including clinical observations and treatment.
Brain Injuries ; Brain* ; Diagnosis, Differential ; Humans ; Necrosis* ; Radiotherapy ; Recurrence

To localize bypass pathways, left and right ventricular regions were analyzed at rest by phase image analysis in 6 patients with Wolff-Parkinoson-White syndrome and 5 patients with concealed bypass pathway. These were compared with image findings in 12 normal subjects. In normal subjects, the earliest emptying occured in ventricular septal, apical and left basal segments. Mean difference between the earlist left and right ventricular phase angle was 2.3+/-5.6degrees in patients with normal conduction, -14.0+/-15.1degrees in patients with left bypass pathways, 15.0+/-0degrees in patients with right bypass pathways and -6.6+/-12.3degrees in patients with concealed bypass pathways. In patients with bypass pathways, there was complete agreement between phase and electrophysiologic maps, but incomplete agreement(4 of 6) between surface ECGs and electrophysiologic map in a patient with left posterior and left bypass pathways. The phase image represents a new, noninvasive method of evaluating ventricular pre-excitation. The method may provide useful information complementary to that of electrocardiographic and electriphysiologic analysis.
Electrocardiography ; Humans ; Wolff-Parkinson-White Syndrome*

No abstract available.
Eosinophilia* ; Fever* ; Glomerulonephritis*

OBJECTIVE: To establish a treatment guideline for intracranial cavernous malformation, the authors analyzed the clinical features, treatment modality, complications, and late outcomes in 76 consecutive cases (45 microsurgical resections, 30 stereotactic radiosurgeries, one microsurgery followed by radiosurgery) managed at the Yonsei University Medical Center from 1985 to 1998. RESULTS: Among 104 lesions in 76 patients, 64(61.5%) lesions were supratentorial and 40(38.5%) infratentorial. Hemorrhage was the most common presentation(31 patients, 40.8%), followed by generalized seizure(15 patients, 19.7%). Fifteen(19.7%) patients had mixed presentation with generalized seizure and hemorrhage, while 9(11.9%) patients presented focal deficits. The remaining 6(7.9%) patients had headache or incidental lesion. Almost all infratentorial lesions(92.5%) were managed with radiosurgery, and 65.6% of supratentorial lesions with microsurgery. The average follow-up period was 14.6 months for the microsurgery group and 32 months for the radiosurgery group. The overall outcome was good in 68(89.5%), fair in 6(7.9%), poor in 1(1.3%), and dead in 1(1.3%). Total microsurgical resection and symptomatic cure rate was 95.6%. Two lesion were incompletely resected. One lesion was followed by radiosurgery and the other was followed by reoperation. Only 38.5% of lesions with radiosurgery were shrunken. CONCLUSION: Microsurgical removal is effective for lesions in the non-eloquent area, or with recurrent hemorrhages and seizures. Although radiosurgery could be considered for lesions with multiplicity in the eloquent or deep-seated area, further study for the radiosurgical effect on cavernous malformations is required.
Academic Medical Centers ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Microsurgery ; Radiosurgery ; Reoperation ; Retrospective Studies* ; Seizures