No abstract available.
Child* ; Humans

To make guideline to the diagnosis and treatment and of the intracranial nodular lesions, the authors made a clinical analysis on 81 pediatric patients who had showed nodular lesions on brain CT scan at Severance Hospital from Mar. 1979 to Feb. 1989 and the results were summarized as follows. 1) The peak incidence of intracranial nodular lesions was found in the 2nd decade(61.7%). There was no sexual difference. 2) The most common clinical symptom was seizure(92.6%) and the predilection site was parietal area. The nodular enhancing type on brain CT scan showed not only the most common type but also the most favorable clinical course. 3) As the etiology of the intracranial nodular lesions, tuberculosis, paragonimiasis, cysticercosis, tumor(meningioma), and aspergillosis were confirmed or suspected, but tuberculosis was the most common. CSF routine examination, chest PA, PNS X-rays, skin test for paragonimiasis and tuberculosis, CSF ELISA test for cysticercosis and paragonimiasis should be routine as the diagnostic studies. 4) We made treatment principle for intracranial nodular lesions. In cases that initial brain CT scan show low density or calcified density without contrast enhancement, we treat those patients with anticonvulsants and steroid with regular check-up. If the lesion increases in size or new enhancement develops on follow up CTY scan, medications for the suspected etiology should be added. In cases that initial brain CT scan show enhancing lesions, treatment is started with anticonvulsants and medications for the etiology with regular check up. If the lesion increase in size on follow up CT scan or seizure is uncontrolled. Surgery should be considered.
Anticonvulsants ; Aspergillosis ; Brain* ; Child* ; Cysticercosis ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Humans ; Incidence ; Meningioma ; Paragonimiasis ; Rabeprazole ; Seizures ; Skin Tests ; Thorax ; Tomography, X-Ray Computed* ; Tuberculosis

Four children with medically refractory multiform seizures were submitted for section of the corpus callosum for last 3 years. These patients had medically intractable generalized seizures diagnosed preoperatively as the Lennox-Gastaut syndrome characterized by a combination of seizure patterns, most frequently drop attack with generalized tonic-clonic, generalized tonic and atonic seizure. Guided by pre- and intra-operative electroencephalographic monitoring, the section was carried out in the anterior 2/3 or 4/5 part of callosum. Five to 28 months' postoperative follow-up suggests good results:Three patient showed no more drop attack except intermittent focal myoclonic seizures in 1 case and one patient had generalized seizures less in frequency than preoperative state. Corpus callosotomy seems to be an effective surgical approach for the intractable epilepsy with drop attack of multifocal origin, but longer follow-up is needed.
Child* ; Corpus Callosum ; Electroencephalography ; Epilepsy* ; Follow-Up Studies ; Humans ; Seizures ; Syncope

Isolated lateral ventricle after ventriculoperitoneal shunt for hydrocephalus can occur by obstruction of foramen of Monro. Two cases of isolated lateral ventricles after ventriculoperitoneal shunt are reported. Patients showed neurological deterioration and brain CT scan revealed unilateral dilatation of lateral ventricle after ventriculoperitoneal shunt. They were successfully managed by another shunt system into dilated lateral ventricle.
Brain ; Cerebral Ventricles ; Dilatation ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

Third ventriculostomy has been used for the treatment of obstructive hydrocephalus since Dandy first performed such operation in 1922. With the development of fiberopic technology and new endoscopic equipments, neuroendoscopic procedure has become one of the highlights of recent advance in neurosurgery. The author has performed endoscopic third ventriculostomies in 26 patients suffering from obstructive hydrocephalus since 1989. The most common cause of obstructive hydrocephalus in those patients was aqueductal stenosis. Twenty of the 26 patients were treated by endoscopic third ventriculostomy only, and 16 of the cases(i.e., 80%) were successful without the need of shunting operation. However, the remaining 4 cases required ventriculopritoneal shunt. Six patients, who were either under the age of one year old or had previous multiple shunts, received endoscopic third ventriculotomy and ventriculopritoneal shunt simultaneously. The 10 patients(out of the original group of 26) who received both endoscopy and shunt, required no shunt revision during the follow-up periods of 6 months to 4 years. Of all the cases, while no mortalities occurred, we had encountered 3 complications which consists of 2 transients diabetes insipidus and 1 postoperative epidural hematoma around a burr hole site. The authors therefore concludes that endoscopic third ventriculostomy is a simple and effective procedure for the treatment of obstructive hydrocephalus. Equipment, procedure, pre and post operative workup and results were fully discussed with literature review.
Diabetes Insipidus ; Endoscopes ; Endoscopy ; Follow-Up Studies ; Hematoma ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Third Ventricle ; Ventriculostomy*

The authors analyzed the 14 cases of surgically confirmed cerebral paragonimiasis from 1969 to 1980. Thirteen patients had excellent results but one patient was expired due to the complication of ventriculoperitoneal shunt. In this analysis cerebral paragonimiasis was predominant in young aged male and major clinical symptoms were seizure, visual disturbance and motor weakness. Diagnosis was made by the paragonimus skin test, chest X-ray, plain skull X-rays, cerebral angiography, PEG and brain CT scan. Brain CT scan was thought to be very helpful to make a diagnosis and to get a therapeutic guide in this disease. Operative treatment was very effective for the patient who have focal mass lesion.
Brain ; Cerebral Angiography ; Diagnosis ; Humans ; Male ; Paragonimiasis* ; Paragonimus ; Seizures ; Skin Tests ; Skull ; Thorax ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

No abstract available.
Craniosynostoses*

There had been a lot of changes and advances in treatment of hydrocephalus. Many efforts also had been made to prevent complication of shunting, but there are a lot of inevitable problems in shunting operation. This paper attemps to review and summarize these shunt complications.
Hydrocephalus

No abstract available.
Cell Line* ; Glioma*

No abstract available.
Brain Neoplasms ; Child* ; Humans ; Radiotherapy