Albendazole is a new drug for the treatment of cerebral cysticercosis. We have recently experience a case that had shown poor therapeutic response to praziquantel. The patient have multiple parenchymal cysts. She was treated with 15mg/kg/day of albendazole for 1 month to confirm healing of the intracranial lesion by the follow up brain CT scan and CSF-ELISA associated with marked clinical improvement.
Albendazole* ; Brain ; Cysticercosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Neurocysticercosis* ; Praziquantel ; Tomography, X-Ray Computed

A case of traumatic acute bilateral subdural hematoma with different times is expierenced. The contralateral shbural hematoma was developed during the evacuation of an acute subdural hematoma. The reduction of intracranial pressure after removal of subdural hematoma was postulated to be contributing factor to formation of the contralateral subdural hematoma.
Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural* ; Hematoma, Subdural, Acute* ; Intracranial Pressure

A case of a acute expanding venous extradural hematoma was treated. Initial CT scan was favorable, but delayed bleeding & its expansion was developed. The bleeding points were left transverse sinus and superior petrosal sinus. Serial neurologic examination & serial CT scan in patients with head injuries are recommended.
Brain* ; Craniocerebral Trauma ; Hematoma* ; Hemorrhage ; Humans ; Neurologic Examination ; Tomography, X-Ray Computed*

Delayed traumatic extradural hematoma is a new pathological dimension. Thirteen patients with delayed traumatic extradural hematoma were seen 70 treated cases of extradural hematomas for a frequency of 18.6%. The hematomas were insignificant or not present on the initial CT scanning. All patients had a skull fracture at the site of delayed extradural hematoma formation. Ten hematomas were surgically evacuated and three were reabsorbed spontaneously. Repeated CT scanning was performed if the patient has any new focal neurological deficits or clinical status was not improved despite of minimal extradural hematoma after head injury. Delayed extradural hematoma were classified into two groups based on the presence of hematoma in initial CT scan : delayed bleeding type(newly formed xtradural hematoma/4 cases : 5.7%) & delayed expansion type(enlargement of initial thin hematoma/9 cases : 12.6%).
Craniocerebral Trauma ; Hematoma* ; Hemorrhage* ; Humans ; Skull Fractures ; Tomography, X-Ray Computed

During 3-year period, fourteen patients with air bubble in acute extradural hematomas were seen among 84 consecutively cases of extradural hematomas for a frequency of 16.7%. Extradural air were classified into 3 groups based on the location of air bubble ;frontal type(4 cases), temporal type(8 cases) & occipital type(2 cases). A skull fracture was seen in all cases & the air entrance was considered to frontobasal or laterobasal skull fractere. In patients with 4 cases of CSF leak & multiple air bubbles, delayed expansion of extradural hematoma was seen. The clinical significance of air bubble in acute extradural hematoma is disscussed.
Craniocerebral Trauma ; Hematoma* ; Humans ; Pneumocephalus ; Skull ; Skull Fractures

The authors analysed retrospectively, 69 cases of chronic subdural hematoma admitted to the Department of Neurological Surgery, from January 1992 to February 1995. All hematomas were operated on by one burr hole trephination and continuous closed-system cather drainage system. The results were as follows: 1) Male was more frequently involved than female with ratio of 5.3:1 and the incidence was prredominent in the patients whose ages were over 50. 2) History of head trauma was found in 52 cases(75.4%), among which habitual alcoholism was found in 6 cases(8.7%). 3) The major symptoms and signs at admission were headache(55.1%), hemiparesis(44.9%), and mental changes(30.4%). 4) On the brain CT scan, hematoma showed low, iso, mixed, and high in density, and the shapes of hematoma were crescenteric, biconvex, planoconvex, and concave in order of frequency. 5) We have found a significant relationship between the neurological grade at admission and the prognosis, and noted full recovery in 45 cases(65.2%) and no d eath as a result of 1-burr hole trephination.
Alcoholism ; Brain ; Craniocerebral Trauma ; Drainage ; Female ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Incidence ; Male ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Trephining

Extraosseous extradural tuberculosis of the spine is rare entity. A 21-year-old man with low back pain, left-sided sciatica & motor weakness was admitted. Simple X-ray were normal. At operation, extradural, extraosseous granuation tissue were removed, which proved upon histologic examination to be tuberculous granulomas. The authors report a rare case of extraosseous tuberculoma in the posterior extradural space of whole lumbar region with review of literatures.
Granuloma ; Humans ; Low Back Pain ; Lumbosacral Region ; Sciatica ; Spine ; Tuberculoma* ; Tuberculosis ; Young Adult

Recently we experienced stereotaxic endoscopic biopsy and resection of intracranial tumors using the Brown-Robert-Wells system. Surgical exploration was undertaken under the local anesthesia:1 germinoma in pineal region, 1 arachnoid cyst in basal cistern. The method is described, and the its potential clinical applications is discussed.
Arachnoid ; Biopsy ; Endoscopy* ; Germinoma

In spontaneous brain stem hemorrhage, efforts are being made to treat the hemorrhage by means of active medical treatment of intricate suboccipital craniectomy. But these efforts are still unsatisfactory in decreasing the high mortality and morbidity. Our recent efforts have got good results in the 11 cases of brain stem hemorrhage by removing the hemorrhage through the application of R.R.W. stereotactic system and gradual urokinase irrigation. The residual hemorrhage following the initial aspiration was completely evacuated by gradual urokinase irrigation through stereotactically placed catheter. Also this catheter was used for monitoring of intrahematomal intracranial pressure for an early stoppage of the increased intracranial pressure or early detecting of rebleeding. This kind of stereotactic evacuation and gradual irrigation with urokinase could remove the brain stem hemorrhage accurately and easily in a short time under the local anesthesia. Mean-while the normal brain tissue is subjected to less surgical trauma by this procedure, which can be interpreted as having a wide indication, a definite advantage, with a low mortality of 27.3%.
Anesthesia, Local ; Brain Stem* ; Brain* ; Catheters ; Electric Impedance ; Hemorrhage* ; Intracranial Pressure ; Mortality ; Urokinase-Type Plasminogen Activator*

We previoulsy reported the successful performances of the BRW stereotactic biopsy and aspiration of supratentorial and brain stem lesions. The BRW system has disadvantage of less accessibility to the cerebellar lesions by suboccipital approach. To overcome this disadvantage, we have tried to treat four patients having a cerebellar lesions, a case of hemangioblastoma, two cerebellar hemorrhages and acoustic neuroma, by transtentorial BRW stereotactic approach. This approach has been used successfully under the local anesthesia with satisfactory postoperative neurological results. We present a detailed technique of this approach.
Anesthesia, Local ; Biopsy ; Brain Stem ; Hemangioblastoma ; Hemorrhage ; Humans ; Neuroma, Acoustic