Hypertensive intracerebral hematoma is a serious and potentially lethal condition. The indication of surgery in this hematoma is still controversial. Authors have treated 335 cases of hypertensive intracerebral hematomas which were confirmed by computerized tomography between July 1, 1982 and June 30, 1986. The hematomas have been classified according to their modes of extension on computerized tomography. The outcome was assessed on their basis of activity daily living. According to our study, moderate and severe types of putaminal hematoma cases have shown better results with surgery than conservative management. Mortality was 23.7 percent in surgery and 35.3 percent in conservative management.
Hematoma* ; Mortality ; Putaminal Hemorrhage

Interhemispheric approach has been accepted as a standard method approaching distal anterioir cerebral artery(DACA) aneurysm. In the approach, most authors use the surgical method retracting the superior sagittal sinus(SSS) after dural reflection. However, it results in limited surgical space and makes the surgical procedure difficult technically. To overcome the limitation, we tried to ligate and cut SSS in 13 patients out of 23 patients of DACA aneurysm from Mar. 1983 to Feb. 1993. Out of total 583 intracranial aneurysms operated on in that period, the proportion of DACA aneurysm was 3.95%. Mean age was 52.7 years ranging from 32 to 66 years. The sex ration was 7:16, showing female predominancy. As presenting symptoms, twenty two patients had subrachnoid hemorrhage and one patient had a third nerve palsy due to an unruptured posterior communicating artery aneurysm. On admission, 4 patients(17.4%) were in grade I, 10(43.5%) in grade II, 6(26.1%) in grade III, 3(13%) in grade IV according to the Hunt and Hess grading system. In 18 patients(78.3%), aneurysms were located at bifurcation of pericallosal and callosomarginal artery and in 5(21.7%) at bifurcation of frontopolar and pericallosal artery. Associated vascular anomalies were A1 hypoplasia(2 cases), multiple aneurysms(5 cases), fenestration of anterior cerebral(1 case) and arteriovenous malformation(1 case). Thirteen cases were operated on with ligation of the SSS and 10 without ligation. Overall surgical outcomes scored by Glasgow outcome scale were : 11 patients(47.8%) in Grade I, 6(26.1%) in Grade II, 2(8.7%) in Grade III, 4(17.4%) in Grade V. The outcomes in ligation group were : 8 patients(61.5%) in Grade I, 4(30.8%) in Grade II, 1(7.7%) in Grade III, and no death. The outcomes in non-ligation group were : 4 patients(40%) in Grade I, 1(10%) in Grade II, 1(10%) in Grade III, and 4(40%) in Grade V. These results showed that the patients operated on with ligation of SSS had more favorable outcomes than the patients without ligation. It seems that the SSS in the interhemispheric approach might provide several advantages and better operative outcome over the conventional method.
Aneurysm ; Anterior Cerebral Artery* ; Arteries ; Female ; Glasgow Outcome Scale ; Hemorrhage ; Humans ; Intracranial Aneurysm* ; Ligation* ; Oculomotor Nerve Diseases ; Superior Sagittal Sinus

Authors reviewed 37 cases of 25 patients with carpal tunnel syndrome treated surgically at Department of Neurosurgery of Kyung Hee University Hospital from January 1981 to February 1992. The sex ratio was 1:24 showing female predominancy. Distribution of age ranged from 26 years to 65 years. Duration of symptoms ranged from 15 days to 20 years. Tinel's sign was positive in 24 patients ans 10 patients had muscle atrophy. Twelve patients were operated on both hands, 7 patients on the right and 6 patients on the left. Operations were performed under the general anesthesia in 4 patients, under the axillary block in 3 patients and under the local lidocaine infiltration in 18 patients. In postoperative periods, 5 patients experienced transient aggravation of numbness of fingers, 1 patient had wound problem, 1 patient hypalgesia and 1 patient transient motor weakness which was thought to be due to residual effect of axillary block. Surgical outcomes were good in 35 cases(94.6%), fair in 1 case(2.7%) and poor in 1 case(2.7%).
Anesthesia, General ; Carpal Tunnel Syndrome* ; Electromyography ; Female ; Fingers ; Hand ; Humans ; Hypesthesia ; Lidocaine ; Median Nerve ; Muscular Atrophy ; Neurosurgery ; Postoperative Period ; Sex Ratio ; Wounds and Injuries

Portal hypertension often leads to the development of several collateral vessels that shunt blood flow from the portal to the systemic circulation. The rupture of intra-abdominal varix is an unusual complication of portal hypertension that can lead to life-threatening hemoperitoneum. If the patient is hemodynamically unstable due to massive intra-abdominal bleeding, exploratory laparotomy should be performed on the patient. There are several reported cases of intra-abdominal variceal bleeding such as paraumbilical varix, the varix from the small intestine and proximal colon etc. Spontaneous hemoperitoneum caused by the rupture of gastroepiploic vein varix, however, has not been reported in Korea, to the best of our knowledge. We will discuss a patient with portal hypertension due to liver cirrhosis who presented with acute intra-abdominal bleeding. During the laparotomy, he was found to have a rupture of the gastroepiploic vein. The vessel was ligated, and the patient recovered uneventfully by operative variceal ligation.
Alcoholics* ; Colon ; Esophageal and Gastric Varices ; Hemoperitoneum* ; Hemorrhage ; Humans ; Hypertension, Portal ; Intestine, Small ; Korea ; Laparotomy ; Ligation ; Liver Cirrhosis ; Liver Cirrhosis, Alcoholic* ; Rupture* ; Varicose Veins ; Veins*