Three cases of cerebral rete mirabile associated with aneurysms are presented. In two cases the aneurysms were located at the anterior communicating arteries, and in one at the peripheral portion of the middle cerebral artery. For the anterior communicating artery aneurysms, operations were performed. Based on these experiences, the difficulties and necessities of operations for the aneurysms associated with cerebral rete mirabilies are briefly discussed.
Aneurysm* ; Arteries ; Intracranial Aneurysm ; Middle Cerebral Artery ; Mirabilis ; Moyamoya Disease*

Using Xenon inhalation method, the authers measured the rCBF's within 24 hours before and after the operation of 4 AVM patients. We found the obliteration of the cerebral steal syndrome in all cases and the loss of initial shunt peak in 2 cases after excision of AVM. We discussed these hemodynamic changes in AVM and reviewed the literatures.
Hemodynamics ; Humans ; Inhalation ; Intracranial Arteriovenous Malformations* ; Xenon

1210 patients with adult head injury who were admitted to the Department of Neurosurgery, Kyung Hee University Hospital during the period of 5 years from January, 1980 were analyzed clinicostatistically. The results were as follows : 1) There were 842 male and 368 females with the ratio of 2.3 : 1. 2) Higher incidence was observed on May and September of the year, and between 6:00 P.M. and 8:00 P.M. of the day. 3) The most common cause of head injury was traffic accident(58.3% of the total cases), especially pedestrian accident and the next causes were fall-down and assaults. 4) Loss of consciousness was observed in 862 cases(71% of the total cases) and the duration of unconsciousness seemed to be related with severity of clinical course. 5) Lucid interval was observed in 21.4% of the cases of intracranial mass lesion and the highest manifestated lesion was epidural hematoma. There was vomiting in 31.2% of the total cases and early posttraumatic epilepsy in 2.1%. 6) Skull fractures were identified in 375 cases ; 273 cases of linear, 50 cases of depressed, 41 cases of basal and 11 cases of diastic fractures. The most common site of linear skull fracture was temporoparietal bone. 7) 79.8% of epidural hematomas were associated with skull fractures and the most common site of hematoma was temporal area. 8) Of all cases of subdural hematoma, acute type was prevalent(59.7%) and in main involved site was frontotemporoparietal area. 9) The frequent associated injuries were mandible fracture and other facial bone fracture, chest injury and lower extrimities fracture in order. 10) The minor head injury of Glasgow Coma scale score(GCS) of 13 to 15 was 864 cases(71.4%), the moderate head injury of 9 to 12, 139 cases(11.5%), and the severe head injury of 3 to 8, 207 cases(17.1%). 11) Of 270 cases of severe head injury, the mortality was 43% and 21% had good recovery. But outcome was different according not only to GCS but also to the type of lesion. 12) Acute subdural hematoma with GCS of 3 to 5 was uniformly the worst problem(88% mortality), whereas subacute and chronic subdural hematoma had good outcome. 13) The overall mortality was 8.0% and the operation mortality in 283 cases was 19.8%. Among the 1,210 cases of head injury in adults, 80.8% showed good recovery and 11.2% remained in disabled or vegetative state.
Adult* ; Craniocerebral Trauma* ; Epilepsy ; Facial Bones ; Female ; Glasgow Coma Scale* ; Head* ; Hematoma ; Hematoma, Subdural, Acute ; Hematoma, Subdural, Chronic ; Humans ; Incidence ; Male ; Mandible ; Mortality ; Neurosurgery ; Persistent Vegetative State ; Skull Fractures ; Thoracic Injuries ; Unconsciousness ; Vomiting

A case of Tuberculous abscess in cerebrum, in a 17 years-old male, is presented, which was confirmed Pathologically and microbiologically. At present, tuberculous infection progressively decrease, and especially occurs rarely tuberculous abscess in central nerve system. The prognosis is known to be poor. We have experienced a case of tuberculous abscess in cerebrum and obtained a good result after surgery. So, we report our case with a brief review of the articles.
Abscess* ; Adolescent ; Cerebrum* ; Humans ; Male ; Prognosis

Authors experienced fifteen cases of the pineal tumors during about 5 years from October, 1977 to September, 1982, which were diagnosed with brain C-T scanning. The details of clinical evaluation and follow up of 15 cases of the pineal tumors are presented. The following results were obtained. 1) The age group below age of 20 years in predominant and include 11 cases(73%) of 15 cases, and male is predominantly much than female. 2) On the neurological examination at admission, the RICP signs were showed in 15 cases, Parinaud's syndrome showed in 6 cases, cranial nerve palsy in 8 cases and DI symptom in 5 cases of all 15 cases. 3) In the follow up study, brain CT was more effective than any other conventional neuroradiologic technique. 4) 8 cases of all 15 cases have had normal life in follow up period with minium of 6 months and maximum of 6 months and maximum of 5 years, and one case with mild neurological deficit has been spent life for about 12 months. 5) Of 6 cases died within 2 years, 3 cases had insufficient treatment and 3 cases had sufficient treatment, of whom ond had tumor recurrence at primary site and dissemination to spinal epidural space and other two cases were suspected to have clinical dissemination to spinal cord. 6) On the basis of high survival rate in 9 cases of 12 cases who were treated completely, we thought that good survival rate in the patient with pinealoma will be resulted from a series of planed treatment, including early diagnosis, correction of hydrocepalus, surgical intervention and irradiation.
Brain ; Cranial Nerve Diseases ; Early Diagnosis ; Epidural Space ; Female ; Follow-Up Studies* ; Germinoma ; Humans ; Immunotherapy ; Male ; Neurologic Examination ; Ocular Motility Disorders ; Pinealoma* ; Recurrence ; Spinal Cord ; Survival Rate

Three patients development subdural pneumocephalus after undergoing posterior fossa surgery performed in sitting position. The mechanism for entry of air into the intracranial compartment is analogous to the entry of air into an inverted bottle. As the fluid pours out, air bubbles to the top of the container. A brow-up lateral skull radiograph with a horizontal beam provided prompt diagnosis and confirmed brain displacement as well as computerized tomography did. Tension pneumocephalus appears to be another potential complication of posterior fossa surgery in sitting position. This condition is easily diagnosed and treated, and should be considered whenever a patient fails to recover as expected following posterior fossa surgery.
Brain ; Diagnosis ; Humans ; Pneumocephalus* ; Skull

With 4 channel Nicolet-CA 1000 clinical averager and 133 Xenon inhalation method, somatosensory evoked potentials (SSEP), brainstem auditory evoked potentials (BAEP) and regional cerebral blood flow (r-CBF) were studied in 30 patients with ruptured cerebral aneurysms. 8 out of 30 patients had abnormal SSEP, 11 out of 30 patients had abnormal BAEP and 4 out of 14 patients had decreased r-CBF. The SSEP was abnormal in 6 out of 10 patients with severe vasospasm but in only 2 out of 20 patients without vasospasm or with mild and moderate spasm. The BAEP was abnormal in 5 out of 10 patients with severe vasospasm but 6 out of 20 patients without spasm or with mild and moderate spasm. Regional CBF was decreased in 3 out of 4 patients with severe vasospasm but only 1 out of 10 patients without spasm or with mild and moderate spasm. Abnormal SSEP, BAEP & decreased r-CBF in patients with severe vasospasm indicated a poor prognosis. We got the results as follows ; 1) Abnormal SSEP, BAEP and decreased r-CBF are correlated with severity of vasospasm in SAH patients. 2) Abnormal SSEP and BAEP correlated with the clinical status. 3) Brain stem transmission time (BTT) is less sensitive than central conduction time (CCT) as indicator of vasospasm.
Brain Stem ; Evoked Potentials* ; Evoked Potentials, Auditory, Brain Stem ; Evoked Potentials, Somatosensory ; Humans ; Inhalation ; Intracranial Aneurysm ; Prognosis ; Spasm ; Xenon

Problems of birth defects and low birth weight are important issues of public health because most infant mortality are caused by these two. To discover the etiology of birth defects and low birth weight, it is necessary to establish epidemiological birth defects monitoring system in Korea. With the rapid growing of internet usage in korea, the computer network has become the popular means of communicating and sharing of information. Our aim was to develop web-based reporting and database management system in Incheon to establish birth defects monitoring system to evaluate the incidence rate and patterns of birth defects in Korea. Public health center and private hospitals and clinics participated in this monitoring system. Web based reporting system have been built and operated during 2 years (first year: December 1st, 1998-November. 31, 1999; second year: January 1st, 2000 - December 31th, 2000). Trained nurses actively collected the records obtained from delivery units in the participating hospitals. During first and second year, the incidence rate of birth defect per thousand person was 10.0 and 8.0 respectively. In conclusion, we could build web-based monitoring system for birth defects successfully in Yonsu gu, Incheon. It could be a model of national standard for population-based monitoring system for birth defects in Korea.
Congenital Abnormalities* ; Database Management Systems ; Hospitals, Private ; Humans ; Incheon* ; Incidence ; Infant ; Infant Mortality ; Infant, Low Birth Weight ; Infant, Newborn ; Internet ; Korea ; Parturition* ; Public Health

A case of persistent Cushing's syndrome in a 25 year-old male is presented. Inspite of bilateral total adrenalectomy twice during two years, there was no clinical improvement. Adrenal scanning revealed no adrenal remnants. ACTH secreting pituitary microadenoma is demonstrated by computed tomographic brain scan and hormonal studies. Selective transsphenoidal microadenomectomy results in clinical and endocrinological improvement.
Adrenalectomy ; Adrenocorticotropic Hormone ; Adult ; Brain ; Cushing Syndrome* ; Humans ; Male

A case of persistent Cushing's syndrome in a 25 year-old male is presented. Inspite of bilateral total adrenalectomy twice during two years, there was no clinical improvement. Adrenal scanning revealed no adrenal remnants. ACTH secreting pituitary microadenoma is demonstrated by computed tomographic brain scan and hormonal studies. Selective transsphenoidal microadenomectomy results in clinical and endocrinological improvement.
Adrenalectomy ; Adrenocorticotropic Hormone ; Adult ; Brain ; Cushing Syndrome* ; Humans ; Male