OBJECTIVE: To introduce the frequency and segment analysis of in-stent stenosis for intracranial stent assisted endovascular treatment on complex aneurysms. METHODS: A retrospective study was performed in 158 patients who had intracranial complex aneurysms and were treated by endovascular stent application with or without coil embolization. Of these, 102 patients were evaluated with catheter based angiography after 6, 12, and 18 months. Aneurysm location, using stent, time to stenosis, stenosis rate and narrowing segment were analyzed. RESULTS: Among follow-up cerebral angiography done in 102 patients, 8 patients (7.8%) were shown an in-stent stenosis. Two patients have unruptured aneurysm and six patients have ruptured one. Number of Neuroform stents were 7 cases (7.5%) and Enterprise stent in 1 case (11.1%). Six patients demonstrated in-stent stenosis at 6 months after stent application and remaining two patients were shown at 12 months, 18 months, respectively. CONCLUSION: In-stent stenosis can be confronted after intracranial stent deployment. In our study, no patient showed symptomatic stenosis and there were no patients who required to further treatment except continuing antiplatets medication. In-stent stenosis has been known to be very few when they are placed into the non-pathologic parent artery during the complex aneurysm treatment, but the authors found that it was apt to happen on follow up angiography. Although the related symptom was not seen in our cases, the luminal narrowing at the stented area may result the untoward hemodynamic event in the specific condition.
Aneurysm ; Angiography ; Arteries ; Catheters ; Cerebral Angiography ; Constriction, Pathologic ; Dimaprit ; Follow-Up Studies ; Hemodynamics ; Humans ; Parents ; Phenobarbital ; Retrospective Studies ; Stents

No abstract available.
Nuchal Cord* ; Ultrasonography*

Spinal cord injury without radiological abnormality (SCIWORA) is a unique concern in pediatric spine injuries. The incidence of pediatric spinal injuries is relatively low, with cervical spine being the most frequently involved in young children. The immature anatomical structure of the cervical spine in young children is attributable to the occurrence of SCIWORA. The author had experienced a case of failure to detect the spinal cord injury during the initial neurologic assessment in the emergency room, in a 22-month-old girl who had suffered a brain injury subsequent to a traffic accident. Since the brain injury resulted in decreased mentality and posttraumatic seizure, precise motor and sensory examinations were not performed, thereby resulting in the missed spinal cord injury during initial diagnosis.

Intradural schwannoma accompanied with torsion is rare. Intradural lumbar schwannoma was found in a 63-year-old man presenting with right sacral pain radiating to the lower extremity. This mass showed minimal enhancement on MRI. The tumor's location changed each time on MRI and CT-myelography. The patient underwent surgical resection and the cauda equina, linked to this schwannoma, was severely twisted.

Intradural schwannoma accompanied with torsion is rare. Intradural lumbar schwannoma was found in a 63-year-old man presenting with right sacral pain radiating to the lower extremity. This mass showed minimal enhancement on MRI. The tumor's location changed each time on MRI and CT-myelography. The patient underwent surgical resection and the cauda equina, linked to this schwannoma, was severely twisted.

Uncontrolled cerebrospinal fluid (CSF) leakage after transsphenoidal surgery (TSS) for pituitary adenoma can lead to meningitis. Intracranial mycotic pseudoaneurysm is a rare complication in central nervous system infection. Large single pseudoaneurysm is more uncommon. Most mycotic aneurysms occur due to endocarditis. The present patient had no heart problem and was infected by CSF leakage after transsphenoidal surgery. We present a case of large ruptured mycotic pseudoaneurysm as a complication of cerebral infection after TSS for pituitary macroadenoma.
Aneurysm, False ; Aneurysm, Infected ; Central Nervous System Infections ; Cerebrospinal Fluid ; Endocarditis ; Heart ; Humans ; Intracranial Aneurysm* ; Meningitis ; Pituitary Neoplasms

We report a case of erythema nodosurn associated with ulcerative colitis which occurred in a 13-year-old girl who showed well demarcated, painful, erythematous nodules and plaques on both upper and lower extremities. The patient also experienced frequent intermittent abdominal pain and bloody stools for about 1 year. Laboratory findings revealed polymorphonuclear leukocytosis and occult blood in the stool. Findings of sigmoidoscopy, barium enema, and rectal biopsy were consistent. with ulcerative colitis. A skin biopsy from the lesion on the right shin revealed a moderate inflammatory cell infiltrate in the septa of the subcutaneous fat layer, composed chiefly of lymphohistiocytes and a few epitheloid cells. The symptoms and signs responded well to orally administered prednisolone and sulfasalazine.
Abdominal Pain ; Adolescent ; Barium ; Biopsy ; Colitis, Ulcerative* ; Enema ; Erythema Nodosum* ; Erythema* ; Female ; Humans ; Leukocytosis ; Lower Extremity ; Occult Blood ; Prednisolone ; Sigmoidoscopy ; Skin ; Subcutaneous Fat ; Sulfasalazine ; Ulcer*

Spinal epidural hematoma results from various causes such as use of anticoagulants, hemorrhagic diathesis, pregnancy, labor, arteriovenous malformation and spinal anesthesia as well as idiopathic orgin. We report a 3-year-old boy who was found to have spinal epidural hematoma and presented with lower back pain and fever. He developed paraplegia of lower legs after two consecutive lumbar punctures during two days. The lesion of spinal epidural hematoma was not found with lumbar spinal MRI but with cervico-thorasic one, because the lesion was at the C7-T6 level. Laminectomy was done to evacuate the hematoma and some specimen was obtained, of which pathologic finding was arteriovenous malformation. The boy is receiving physical therapy continuously due to unsatisfactory results with hematoma aspiration procedure and laminectomy treatment.
Anesthesia, Spinal ; Anticoagulants ; Arteriovenous Malformations* ; Child, Preschool ; Fever ; Hematoma ; Hematoma, Epidural, Spinal* ; Hemorrhagic Disorders ; Humans ; Laminectomy ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Paraplegia ; Pregnancy ; Spinal Puncture

Traumatic spondyloptosis is a rare trauma entity and clinically challenging. Mostly, traumatic spondyloptosis combines severe neurologic deficit and is hard to expect good clinical outcome. It is also named grade 5 spondylolisthesis and reduction of dislocated vertebral bodies is not easy. Initial reduction at the emergency room can cause secondary neurologic injury, therefore, a careful and gentle approach is required. A 54-year-old male suffered an accident at a construction site. The heavily reinforced concrete structure hit him from the back side. Initially, motor grade of both legs decreased to grade 2 at the emergency room. Imaging studies showed lumbar spondyloptosis L4 on L5. Surgery was required and reduction was performed in the-operating room under general anesthesia. Complete reduction and posterior fixation was performed and neurologic deficit improved after surgery. The authors report on a rare case of spinal trauma and discuss initial management and surgical solutions.
Anesthesia, General ; Emergency Service, Hospital ; Humans ; Leg ; Lumbar Vertebrae ; Male ; Middle Aged ; Neurologic Manifestations* ; Spondylolisthesis

A 26-year-old male who had no underlying disease, including coagulopathy, underwent thoracotomy and bleeding control due to hemothorax. On the fifth postoperative day, paralysis of both lower limbs occurred. Urgent spine magnetic resonance imaging showed a massive anterior spinal epidural hematoma from C2 to L1 level with different signal intensities, which was suspected to be staged hemorrhage. Hematoma evacuation with decompressive laminectomy was performed. The patient's neurologic deterioration was recovered immediately, and he was discharged without neurological deficits. A drug history of naftazone, which could induce a drug-induced platelet dysfunction, was revealed retrospectively. To our knowledge, this is the first report of whole spontaneous spinal epidural hematoma in a young patient, with a history of hemorrhoid medication.
Adult ; Blood Platelets ; Hematoma ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Hemorrhoids ; Hemothorax ; Humans ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Paralysis ; Retrospective Studies ; Spine ; Thoracotomy