Spontaneous spinal epidural hematoma is a rare entity. Various definitions for spontaneous epidural hematoma have been reported in the literature. The expression of nontraumatic spinal epidural hematoma seems to be less ambiguous and includes idiopathic hematomas and hematomas secondary to coagulopathy, vascular malformations, and tumors. We report three cases of nontraumatic spinal epidural hematomas observed from 1991 to 2000. The causes of the spinal epidural hematomas were not clear in two cases among them, but in the another one case, the cause was determined to be an acquired coagulopathy. We reviewed 24 cases reported in the Korean Journal of Neurosurgery and our three cases with particular emphasis on the various causes such as coagulopathy, vascular malformations and tumors. Among the 27 cases, numerous causes were detected such as three cases of vascular malformation, one case of anticoagulant treatment, five cases of combined lumbar disc herniation, two cases associated with pregnancy and postpartum, one case associated with hypertension, and one case associated with ossification of ligamentum flavum. No causes were detected in the ten cases. The authors reviewed the literature.
Hematoma ; Hematoma, Epidural, Spinal* ; Hypertension ; Ligamentum Flavum ; Neurosurgery ; Postpartum Period ; Pregnancy ; Vascular Malformations

No abstract available.
Osteosarcoma* ; Sphenoid Bone*

No abstract available.
Drainage* ; Humans ; Hydrocephalus*

PURPOSE: To evaluate accuracy of magnetic resonance(MR) imaging for staging of lung cancer and to compare the accuracies of CT and MRI. MATERIALS AND METHODS: We retrospectively analyzed 25 cases of lung cancer, which were confirmed surgically and pathologically. Five experienced radiologists participated in the receiver operating characteristic (ROC) analysis to evaluate and compare accuracies of the CT and MR imaging in preoperative staging of non small cell lung cancer by assessing tumor invasion of bronchus, mediastinum, chest wall, and hilar or mediastinal lymph node metastasis. Imaging results were evaluated against "truth" data based on both surgery and pathologic examination. RESULTS: Sensitivity of CT in distinguishing T3-T4 tumors was 60% ;specificity was 76%. These values for MR imaging were not significantly different(53% and 72%). With ROC analysis, no difference existed between accuracies of CT and MR imaging in diagnosis of bronchial involvement, but MR imaging was significantly more accurate than CT(p<0.05) in diagnosis of mediastinal invasion. There was no significant difference between accuracies of CT and MR imaging in detecting mediastinal node metastasis(N2 or N3); sensitivities were 64% and 78%, respectively, and specificities were 64% and 66%. CONCLUSION: There was no significant difference in accuracies of CT and MR imaging in preoperative tumor classification and assessment of mediastinal node metastasis, but MR imaging was more accurate than CT in assessment of mediastinal invasion.
Bronchi ; Carcinoma, Bronchogenic* ; Classification ; Diagnosis ; Lung Neoplasms ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mediastinum ; Neoplasm Metastasis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Thoracic Wall

PURPOSE: To evaluate accuracy of magnetic resonance(MR) imaging for staging of lung cancer and to compare the accuracies of CT and MRI. MATERIALS AND METHODS: We retrospectively analyzed 25 cases of lung cancer, which were confirmed surgically and pathologically. Five experienced radiologists participated in the receiver operating characteristic (ROC) analysis to evaluate and compare accuracies of the CT and MR imaging in preoperative staging of non small cell lung cancer by assessing tumor invasion of bronchus, mediastinum, chest wall, and hilar or mediastinal lymph node metastasis. Imaging results were evaluated against "truth" data based on both surgery and pathologic examination. RESULTS: Sensitivity of CT in distinguishing T3-T4 tumors was 60% ;specificity was 76%. These values for MR imaging were not significantly different(53% and 72%). With ROC analysis, no difference existed between accuracies of CT and MR imaging in diagnosis of bronchial involvement, but MR imaging was significantly more accurate than CT(p<0.05) in diagnosis of mediastinal invasion. There was no significant difference between accuracies of CT and MR imaging in detecting mediastinal node metastasis(N2 or N3); sensitivities were 64% and 78%, respectively, and specificities were 64% and 66%. CONCLUSION: There was no significant difference in accuracies of CT and MR imaging in preoperative tumor classification and assessment of mediastinal node metastasis, but MR imaging was more accurate than CT in assessment of mediastinal invasion.
Bronchi ; Carcinoma, Bronchogenic* ; Classification ; Diagnosis ; Lung Neoplasms ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mediastinum ; Neoplasm Metastasis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Thoracic Wall

Dental Occlusion ; Humans ; Incisor ; Malocclusion ; Orthognathic Surgery ; Skull ; Skull Base

OBJECTIVE: To compare the accuracy of three-dimensional (3-D) ultrasound-assessed fetal thigh volumetry in predicting birth weight with that of other commonly used formulas composed of biparietal dimeter (BPD), abdominal circumference (AC), and femur length (FL) by two-dimentional (2-D) ultrasonography. METHODS: From May 1999 to February 2000 we performed a prospective study of ultrasonography on 100 pregnant women. We assessed the thigh volume of 100 fetuses using 3-D ultrasonography. Meanwhile their BPD, AC, and FL were measured by 2-D ultrasonography. All infants were delivered within 48 hours after the ultrasound examinations. RESULTS: The thigh volume assessed by 3-D ultrasonography was highly correlated with birth weight (r=0.414, n=100, p<0.0001). The 3-D formula had small mean values of absolute mean error (gm) (64.26), absolute mean error (%) (10.20+/-0.80). As well, the 2-D formulas had similar mean values. However, no significant differences in predicting birth weight were found between 3-D formula and 2-D formulas. CONCLUSION: The 3-D ultrasound method assessed by thigh volume showed better accuracy in predicting birth weight than 2-D methed. Further studies may be needed to confirm our conclusions.
Birth Weight* ; Female ; Femur ; Fetus ; Humans ; Infant ; Parturition* ; Pregnant Women ; Prospective Studies ; Thigh* ; Ultrasonography*

The vast majority of schwannomas occur on cranial nerves, and rarely in the retroperitoneum. Solitary schwannoma in the psoas muscle is extremely rare. The authors present a case of retroperitoneal neoplasm in the psoas muscle identified as schwannoma which is not associated with von Recklinghausen's disease. A 68 years old female patient was admitted because of low back pain and weakness at the left leg. CT and MRI revealed a large cystic mass with well-defined margin and multiple internal septation within the left psoas muscle. The tumor was totally extirpated and histologically confirmed as a schwannoma.
Aged ; Cranial Nerves ; Female ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Neurilemmoma* ; Neurofibromatosis 1 ; Psoas Muscles* ; Retroperitoneal Neoplasms

The authors report a surgically treated patient with very unusual combination of a giant posterior fossa cyst in cerebellopontine area, Chiari I malformation and syringomyelia in cervico-thoracic area. Ventricles were not dilated. He complained weakness and clumsiness on the right upper extremity. His symptom was attributable to the syringomyelia of cervical spinal cord. The authors managed this patient by removing the arachnoid cyst and cystoperitoneal shunt on the assumption that this cyst has an influence on the formation of Chiari malformation and syringomyelia. After operation there was marked improvement in the motor power in the arm, and a follow-up MRI one month later showed a disappearance of syringomyelia. The authors believe that this very unusual condition is of interest in making the pathogenesis of syringomyelia clear.
Arachnoid* ; Arm ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Spinal Cord ; Syringomyelia* ; Upper Extremity

The authors present a case of unilateral agenesis of internal carotid artery associated with an aneurysm at the unusual site. A 22-years old female was admitted with sudden headache and nausea. She was alert on admission and no focal neurologic deficit was detected. Brain computed tomography(CT) scan showed subarachnoid hemorrhage. In the cerebral angiography, right internal carotid artery was absent and an aneurysm was arisen from the junction of the right middle cerebral artery and posterior communicating artery. The blood supply of the right anterior cerebral artery was maintained from the left internal carotid artery via the anterior commuicating artery. The territory of the right middle cerebral artery was supplied from the basilar artery through enlarged right posterior communicating artery. Direct clipping of the aneurismal neck was performed through right pterional approach. In the postoperative high resolution CT scan, there was no carotid canal in the right skull base suggesting agenesis of the right internal carotid artery.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Basilar Artery ; Brain ; Carotid Artery, Internal* ; Cerebral Angiography ; Female ; Headache ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Nausea ; Neck ; Neurologic Manifestations ; Skull Base ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed ; Young Adult