Recently microvascular decompressive approach to the hyperactive type of low cranial nerves dysfunction has been popular procedures in neurosurgical operation. The neurosurgical teams at St. Paul's Hospital, Catholic Medical College operated on 11 patients employing this technique for 2 years. The patients were diagnosed as 9 patients with hemifacial spasm, one with trigeminal neuralgia, and one with glossopharyngeal neuralgia. The results were very encouraging of the 10 patients. But remaining one patient was failed with therapy. The authors would like to share with you their experiences employing the microvascular surgical technique, the results & the prognosis.
Cranial Nerves* ; Glossopharyngeal Nerve Diseases ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery ; Prognosis ; Trigeminal Neuralgia

Since 1967 the STA-MCA anastomosis has been popular procedure in neurosurgical operation. The meurosurgical teams at St. Paul's Hospital, Catholic Medical College, recently operated on 8 patients employing 9 times of this technique. The patients were diagnosed as four patients with complete stroke, one with traumatic middle cerebral stenosis, two with moyamoya disease, and one with huge aneurysm at intracavernous portion of ICA. The results were very encouraging of the 8 patients, 7 had favorably improved clinically, and proved by follow-up cerebral angiographies, CT Scanning, EEG or MEP recordings. The remaining one patient had intracerebral and intracerebellar hematoma, two months later after discharge, thus the result was poor. The authors would like to share with you their experiences employing the STA-MCA anastomosis technique, indications the results and the prognosis.
Aneurysm ; Cerebral Angiography ; Constriction, Pathologic ; Electroencephalography ; Follow-Up Studies ; Hematoma ; Humans ; Moyamoya Disease ; Prognosis ; Stroke ; Tomography, X-Ray Computed

20 patients who were diagnosis neurologic diseases were treated deproteinized extract Actigen for 1-2 weeks. Comparing before and after treatment, clinical state, EEG, MEP, CT Scan and CBF have been improved to postmedicated state. According to above findings, it is indirectly confirmed that Actigen is improve brain motabolism, cerebral blood flow and peripheral blood flow. During medication there are no side effects and complications.
Brain ; Diagnosis ; Electroencephalography ; Humans ; Tomography, X-Ray Computed

Our experienced is based on a series of 5 cases of dystonia who underwent stereotaxic thalamotomy. The immediate good results have been obtained by thalamotomy. We have been able to estimate secondary deterioration on long term results in patients examined 2-5 years postoperatively. Some deterioration is noted patients operated on for athetosis over the age of 20. A pallido-subthalamic lesion is efficient at the beginning of the disease course since it improves motor performance and thereby helps possiblities of intellectual acquirement. Bilateral lesions have done after improved. I.Q. Effects of this treatment specially on spasticity must be discussed among other types of surgery.
Athetosis ; Dystonia* ; Humans ; Muscle Spasticity

Recently, brainstem auditory evoked potential is very important for the evaluation of functions of the 8th nerve & brainstem. Especially, it appears that waves I, III, and V primarily represent volume- conducted electrical activity from the acoustic nerve, pons and midbrain, respectively, and that latencies between these three potentials indirectly reflect neural conduction in the corresponding segments of the central auditory pathway. For example, wave I to wave III interpeak latency(I-III IPL) is a measure of conduction in the more caudal segment of the brainstem auditory pathway-acoustic nerve and potomedullary portion-while the III-V IPL is a measure of conduction in the more rostral pontine and midbrain portions of the pathway. This study was undertaken to identify the normal measurements of the waves I, III and V and I-III IPL, III-V IPL in order to for provide basic data for clinical use in diagnosis, monitering in operation and management of patients with brainstem lesions. The literature is reviewed and results compared to the current study.
Auditory Pathways ; Brain Stem* ; Cochlear Nerve ; Diagnosis ; Evoked Potentials, Auditory, Brain Stem* ; Humans ; Mesencephalon ; Neural Conduction ; Pons

Recently for 2 years, 24 cases of microabscesses have been experienced and treated at St. Paul's Hospital, Catholic Medical College. Investigations had been made & analyzed to characteristic clinical symptoms and signs, typical CT findings and therapeutic management and prognosis. The CT scan is most choice of and early and accurate diagnosis and has made feasible the follow up of the evolution and eventual resolution of abscess lesions. In the authors opinion and experience, when microabscess is diagnosed at it early stage, it could be treated in 2week with the administration of antibiotics & not need any other surgical interventions.
Abscess ; Anti-Bacterial Agents ; Diagnosis* ; Follow-Up Studies ; Prognosis ; Tomography, X-Ray Computed

BACKGROUND: Carotid endarterectomy has been proven to be beneficial for the prevention of strokes in both symptomatic and asymptomatic patients with significant carotid stenosis. Even if there is no consensus as to the most appropriate monitoring method for detecting cerebral ischemia during carotid endarterectomy, electroencephalography (EEG) and/or somatosensory evoked potential (SSEP) has been extensively used to evaluate cerebral functions. We estimated the efficacy of EEG and SSEP for detecting cerebral ischemia during carotid endarterectomy in conscious patients. METHODS: One or both of 16-channel EEG and SSEP monitoring were performed in 103 patients scheduled for carotid endarterectomy under cervical plexus block. We estimated the sensitivity and specificity of EEG and SSEP for detecting cerebral ischemia expressed by altered consciousness and shunt insertion. RESULTS: During carotid clamp in 74 cases studied, significant EEG changes were noted in 5 of the 16 patients who had cerebral ischemia, however 11 patients had no EEG changes despite cerebral ischemia. During carotid clamp in 84 cases studied, significant SSEP changes were noted in 7 of the 19 patients who had cerebral ischemia, however 12 patients had no SSEP changes despite cerebral ischemia. The sensitivity and specificity for detecting cerebral ischemia were 31% and 86% for EEG and 37% and 95% for SSEP, respectively. CONCLUSIONS: We conclude that EEG and SSEP monitoring during carotid endarterectmy under regional anesthesia is not a sensitive method for detecting cerebral ischemia.
Anesthesia, Conduction* ; Brain Ischemia* ; Carotid Stenosis ; Cervical Plexus ; Consciousness ; Consensus ; Electroencephalography* ; Endarterectomy, Carotid* ; Evoked Potentials, Somatosensory* ; Humans ; Sensitivity and Specificity ; Stroke

Pain is one of the most complex human experience and the commonest cause of stress and the most frequent symptom that makes people seek medical help. The mechanism of its production and perception are poor understood. Since the past, various procedures have been tried to control or relieve pain. It had been observed that acupuncture stimulation has been effective in the relief of painful conditions. However, up to the present there had been no definite proof that acupuncture treatment has cured any pathological condition. Work is at present proceeding to make this a practical possibility. Recently, in modern medical science, several experiments are in progress and in some cases, cure had been obtained but until these studies are completed and proved to be effective, it is impossible at the present stage to evaluate whether these occasional cures are statistically significant. So, we launched studies and observations at our pain clinic at St. Paul's Hospital employing the "Somatosensory evoked Potential",(SEP) responses for chronic pain patient to relieve pain with acupuncture. The median and sural nerve of patients with chronic pain were stimulated and recorded using the SEP. Recordings were made before and after the acupuncture therapy was initiated. We analyzed the recorded SEP responses to see if ther are any physiological effects of the acupuncture therapy in patients with chronic pain. Findings: The important changes of the SEP responses recorded during acupuncture therapy in patients with chronic pain were the suppression of the amplitude of the SEP waves and delayed latency of the responses, similar to those manifested by patients, who are under morphine therapy. Then, naloxone an antagonist to morphine was administered. The effects were the same, that is the SEP responses were reversed in both the patients under morphine therapy and those under acupuncture therapy. So, we postulated that, since the meridian system is closely connected to the posterior column of the spinal cord conducting system, which is concerned in the somatosensory conducting system, peripheral stimulation by acupuncture may bring about the so called "pain suppression of descending system", which is closely connected to the meridian system of acupuncture. Though it is quite early to draw positive and definite conclusions, the results are very encouraging. More cases and further observations are advocated.
Acupuncture Therapy ; Acupuncture* ; Chronic Pain* ; Humans ; Morphine ; Naloxone ; Pain Clinics ; Spinal Cord ; Sural Nerve

In 1960, Tskimoto first mentioned the spinal cord lesions caused by compression of posterior longitudinal ligament(OPLL), thereafter, hundreds of cases have been reported. There are, however, some controversial opinions concerning the mechanisms of the formation and development of OPLL and questions why a special ligaments, posterior longitudinal ligaments can be calcified, enlarged and compress the cord. And also, there have been many reports describing various surgical method that could manage OPLL, but the OPLL still has many problems in surgical treatment. Recently, the neurosurgical team at the St. Pauls Hospital, encountered and operated on 7 cases of OPLL at cervical area. After all dignostic tests and examinations were done, the morphological classification, combined other lesions and pathological status were verified and analyzed during treatment. The different surgical methods were taken case by case. The authors would like to share with you our experiences of the surgical methods, indications of operation the results and the progrosis of treatment in OPLL.
Classification ; Ligaments ; Longitudinal Ligaments ; Ossification of Posterior Longitudinal Ligament* ; Spinal Cord

No abstract available.
Humans ; Infant, Newborn* ; Vitamin K Deficiency* ; Vitamin K* ; Vitamins*