The most important spinal disorders in childhood are malformations and mass lesions. High-resolution, real-time ultrasonography of the spine enables the differentation of intraand paraspinal structures in a significant way. This examination does not require sedation, does not use radiation, can be performed in the nursery or an incubator and is less expensive than computed tomography or magnetic resonance imaging. The sonographic appearence of the various kinds of spinal dysraphism is demonstrated and illustrated. Based on our preliminary experience spinal sonography appears to be useful in neonates and infants as the first imaging device for differentiation of cmplex malformation and as a screeing method for occult spinal dysraphism.
Humans ; Incubators ; Infant* ; Infant, Newborn* ; Magnetic Resonance Imaging ; Neural Tube Defects ; Nurseries ; Spinal Dysraphism* ; Spine ; Ultrasonography*

No abstract available.
Humans ; Uterine Cervical Neoplasms*

No abstract available.

The human motor cortex can be stimulated by electric shock or by brief intense magnetic fields. Transcranial magnetic stimulations(TCMS) cause only a trivial scalp sensation, compared with electrical stimulations. TCMS caused contralateral hand muscle responses and the resultant compound muscle action potentials or motor evoked potentials can be recorded. Central motor conduction time(CMCT) can be estimated by stimulating over the scalp and over the cervical area. In healthy subjects, the CMCT is 10.3+/-1.8ms(n=70 sides). Facilitation of responses in hand muscle is produced by voluntary contraction and the overall latency from scalp to hand muscle is shorter by 2.4ms(n=24 sides). TCMS is a non-invasive method to evaluate the central motor pathways and inaccessable portion of the peripheral pathways and so it has important implications not only for the diagnosis of disorders in the central motor pathways but also for evaluating treatments.
Action Potentials ; Diagnosis ; Efferent Pathways ; Electric Stimulation ; Evoked Potentials, Motor* ; Hand ; Humans ; Magnetic Fields ; Motor Cortex ; Scalp ; Sensation ; Shock ; Transcranial Magnetic Stimulation*

Two major factors, delayed hypoperfusion and membrane failure influence the sequelae of cerebral ischemic injury. Calcium ions play a major role in both pathophysiological mechanisms. Calcium channel blockers are a logical choice for investigation as possible therapeutic agents for the treatment of cerebral ischemia. Nimodipine, a dihydropyridine derivative, is one of the most potent calcium channel blocking agent with a selective action on the intracranial vessels. The present study was designed to test the effects of nimodipine on focal cerebral ischemia in rats. At 1,2 or 6 hours after occlusion of the middle cerebral artery(MCA), rats were treated with either nimodipine or saline. Neurological and pathological evaluation was performed at 24 hours after occlusion. Neurological outcome was better in nimodipine-treated rats and the size of the infarcted area was statistically smaller in rats treated with nimodipine 1,2 or 6 hours after occlusion(P<0.001, P<0.001, P<0.001, respectively) when compared with control rats(MCA occlusion only) or saline-treated rats. The results show that nimodipine improves neurological outcome and decreases the size of infarction after ischemic insult. The mechanism of action of nimodipine is not fully understood but nimodipine could influence cerebral postischemic changes by improving blood flow and/or by a direct action on neurons.
Animals ; Brain Ischemia* ; Calcium ; Calcium Channel Blockers ; Calcium Channels ; Infarction ; Ions ; Logic ; Membranes ; Neurons ; Nimodipine* ; Rats

Vestibular neurectomy is known as an effective procedure in the management of intractable peripheral vertigo from Meniere's disease and other episodic peripheral vertigo disorders. Various approaches have been developed for selectively sectioning the vestibular nerve, in order to preserve hearing and avoid facial nerve injury. Vestibular neurectomy is performed in two patients with Meniere's disease to control intractable episodic vertigo through retrolabyrinthine approach. Vertigo was improved with preserving their hearing. We report the surgical technique and advantages of retrolabyrinthine vestibular neurectomy in the treatment of vertigo.
Facial Nerve Injuries ; Hearing ; Humans ; Meniere Disease ; Vertigo* ; Vestibular Nerve

Since introduction of magnetic resonance imaging(MRI), six cases of multiple intracranial meningiomas without signs of neurofibromatosis were found among the forty eight cases of meningiomas. The incidence of multiple intracranial meningiomas in our series was 12.5% of all meningiomas. We analyzed six cases of multiple intracranial meningiomas that were evaluated by MRI. Two tumors were found in five patients, whereas the other one patient had more than ten tumors at different sites. The tendency of unihemispheric distribution was not seen and two cases had bilaterally located tumors and other two cases had tumors above and below the tentorium without tentorial involvement. Relatively high occurrence of meningioma in posterior fossa was observed. Half of the six cases had posterior fossa tumors and 6 tumors(28.6%) of the total 21 tumors were located in the posterior fossa. All the cases were female. Mean age on admission was 61.3 years, ranged from 44 to 77 years. All six patients were treated surgically and three of them underwent multiple staged operations. Histologically, of the 12 tumors removed, 5 were transitional, 4 were fibroblastic, 3 were meningothelial. The histological subtypes of tumors in each case were different in two cases, but identical in other three cases. The surgical results, although the follow-up periods(ranged 3 months to 2.5 years) were not long enough in some cases, were favorable.
Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Incidence ; Infratentorial Neoplasms ; Magnetic Resonance Imaging ; Meningioma* ; Neurofibromatoses

To clarify possible causes, pathogenesis, and appropriate prevention method of remote intracerebral hemorrhage (RICH), we analyzed the clinical findings and the possible predisposing factors of six cases who developed RICH among the 206 surgical series of cerebral aneurysm operated in our hospital over recent 5-year period. The locations of aneurysm were anterior communicating artery in three cases and internal carotid artery in three other cases. The sites of RICH were dependent regions considering the operative position in five of six cases, con-tralateral cerebellum in three cases, bilateral cerebellum in one case, and contralateral occipital area in one case. Peripheral low density around the RICH, suggesting hemorrhagic infarction, was observed on computed tomography in four cases. No patient had preoperative hypertension; however, significant elevation of blood pressure was observed intraoperatively or postoperatively in three cases. The factors which could have induced brain shift(large amount of removed or drained cerebrospinal fluid, large amount of infused mannitol, too low PaCO2) were observed in all cases except one case. There was no case with coagulopathy or underlying occult lesion. Two patients in whom detection of RICH was delayed showed poor outcomes. The possible underlying mechanisms involved in such complication seem to be shifting of brain due to sudden decreased intracranial pressure and excessive removal of cerebrospinal fluid, and subsequent injury of blood vessels such as compression or breakdown of vein. Moreover, the sudden elevation of blood pressure may have played a role as contributing factor. Therefore, consideration should be given to the maintenance of an adequate volume of intracranial cerebrospinal fluid and the appropriate blood pressure to prevent this complication. Early detection and immediate treatment with awareness of the possibility of this complication should be borne in mind when treating these patients to prevent such complications and to obtain good results.
Aneurysm* ; Arteries ; Blood Pressure ; Blood Vessels ; Brain ; Carotid Artery, Internal ; Causality ; Cerebellum ; Cerebral Hemorrhage* ; Cerebrospinal Fluid ; Hemorrhage ; Humans ; Hypertension ; Infarction ; Intracranial Aneurysm ; Intracranial Pressure ; Mannitol ; Veins

We evaluate the detection of cerebral aneurysms with 3-dimensional(3D) computed tomographic angiography(CTA) and compare the results with those of magnetic resonance angiography(MRA) and conventional cerebral angiography(CCA). Ten patients with 12 cerebral aneurysms were studied with spiral CT in conjuction with CCA and MRA. All aneurysms(3-20mm in diameter) were seen in CTA, MRA and CCA except 1 aneurysm(3mm in diameter) in MRA. CTA demonstrated neck, shape, direction of the aneurysm, and adjacent vascular and bony structures well. Of 12 aneurysms, 4 were seen equally with CCA and MRA, 4 were seen better with CCA owing to flow-related or motion artifact in MRA, and 4 were seen better with MRA. CTA was considered to be superior to CCA and MRA in demonstrating calcification and thrombosis in the aneurysm. 3D CTA with spiral CT is a rapid non-invasive method of visualizing the cerebral aneurysms and is comparable with MRA in demonstrating the aneurysms. We think 3D CTA can be a screening tool for use in the patients with suspected cerebral aneurysms and will be of a value in surgical planning for patients with complex cerebral aneurysms, in demonstrating the anatomy o the aneurysms and surrounding structures.
Aneurysm ; Angiography* ; Artifacts ; Humans ; Intracranial Aneurysm* ; Mass Screening ; Neck ; Thrombosis ; Tomography, Spiral Computed*

No abstract available.