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*

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

No abstract available.
Humans ; Uterine Cervical Neoplasms*

No abstract available.

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

A case of metastatic alveolar soft part sarcoma is presented with clincal, pathological and radiological features. Alveolar soft part sarcoma is a rare soft-tissue neoplasm that is malignant and invariably fatal. It was first described and named by Christopherson, et al. in 1952. Since 1952 numerous examples of this tumor have been reported and have been studied with the electron microscope, but there is still considerable uncertainty as to the exact histogenesis of the tumor. Most cases occur in young females involving the lower extrimities especially in the right side. The most initial presenting symptom is a slowgrowing painless mass and the principal metastatic sites are the lungs, followed by the brain and skeleton. Cerebral metastasis, in fact, may be the first manifestation of the disease. Treatment is radical surgical excision but radiotherapy and chemotherapy are less effective. We present the reported case of metastatic alveolar soft pat sarcoma with electron microscopic findings.
Brain ; Drug Therapy ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Skeleton ; Uncertainty

OBJECTIVE: The purposes of this study are to compare imaging features with operative findings and to determine significance of imaging studies for early detection of craniosynostosis(CS). METHODS: Plain radiograph of skull and three-dimensional(3D) CT reconstruction were analyzed in 10 consecutive patients with CS to assess the presence and the extent of synostosis. The radiological findings were investigated and compared with operative findings. RESULTS: The locations of lesion were coronal suture in 6, sagittal suture in 3 and multiple sutures in one patient, and the age ranged 1 to 53 months(mean age: 17.4 months). Reconstructive procedures with or without advancement of supraorbital rim were performed in coronal CS patients and PI-procedures or synostectomy were done in sagittal CS patients. Radi-ological abnormalities such as sutural indistinctness or sclerosis, bony ridge, bossing and other bony deformities were nearly consistent with surgical findings. CONCLUSION: The interpretation of imaging study are very important for early detection of craniosynostosis, especially, the plain radiographs of skull. Also 3D CT imaging is helpful in diagnosis and surgical planing of craniosynostosis. There are no significant differences between imaging features and operative findings in CS patients.
Congenital Abnormalities ; Craniosynostoses* ; Diagnosis ; Humans ; Sclerosis ; Skull ; Sutures ; Synostosis