No abstract available.
Animals* ; Brain* ; Hypothermia* ; Models, Animal*

Upward migration of the peritoneal catheter of a subgaleo-peritoneal (SP) shunt and coiling into the subgaleal space is an extremely rare complication of a SP shunt. A 32-year-old male patient visited our hospital presenting with a large skull defect due to a prior craniectomy performed elsewhere. The patient underwent a cranioplasty with methylmetacrylate, but subsequently developed progressive pseudomeningocele and subgaleal cerebrospinal fluid (CSF) collection. The patient underwent CSF diversion via a SP shunt. After SP shunting, the pseudomeningocele disappeared completely. Six months later, the patient presented with progressive scalp swelling. Skull X-ray showed migration and coiling of the distal catheter of the SP shunt. The patient was treated by removing the entire shunt catheter and the dura was covered with a subgaleal flap. We would like to report our experience with a very rare complication of subgaleo-peritoneal shunting.
Adult ; Catheters* ; Cerebrospinal Fluid ; Humans ; Male ; Scalp ; Skull

The clay-shoveler's fracture is an isolated avulsion fracture of the lower cervical or upper thoracic spinous process. Among them, multiple spinous process fractures are very rare. We present 34-year-old male patient who have multiple spinous process fractures with twelve contiguous levels of cervico-thoracic spine (from C4 to T8) after motorcycle accident. This case is multiple isolated spinous process fractures with good clinical outcome.
Adult ; Humans ; Male ; Motorcycles ; Spine*

Low-grade myofibroblastic sarcoma (LGMS) is a rare sarcoma with myofibroblastic differentiation. LGMS has a propensity for local recurrence and is associated with a low risk of metastatic spread. A 26-year-old man presented with a 12-month history of a slow growing palpable hard mass in the right parietal scalp. Enhanced CT scan of head showed a 3x4 cm sized well-defined and heterogeneously enhancing scalp mass. The patient underwent excision of the tumor. The histological and immunohistochemical features were consistent with a LGMS. We performed re-operation for remnant tumor removal after diagnosis. After 14 months of surgery, the patient was well-being state.
Adult ; Diagnosis ; Head ; Humans ; Myofibroblasts* ; Rabeprazole ; Recurrence ; Sarcoma* ; Scalp* ; Tomography, X-Ray Computed

Spontaneous regression of cervical disc herniation is a rare, and such reports are few. A 39 year-old woman complained of severe neck pain associated with tingling and numbness of right upper extremity. The MRI of the cervical spine revealed a posterior disc extrusion at the C4-C5 level in the right para-central location. The patient was treated with conservative management without any surgical treatment. The patient's symptoms were significant improvement. After two years later, we performed follow-up cervical MRI that revealed significant spontaneous regression of the C4-C5 intervertebral disc extrusion.
Female ; Follow-Up Studies ; Humans ; Hypesthesia ; Intervertebral Disc ; Magnetic Resonance Imaging ; Neck Pain ; Spine ; Upper Extremity

Chemotherapy offers palliative treatment to patient with advanced nonresectable hepatoma. The usefulness of systemic chemotherapy is limited becaused of serious side reaction and low concentration of drug at tumor. Butthis problem may be overcome by intraarterial infusion. Nonsurgical percutaneous hepatic arteiral catheterizationwas done in 21 patients with primary hepatoma, and infusion chemotherapy was done in 19 patients who were successful in catherization. The results were as follows; 1. Selective catheterization of hepatic artery proper,common hepatic artery, and celiac artery were seccessful in 4, 9 and 4 patients, respectively. The success rate ofselective catheterization is 80.9% including celiac artery among 21 patients with hepatoma. 2. Simple catherization method was applied in 14 patients, and catheter exchange and Loop methods were applied in 2 and 1patient respectively. 3. Complications related to catheterization, such as infection and bleeding on punctured site, intimal injury and dislodgement of catheter were not serious. 4. Drugs were well tolerated without serioustoxicity or complication. 5. 3 patients showed objective response and median survival time of treated patients is 2.5 months.
Carcinoma, Hepatocellular ; Catheterization ; Catheters ; Celiac Artery ; Drug Therapy ; Hemorrhage ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Methods ; Palliative Care

The authors describe a case of aneurysmal bone cyst of a thoracic vertebra. A 34-year-old woman presented with posterior neck and upper back pain. Radiological examination demonstrated an aneurysmal bone cyst involving the posterior elements of the second thoracic vertebra. The spinal cord was compressed severely also. Satisfactory results were obtained after complete resection of the lesion.
Adult ; Aneurysm* ; Back Pain ; Bone Cysts* ; Female ; Humans ; Neck ; Spinal Cord ; Spine*

OBJECTIVE: The aim of this study was to evaluate the microanatomy and histological features of the central myelin in the root exit zone of facial nerve. METHODS: Forty facial nerves with brain stem were obtained from 20 formalin fixed cadavers. Among them 17 facial nerves were ruined during preparation and 23 root entry zone (REZ) of facial nerves could be examined. The length of medial REZ, from detach point of facial nerve at the brain stem to transitional area, and the thickness of glial membrane of central myelin was measured. We cut brain stem along the facial nerve and made a tissue block of facial nerve REZ. Each tissue block was embedded with paraffin and serially sectioned. Slices were stained with hematoxylin and eosin (H&E), periodic acid-Schiff, and glial fibrillary acid protein. Microscopy was used to measure the extent of central myelin and thickness of outer glial membrane of central myelin. Thickness of glial membrane was examined at two different points, the thickest area of proximal and distal REZ. RESULTS: Special stain with PAS and GFAP could be differentiated the central and peripheral myelin of facial nerve. The length of medial REZ was mean 2.6 mm (1.6-3.5 mm). The glial limiting membrane of brain stem is continued to the end of central myelin. We called it glial sheath of REZ. The thickness of glial sheath was mean 66.5 microm (40-110 microm) at proximal REZ and 7.4 microm (5-10 microm) at distal REZ. CONCLUSION: Medial REZ of facial nerve is mean 2.6 mm in length and covered by glial sheath continued from glial limiting membrane of brain stem. Glial sheath of central myelin tends to become thin toward transitional zone.
Brain Stem ; Cadaver ; Eosine Yellowish-(YS) ; Facial Nerve* ; Formaldehyde ; Glial Fibrillary Acidic Protein ; Hematoxylin ; Membranes ; Microscopy ; Myelin Sheath* ; Paraffin

The abducens nerve usually travels from the brainstem to the lateral rectus muscle as a single trunk. However, it has been reported that this nerve could split into branches occasionally. We attempted to show the aberrant course of abducens nerve in a specimen with unilateral duplicated abducens nerve and review relevant literatures. The micro-dissections were performed in a head specimen injected with colored latex under the microscope. The abducens nerve was duplicated unilaterally. This nerve emerged from the pontomedullary sulcus as a single trunk and splitted into two branches in the prepontine cistern. These two separate branches were piercing the cerebral dura of the petroclival region respectively. The slender lower branch passed between the petroclinoid and petrosphenoid ligaments and the thick lower one passed under the petrosphenoid ligament. These two branches united just lateral to the ascending segment of internal carotid artery in the cavernous sinus. The fact that there are several types of aberrant abducens nerve is helpful to perform numerous neurosurgical procedures in the petroclival region and cavernous sinus without inadvertent neurovascular injuries
Abducens Nerve ; Brain Stem ; Cadaver ; Carotid Artery, Internal ; Cavernous Sinus ; Head ; Latex ; Ligaments ; Muscles ; Neurosurgical Procedures

OBJECTIVE: There has been inconsistency about definition of the temporal stem despite of several descriptions demonstrating its microanatomy using fiber dissection and/or diffusion tensor tractography. This study was designed to clarify three dimensional configurations of the temporal stem. METHODS: The fronto-temporal regions of several formalin-fixed human cerebral hemispheres were dissected under an operating microscope using the fiber dissection technique. The consecutive coronal cuts of the dissected specimens were made to define the relationships of white matter tracts comprising the temporal stem and the subcortical gray matters (thalamus, caudate nucleus, amygdala) with inferior limiting (circular) sulcus of insula. RESULTS: The inferior limiting sulcus of insula, limen insulae, medial sylvian groove, and caudate nucleus/amygdala were more appropriate anatomical structures than the roof/dorso-lateral wall of the temporal horn and lateral geniculate body which were used to describe previously for delineating the temporal stem. The particular space located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus could be documented. This space included the extreme capsule, uncinate fasciculus, inferior occipito-frontal fasciculus, anterior commissure, ansa peduncularis, and inferior thalamic peduncle including optic radiations, whereas the stria terminalis, cingulum, fimbria, and inferior longitudinal fiber of the temporal lobe were not passing through this space. Also, this continued posteriorly along the caudate nucleus and limiting sulcus of the insula. CONCLUSION: The temporal stem is white matter fibers passing through a particular space of the temporal lobe located inside the line connecting the inferior limiting sulcus of insula, limen insulae, medial sylvian groove/amygdala, and tail of caudate nucleus. The three dimensional configurations of the temporal stem are expected to give the very useful anatomical and surgical insights in the temporal lobe.
Animals ; Caudate Nucleus ; Cerebrum ; Diffusion ; Geniculate Bodies ; Horns ; Humans ; Temporal Lobe