In a series of 20 young rats, three cortical lesions were made in each hemisphere. Two of these lesions were filled with avitene and gelfoam, while the third was left empty as a control. The animals were killed successively on weeks 1, 2, 4 and 8 after the operation. The results were as follows : 1) Although there was no difference in the type of tissue reactions, avitene was more rapid and profound than gelfoam in the process and degree of inflammatory reaction at the same periods. 2) Avitene biodegradaded more rapidly than gelfoam. 3) The extent of fibrosis and adhesion to the surrounding brain tissues were not grossly different between these two agents but more profound histopathologically in avitene at the same periods. With these results, we could conclude that the avitene was superior to the gelfoam as the hemostatic agent in neurosurgical area.
Animals ; Brain* ; Collagen ; Fibrosis ; Gelatin Sponge, Absorbable ; Rats

The outcome of acute subdural hematoma(SDH) had been generally unsatisfactory. The authors have analyzed the factors influencing the outcome of 70 patients who underwent acute SDH evacuation. Thirty five patients(50%) died and twenty two(31.4%) had a favorable outcome. A significant correlation was found between the outcome and the motor score at operation, the time interval to operation papillary response, type of operation and the Glasgow Coma Scale(GCS) at operation. But the patient's age, the mode of injury, the skull fracture, the degree of midline shift, the hematoma location, the type of brain swelling, the hematoma thickness, and the systolic blood pressure did not correlate with the outcome scale.
Blood Pressure ; Brain Edema ; Coma ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Skull Fractures

No abstract available.
Aneurysm* ; Arteries*

No abstract available.
Glioblastoma*

Mental deterioration and signs of cerebellar dysfunction developed 5 years after lateral ventricle shunting in 36-year-old hydrocephalic female patient. Fourth ventricle enlargement was seen on CT scan. Reevaluation of the cerebrospinal fluid pathways with metrizamide ventriculography showed isolated fourth ventricle with aqueductal stenosis. Shunting of the fourth ventricle with an Y-connector returned the patient to normal neurological status.
Adult ; Cerebellar Diseases ; Cerebrospinal Fluid ; Female ; Fourth Ventricle* ; Humans ; Hydrocephalus* ; Lateral Ventricles ; Metrizamide ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

Primary spinal glioblastoma multiforme is very rare, especially in childhood. 13-year-old boy was admitted to our neurosurgical department because of paraparesis, sensory loss below T10 and sphincter disturbance. Thoracic myelogram showed complete obstruction at T10 level and total laminectomy with partial removal of the intramedullary cord tumor mass was performed under the impression of spinal cord tumor. Postoperatively, his symptoms and signs unchanged. Pathological diagnosis was intramedullary glioblastoma multiforme involving thoracic cord.
Adolescent ; Child* ; Diagnosis ; Glioblastoma* ; Humans ; Laminectomy ; Male ; Paraparesis ; Spinal Cord Neoplasms

A series of 54 adult patients with intraventricular hemorrhage(IVH) diagnosed by computed tomography(CT) scan and treated with external ventricular drainage were reviewed. In cases who occurred poor drainage of bloody cerebrospinal fluid obstruction, irrigation with urokinase solution(6,000 U/ml) was tried. Hypertension and ruptured aneurysms accounted for 65% of the cases. Although most cases showed poor prognosis, we experienced dramatic improvements in four comatose patients who had fixed dilated pupils after spontaneous intraventricular hemorrhage with secondary acute hydrocephalus. We believe ventriculostomy to be effective in managing IVH especially in the early stage before cerebral herniation occurs. This procedure, accomplished by a convenient and relatively simple technique, led to evacuration of intraventricular blood, or the temporary or permanent cessation of progression of the hydrocephalic process, decrease in ventricular size, and normalization of ICP. However, a relatively high incidence of infection was problematic.
Adult ; Aneurysm, Ruptured ; Cerebrospinal Fluid ; Coma ; Drainage* ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Prognosis ; Pupil ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator ; Ventriculostomy

A case of peripheral T-cell lymphoma, large cell type(NIH) is reported. The literature review yielded a rare case report of a malignant lymphoma especially in the even more rare epidural site. The patient's symptoms were relieved by decompressive laminectomy and subtotal removal of mass and combined scheduled chemotherapy with radiotherapy. The pathological examination revealed malignant lymphoma, diffuse, large cell type(NIH) by H & E and immunologic marker analysis.
Biomarkers ; Drug Therapy ; Epidural Space* ; Laminectomy ; Lymphoma ; Lymphoma, T-Cell, Peripheral* ; Radiotherapy

Seventy-nine children and 433 adults were treated for epidural hematoma at our hospital during the last 10 years. The authors have tried to compare the various clinical characteristics and significant prognostic factors of epidural hematoma in children and adults. The result confirmed that children with traumatic epidural hematoma are less likely to have direct relationship with various causes of head trauma, associated extracranial injuries, skull fractures, temporal region hematomas, and immediate surgeries, but tend to have high preoperative GCS scores, prompt pupil responses, require only conservative treatments, have short durations of coma, and have good outcome. The cause of injury, amount of hematoma and focus of bleeding on surgery are found to be significant prognostic factors in adults, but are not in children. In cases with same scores of preoperative Glasgow Coma Scale(GCS) and durations of coma, very severe neurologic status(below 7 of GCS, both dilated fixed pupil) had a worse outcome in children as well as in adults without significant difference between them. The clinical index on preoperative GCS and pupillary response used when deciding the operation time were different in children compared to adults. Operations performed in delayed fashion in children under close observation for changes in GCS and pupillary response showed good outcome. However, adults require operations as early as possible because of possible rapid progression.
Adult* ; Child* ; Coma ; Craniocerebral Trauma ; Hematoma* ; Hemorrhage ; Humans ; Pupil ; Skull Fractures

This study is a retrospective clinical analysis of 134 cases of anterior communicating artery aneurysms surgically treated in the Department of Neurosurgery, Chungnam National University Hospital from January 1990 to December 1996. The results of analysis were summarized as follows; 1) Peak age incidence was in the sixth decade and male to female ratio was 1: 1.2, showing female predominancy. 2) There was no statistically significant relationship between direction of aneurysm and Fisher's grade, and occurrence of hydrocephalus, and also between the direction, size and shape of aneurysm and preoperative Hunt-Hess grade. 3) There was statistically significant relationship between the shape of aneurysm and angiographic vasospasm; there was high incidence of vasospasm in lobulated and oval shape of aneurysm. But there was no statistically significant relationship between the direction, size of aneurysm and angiographic vasospasm. 4) The correlations between outcome and preoperative Hunt-Hess grade, and occurrence of angiographic vasospasm, and temporary clipping were statistically significant; the outcome was good in cases of no vasospasm, temporay clipping and better preoperative Hunt-Hess grade. 5) The direction, shape and size of aneurysm, existence or not of abnormality in circle of willis, timing of surgery and operative procedure had no statistically significant relationship with outcome. 6) Postoperative complications were vasospasm and infarction(18.7%), brain edema, hydrocephalus, in order of frequency, and the mortality rate was 3%.
Aneurysm ; Brain Edema ; Chungcheongnam-do ; Circle of Willis ; Female ; Humans ; Hydrocephalus ; Incidence ; Intracranial Aneurysm* ; Male ; Mortality ; Neurosurgery ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative