No abstract available.
Glioblastoma*

Myxoma is a rare nonepithelial neoplasm of the larynx frequently misdiagnosed as a large vocal polyp due to its slow-growing nature. Myxoma is a benign but often infiltrating neoplasm of uncertain mesenchymal cell origin, characterized by irregular round, spindle or stellate cells within a matrix containing abundant mucoid material, scant vascularity and a variable meshwork of reticulum and collagen. We report one case of myxoma with life-threatening dyspnea requiring tracheotomy.
Case Report ; Critical Illness ; Human ; Laryngeal Neoplasms/complications* ; Male ; Middle Age ; Myxoma/complications* ; Respiration Disorders/surgery ; Respiration Disorders/etiology* ; Tracheotomy

Primary oligodendroglioma of the spinal cord is very rare tumor. On searching through the literature from 1931, we could find only about 46 cases, and this tumor is almost absent in Korea on the review of the literature. The authors present a case of 8-year-old female patient with the symptoms of paraparesis, urination difficulty, diffuse back pain and hypesthesia in both lower extremities. Spine MRI revealed the mass at the level of T3-T12, with combined nature of cystic and solid portion. Decompressive laminectomy and partial mass removal was performed, and then adjunctive radiotherapy and chemotherapy was done. The patient was improved after operation with radiotherapy and chemotherapy, so she walks alone and has no voiding difficulty at present(postoperative about 20 months) .
Back Pain ; Child ; Drug Therapy ; Female ; Humans ; Hypesthesia ; Korea ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Oligodendroglioma* ; Paraparesis ; Radiotherapy ; Spinal Cord* ; Spine ; Urination

The mortality and morbidity of the intraventricular hemorrhage(IVH) has been decreased since the introduction of external ventricular drainage(EVD) and direct intraventricular infusion of urokinase as an effective therapeutic method. In 1989, we already reported a series of 54 cases of IVH treated with simple EVD or EVD with urokinase irrigation in a few cases. Authors analyzed again a series of 50 cases of IVH treated by EVD with direct intraventricular urokinase irrigation after the pervious report. The mortality rate was 55.5% in former occasion, however 18% in this study and the complications were considerably low. We experienced again that the EVD with urokinase irrigation is an effective method and convenient, simple technique in the management of IVH even though there is no ICP monitoring. So we prefer EVD with urokinase irrigation therapy in managing the IVH even if the patient is moribund state.
Drainage* ; Hemorrhage* ; Humans ; Infusions, Intraventricular ; Mortality ; Urokinase-Type Plasminogen Activator*

OBJECTIVE: The objective of this study was to analyze the clinical course of mild head injury patients and to investigate the risk and prognostic factors of delayed deterioration. METHODS: We retrospectively studied 366 consecutive patients with Glasgow Coma Scale scores ranging from 13 to 15 who were admitted to the neurosugery department from January 1995 to December 1997. RESULTS: Among 51(13.9%) patients with delayed deterioration, 13(25.5%) died and 36(70.6%) patients had favorable outcomes. Statistically correlated risk factors of delayed deterioration were: old age, drowsiness or speech disturbance, a low GCS score, abnormal laboratory findings including coagulopathy, electrolyte imbalance, hyperglycemia, and presence of subdural hematoma in initial brain CT. Twentyeight(54.9%) patients with delayed deterioration underwent neurosurgical intervention and 229(72.1%) patients without delayed deterioration were treated conservatively. Only sex, age and the GCS score on admission or deterioration were statistically correlated with prognosis of delayed deteriorated patients. CONCLUSION: Delayed deterioration following mild head injury may need an urgent operation, or lead to serious complication or disability. Therefore, physicians treating these patients must aware of the risk factors and prognostic factors of delayed deterioration to prevent more serious sequelae or to make an early diagnosis allowing for proper treatment. We also recommend special caution in patients with the abovementioned risk factors to ensure a even better prognosis for patients with mild head injury.
Brain ; Craniocerebral Trauma* ; Early Diagnosis ; Glasgow Coma Scale ; Head* ; Hematoma, Subdural ; Humans ; Hyperglycemia ; Prognosis ; Retrospective Studies ; Risk Factors* ; Sleep Stages

No abstract available.
Hepatitis C* ; Interferons* ; Polymyositis*

The authors report a case of falx meningioma which was first diagnosed with apopletic symptom due to intratumoral hemorrhage. A 72-year-old man was admitted to our hospital with a sudden deterioration of his level of consciousnesss down to a deep drowsiness, generalized seizure, and right hemiparesis. Radiological examinations, including brain CT(Computed Tomographic) scan and MRI(Magnetic Resonance Image) revealed a giant falx meningioma with intratumoral hemorrhage. During the operation the authors found a massive hemorrhage inside the tumor. Histologically, the tumor was meningotheliomatous meningioma and showed a hemorrhagic area with diffuse hemosiderin deposition. The authors also review the relevant literature and discuss the possible mechanism of hemorrhage in the meningioma.
Aged ; Brain ; Brain Neoplasms ; Hemorrhage* ; Hemosiderin ; Humans ; Meningioma* ; Paresis ; Seizures ; Sleep Stages

OBJECTIVE: Oculo-cerebral syndrome is an intraocular hemorrhage and related ocular symptoms caused by sudden increase in intracranial pressure. The authors investigate the clinical significance of oculo-cerebral syndrome after spontaneous subarachnoid hemorrhage and analyze the characteristics of aneurysms which caused intraocular hemorrhage in order to help the treatment of intracranial aneurysm patients. METHODS: From January 2000 to May 2001, 103 patients were admitted to our hospital and diagnosed as spontaneous subarachnoid hemorrhage. We divided the patients into two groups:81 patients without intraocular hemorrhage(non-IOH) and 22 patients with intraocular hemorrhage(IOH). The authors prospectively analyzed the prognostic factors of spontaneous subarachnoid hemorrhage by chi-square test. RESULTS: The initial neurologic state was poor in the IOH group(p<0.001). The Fisher's grade was higher than non-IOH group(p<0.001), and intracranial hemorrhage was great in the IOH group(p<0.001). The prognosis was poor in the IOH group at discharge(p<0.001). The most common rupture site in the IOH group was the anterior communicating artery(p<0.001). Frontal intracerebral hematoma was specific to intraocular hemorrhage(p<0.05). There was a positive correlation between intraocular hemorrhage and rebleeding(p<0.001). CONCLUSION: The authors suggest that oculo-cerebral syndrome is clinically significant with a poor prognostic factor in patients with spontaneous subarachnoid hemorrhage.
Aneurysm ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Intracranial Pressure ; Prognosis ; Prospective Studies ; Rupture ; Subarachnoid Hemorrhage*

OBJECTIVE: The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). METHODS: A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. RESULTS: In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement: initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. CONCLUSION: Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.
Blood Pressure ; Brain ; Cerebral Hemorrhage* ; Cerebral Infarction ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Mortality ; Neurosurgery ; Prognosis ; Prothrombin ; Risk Factors* ; Serum Albumin ; Sodium ; Thromboplastin ; Tomography, X-Ray Computed

Aneurysmal bone cysts are uncommon bony lesions that usually occur in the metaphyseal region of the long bones in adolescents. Approximately 20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region. These lesions commonly arise from the posterior elements(ex, spinous process, laminae) and occasionally invade the pedicles and the vertebral body. We experienced a case of aneurysmal bone cyst on the entire 5th cervical vertebra(vertebral body, pedicle, laminae, spinous process and transverse process). We perfomed C5 corpectomy and fusion with ORION plate and autologous bone graft on C4-5-6, and C5 total laminectomy with gross total mass removal and posterior fusion with Heid lateral plate system and autologous bone graft and wiring on C4-5-6. The patient showed good recovery. We report a rare case of aneurysmal bone cyst on the whole involved 5th cervical vertebra
Adolescent ; Aneurysm* ; Bone Cysts* ; Bone Cysts, Aneurysmal ; Humans ; Laminectomy ; Lumbosacral Region ; Spine* ; Transplants