The use of steroids has long been reported many side effects. Steroid-induced mental disorder is one of many complications associated with corticosteroid therapy. Steroid psychosis is not common disease but it may be more popular due to high steroid therapy such as pulse therapy or high dose steroid therapy. Euphoria, irritability, insomnia, and hallucination are predominating symptoms. The dosage, duration of the treatment may not be correlated with the time of the onset, duration, severity, or type of mental disturbances, but the risk of developing psychosis is increased to the high dose of steroid. It is usually reversible on dose reduction or discontinuation of the drug.
Euphoria ; Hallucinations ; Mental Disorders ; Psychotic Disorders* ; Sleep Initiation and Maintenance Disorders ; Steroids

No abstract available.

Postoperative brain edema and/or hemorrhage is a serious problem especially arteriovenous malformations(AVM) in an eloquent area. It has ben a neurosurgical dilemma whether to surgically remove an unruptured AVM in an eloquent area. It is necessary to define the anatomic location, understand the hemodynamics, vasoreactivity of the adjacent brain parenchyma for safe removal of an AVM in an eloquent area. A successful removal of an AVM at an eloquent motor area without neurological deficit was made. We report method of localizating, angiographic anatomy, mechanism of possible hemodynamic insult related to operation.
Arteriovenous Malformations* ; Brain ; Brain Edema ; Hemodynamics ; Hemorrhage

The authors present a case of cerebrellar venous hemorrhagic infarction which developed after removal of a cerebellopontine angle meningioma. The clinical course was rapidly fatal inspite of an aggressive management including surgical decompression beginning from 30 minutes after complete recovery from anesthesia. The brain C-T scan showed flame-shaped subcortical hemorrhage which is known to be a typical finding of a venous hemorrhagic infarction. The causes may be two fold:One is the cautrization and resection of multiple petrosal veins which were inevitable because of a bleeding from the vein and the other is the venous congestion caused by the compression of an internal jugular vein in oblique supine position. Reminding of one or oth of the above possibilities whenever we are performing surgery around the superior petrosal vein may help us to prevent the rare but fatal complication of this kind.
Anesthesia ; Brain ; Cerebellopontine Angle* ; Decompression, Surgical ; Hemorrhage ; Hyperemia ; Infarction* ; Jugular Veins ; Meningioma ; Supine Position ; Veins

The growth or rebleeding of the spontaneous ICH is catastrophic so that prevention of them is critical in management. We reviewed 233 cases of spontaneous ICH from Jan. 1990 to Dec. 1994 to evaluate the factors associated with the hematoma enlargement. The relationship among the admission time from hematoma onset, the systolic BP at admission, hemostatic parameter, liver dysfunction with rebleeding incidence were assessed. Also, hematoma shape, density, site, volume, and operation tiem from hematoma onset were evaluated. Hematoma growth was oserved at 26 patients(11.6%). Incidence of rebleeding was significantly associated in patients with shorter admission time from hematoma onset, high systoic BP at admission, inhomogenous, irregular-shaped hematoma at CT and liver dysfunction. The incidence of hematoma growth was higher in the early operation group but there was no significant relationship in statistic analysis. Patients admitted within 6 hours of hematoma onset, with irregular-shaped, inhomogenous hematoma on CT, and liver dysfunction should be observed closely for the enlargement of hematoma. The operation time might be delayed at least 6 hours after hematoma onset.
Cerebral Hemorrhage* ; Hematoma ; Humans ; Incidence ; Liver Diseases

OBJECTIVES: The aims of this study were to examine validity and reliability of the Korean version of the Social Function Questionnaire (SFQ) and evaluated social function with SFQ in patients with personality disorder. METHODS: The SFQ was administered to 186 psychiatric patients (155 patients with personality disorder and 31 patients without personality disorder), and 22 healthy men were recruited to examine the test-retest reliability of SFQ. The severity of personality disorders was determined using the proposed the International Classification of Diseases (ICD)-11th revision (ICD-11) personality disorders. All participants completed the NEO-Five Factor Inventory, Beck Depression Inventory, and Spielberger State and Trait Anxiety Inventory to examine the convergent validity of SFQ. RESULTS: The Korean version of the SFQ showed good internal consistency (Cronbach's alpha=0.811) and test-retest reliability (r=0.746). Patients with personality disorder had more social dysfunction than those without personality disorder. A graded increase in social dysfunction was observed with increasing severity of personality disorder. Social dysfunction showed a strong linear relationship with the 5 factor model. CONCLUSION: The Korean version of the SFQ has good psychometric properties. The results of our study support the severity classification of personality disorder integrated to upcoming ICD-11.
Anxiety ; Classification ; Depression ; Humans ; International Classification of Diseases ; Male ; Personality Disorders* ; Psychometrics ; Reproducibility of Results

A case of chronic epidural hematoma in the left frontal region is presented. The patient presented with a unique neurologic sign, exophthalmos, which was not a result of the injury but of in-growth of granulation tissue of the hematoma capsule into the orbit through the orbital roof defect. The time interval between head injury and the operation was about 25 years. Our case represent the second most longest time interval among the reviewed literatures.
Craniocerebral Trauma ; Exophthalmos* ; Granulation Tissue ; Hematoma* ; Humans ; Neurologic Manifestations ; Orbit

Among the series of 272 cases of surgically treated anterior circulation aneurysms, we experienced 6 cases of central infarctions involving caudate nucleus, globus pallidus, putamen and genu of internal capsule respectively or in combination. These surgery related complications were caused by the injury to the perforators going to the anterior perforated substance during manipulation of the large aneurysm or the aneurysms ruptured prematurely. The clinical courses of these patients, however, were not so severe. The morbidities were minimal or none after the average follow-up periods of 17 months. Thorough knowledge of the anatomy of the perforators may help to minimize the severe morbidity in the management of large or difficult aneurysms.
Aneurysm* ; Caudate Nucleus ; Follow-Up Studies ; Globus Pallidus ; Humans ; Infarction* ; Internal Capsule ; Olfactory Pathways ; Putamen

Forty two patients were diagnosed as having subcortical(lobar) intracerebral hemorrhage among 407 consecutive patients presenting with spontaneous intracerebral hemorrhage. Brain CT and MRI or angiography were performed in 39 patients. The authors analyzed clinical features, brain CT, etiological factors, and outcome. Headache(69%) and vomiting(55%) were most common symptoms. The incidence of seizure was 14%. The volume of hematoma on CT was below 20cc in 21 patients, between 20cc and 40cc in 16 patients, and aove 40cc in 5 patients. The most common site of hemorrhage was parietal lobe in 32 of 42 patients. The mortality rate was 9.5% and the functional outcome of the patients was generally better than in other forms of intracerebral hemorrhage. Thirty one patients had arterial hypertension which was the leading cause. Two patients had AVMs and two patients had blood dyscrasias. Unknown etiology occurred in 7 patients. Neither brain MRI nor cerebral angiography showed abnormal vascular lesion in all of the pa tients who had arterial hypertension. We conclude that no further evaluation if recommended in patients with subcortical hemorrhage who were definitely diagnosed as having arterial hypertension.
Angiography ; Brain ; Cerebral Angiography ; Cerebral Hemorrhage ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Magnetic Resonance Imaging ; Mortality ; Parietal Lobe ; Seizures

Paraganglioma of the cauda equina or filum terminale is rare tumor and was first described in 1970. The authors present a case of paraganglioma of the cauda equina in a 55 year-old-man with nonspecific back pain. To our knowledge, there has been only a few report of MRI of a paraganglioma of the cauda equina. Diagnosis can be made with immunohistochemical study and electron microscopy after surgical removal. Because of frequent recurrence, total excision is mandatory.
Back Pain ; Cauda Equina* ; Diagnosis ; Magnetic Resonance Imaging ; Microscopy, Electron ; Paraganglioma* ; Recurrence