No abstract available.
Neurilemmoma* ; Neurofibromatoses* ; Neurofibromatosis 2*

The incidence of the distal anterior cerebral artery(DACA) aneurysm comprises about 2-6% of all intracerebral aneurysms. Because of the low incidence, unique anatomies of the distal anterior cerebral arteries and some technical difficulties in surgery, these aneurysms present such challenge to neurosurgeons. Presently, early surgery using interhemispheric approach is preferred. The auhtors experienced six patients with DACA aneurysms in 130 consecutive intracerebral aneurysms surgically treated between May. 1994 and Dec. 1997. The patients received operations within five days from the ictus, except one patient because of symptomatic vasospasm. The surgical approaches were all unilateral interhemispheric approaches. During the operations, infusion of large amount of mannitol and CSF volume removal were applied, although there were few difficulties in the interhemispheric dissections, the outcomes of the patients were excellent in three, good in three. The authors suggest that early operative interventions using unilateral interhemispheric approach without generous craniotomy can improve the outcomes of the patients with ruptured DACA aneurysm.
Aneurysm ; Anterior Cerebral Artery* ; Craniotomy ; Humans ; Incidence ; Intracranial Aneurysm* ; Mannitol

Pulmonary endomertiosis is a rare disorder with the typical symptom of hemoptysis during menstruation (catamenial hemoptysis). We report a case of a 19-year-old woman, gravida 0, with 3-month history of catamenial hemoptysis which was confirmed with chest computed tomography. She was treated by means of thoracoscopic wedge resection for the right lesion and fuperior segmental resection through the left thoracotomy, successively. Preoperative fluoroscopy-guided hooking for thoracosopic target lwsion was helpful in circumstances with one lung anesthesia. Four months of follow-up after an uneventful discharge revealed out no recurrence of catamenial hemoptysis in symptoms and images.
Anesthesia ; Female ; Follow-Up Studies ; Hemoptysis* ; Humans ; Lung ; Menstruation ; Recurrence ; Thoracotomy ; Thorax ; Young Adult

Mazabraud's syndrome, the etiology of which is unknown, is a rare benign disease, characterized by theas-sociation of intramuscular myxoma and fibrous dysplasia of bone, usually polyostotic. We describe a case ofMazabraud's syndrome in which with two intramuscular myxomas of the forearm were associated with polyostoticfibrous dysplasia.
Fibrous Dysplasia of Bone ; Forearm ; Myxoma

OBJECTIVES: Pituitary apoplexy is a well-described clinical syndrome resulting from pituitary hemorrhage, hemorrhagic infarction, or infarction, almost invariably occurring in the presence of an adenoma. We analyzed pituitary apoplexy with an emphasis on clinical presentation, pathology and predisposing factors. METHODS: We reviewed 35 histologically proven pituitary adenomas, operated from January 1995 to August 1999, to select 8 cases which showed clinical or operative findings compatible with pituitary apoplexy. These patients were analyzed in terms of symptom and sign, hormonal status, and predisposing factors, pathologic findings. RESULTS: Among 35 surgically treated tumors of the pituitary gland, 8 cases(23%) were diagnosed as pituitary apoplexy. The pathologic findings revealed hemorrhage(7 cases) and infarction(1 case) of pituitary adenomas. One case had predisposing factor of appendectomy. The most common presenting symptom and sign were sudden severe headache and visual disturbance. CONCLUSION: We treated pituitary apoplexy surgically and obtained good outcomes. Pituitary apoplexy due to massive infarction of the pituitary gland is very rare condition but surgical treatment by trans-spheniodal surgery showed a good result.
Adenoma ; Appendectomy ; Causality ; Headache ; Hemorrhage ; Humans ; Infarction ; Pathology ; Pituitary Apoplexy* ; Pituitary Gland ; Pituitary Neoplasms

OBJECTIVE: The safety and effectiveness of Guglielmi Detachable Coil(GDC) embolization for cerebral aneurysm has been well documented. However, domestically there are few reports. The purpose of this study is to analyze procedural complications that occurred during endovascular coilling performed for cerebral aneurysms retrospectively. METHODS: From January 1996 to December 2003, a total of 453 patients (484 aneurysms) who had undergone GDC embolization for cerebral aneurysm were selected. The aneurysms were classified according to rupture history, location, dome and neck size. Procedural complications such as aneurysmal rupture, thrombosis and occlusion of patent vessels due to coil escape were noted. RESULTS: Procedural complications occurred 49 cases (10.1%). Among these, there were 27 of procedure-related aneurysmal rupture (5.6%), 14 of thrombosis (2.9%), 8 of occlusion of patent vessels due to coil escape (1.7%). Death or severe neurological deficit were seen in 18 cases of procedure-related rupture, 9 cases of thrombosis and 4 cases of coil escape. Procedure-related mortality and morbidity rates for endovascular coiling were calculated to be 2.9% and 3.6% respectively. CONCLUSION: The potential complications associated with shape, size and relationship to parent vessels of each specific cerebral aneurysm must be considered carefully before treatment. In order to reduce complications, proper equipment, knowledge on the hemodynamics and vascular anatomy, and operator's expertise are desired.
Aneurysm* ; Hemodynamics ; Humans ; Intracranial Aneurysm ; Mortality ; Neck ; Parents ; Retrospective Studies ; Rupture ; Thrombosis ; United Nations

For the treatment of carotid-cavernous fistula, detachable balloon occlusion(DBO) is the method of choice. When it fails, or when the fistula is incompletely occluded, alternative treatment methods include direct surgery and internal carotid artery occlusion at the proximal and distal portion of the fistula. Before ligation or occlusion of the internal carotid artery, however, coil embolization should be considered, as this preserves patent internal carotid artery. The authors used DBO in a 22-year-old male patient with carotid-cavernous fistula which developed after head injury. During the procedures the fistula was partially obstructed by one detachable balloon. In spite of several attempted occlusions with a second balloon, this could not be introduced into the small remnant fistula hole. The second stage of intervention involved embolization with a Guglielmi detachable coil(GDC) ; this was successfully introduced into the partially obstructed fistula, which was thus completely occluded, and the patient's clinical symptoms improved. In this case, GDC emboization was an effective tool for the treatment of carotid-cavernous fistula incompletely occluded by a detachable balloon.
Carotid Artery, Internal ; Craniocerebral Trauma ; Embolization, Therapeutic ; Fistula* ; Humans ; Ligation ; Male ; Young Adult

For the treatment of carotid-cavernous fistula, detachable balloon occlusion(DBO) is the method of choice. When it fails, or when the fistula is incompletely occluded, alternative treatment methods include direct surgery and internal carotid artery occlusion at the proximal and distal portion of the fistula. Before ligation or occlusion of the internal carotid artery, however, coil embolization should be considered, as this preserves patent internal carotid artery. The authors used DBO in a 22-year-old male patient with carotid-cavernous fistula which developed after head injury. During the procedures the fistula was partially obstructed by one detachable balloon. In spite of several attempted occlusions with a second balloon, this could not be introduced into the small remnant fistula hole. The second stage of intervention involved embolization with a Guglielmi detachable coil(GDC) ; this was successfully introduced into the partially obstructed fistula, which was thus completely occluded, and the patient's clinical symptoms improved. In this case, GDC emboization was an effective tool for the treatment of carotid-cavernous fistula incompletely occluded by a detachable balloon.
Carotid Artery, Internal ; Craniocerebral Trauma ; Embolization, Therapeutic ; Fistula* ; Humans ; Ligation ; Male ; Young Adult

A 60 year old male patient with a medical history of pulmonary tuberculosis presented with severe headaches and general weakness. Radiological studies revealed mass lesions both in the right using and the right cerebellar hemisphere. Clinically metastatic brain tumor and tuberculoma were highly suspected. The cerebella mass was totally excised and an unusual pathologic result was reported as botryomycosis. According to literatures reviewed, botryomycosis is a chronic bacterial infectious lesion resembling actinomycosis and mycotic abscess and it has been frequently reported in the skin, subcutaneous lesions and other visceral organs, but the cases of brain involvement were extremely rare. This article is a case report of a cerebellar botryomycosis. The pathologic characteristics and the differential diagnosis of botryomycosis are discussed.
Abscess ; Actinomycosis ; Brain ; Brain Neoplasms ; Diagnosis, Differential ; Headache ; Humans ; Male ; Middle Aged ; Skin ; Tuberculoma ; Tuberculosis, Pulmonary

BACKGROUND: Chlamydia pneumoniae is an important pathogen to cause approximately 5-10% of community-acquired respiratory infections and has been recently reported as a tentative causative agent of atherosclerosis in western countries. Considering that the most common cause of death is cerebral artery disease and coronary heart disease in Korea, we attempted to elucidate C. pneumoniae in atheromatous plaques. METHODS: Twenty-eight cases of atherectomy from 1996 to 1998, which included 20 patients with cerebral artery stenosis, two patients with carotid artery stenosis and six patients with coronary artery stenosis were prepared for immunohistochemistry to demonstrate C. pneumoniae. The Coronary arteries from 35 cadavers obtained were also stained with chlamydia genus-specific and C. pneumoniae-specific monoclonal antibodies. RESULTS: Eighteen of 20(90%) of cerebral artery stenosis, one of two of carotid artery stenosis and all six cases of coronary artery stenosis were positive for C. pneumoniae. Thirteen over 35(37.1%) cadavers presented arterial stenosis, while eight cases(61.5%) were positive for C. pneumoniae. CONCLUSIONS: This is the first report demonstrating C. pneumoniae in atheroma in Korea. In regard of the high positive rate of C. pneumoniae(89.3%) in cases of atherosclerosis, C. pneumoniae might be closely associated with atherosclerosis in Korea.
Antibodies, Monoclonal ; Atherectomy ; Atherosclerosis ; Cadaver ; Carotid Stenosis ; Cause of Death ; Cerebral Arterial Diseases ; Cerebral Arteries ; Chlamydia* ; Chlamydophila pneumoniae* ; Constriction, Pathologic ; Coronary Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Immunohistochemistry* ; Korea ; Plaque, Atherosclerotic ; Pneumonia ; Respiratory Tract Infections