The computed tomographic scan has revolutionized the management of head trauma and has been established as an accurate diagnostic modality. The computed tomography was performed in 308 head injured patients and those findings were retrospectively analyzed. A wide spectrum of traumatic abnormalities was demonstrated by computed tomography. Seventy-six percent of patients had abnormal scans. The yield of abnormal scans varied with Glasgow coma scale at the time of scan:GCS 15-13, 66%:GCS 12-9, 91%:GCS 8-6, 94:GCS 5-3, 100%. Not significant correlation was found between the score of GCS and the extent of the midline shifting on the CT scan(P>0.05). Acute subdural hematoma and intracerebral hematoma were commonly associated with the other lesions, and over 2/3 of intraecrebral hematoma combined acute subdural hematoma.
Craniocerebral Trauma* ; Glasgow Coma Scale ; Head* ; Hematoma ; Hematoma, Subdural, Acute ; Humans ; Retrospective Studies

The patient with complaints of seizure, headache and upward gaze paralysis underwent V-P shunt under the impression of pinealoma. The diagnosis of cerebral paragonimiasis was eventually made by the aid of brain CT scan and PW skin test. The case showed a positive intradermal test with relevant histories of eating rare crayfishes and the characteristic CT findings. Plain skull X-ray showed the round calcifications around the pineal region. Brain CT demonstrated multiple round calcifications in the left fronto-occipital region and dilation of the left lateral ventricle with cortical atrophy.
Astacoidea ; Atrophy ; Brain ; Diagnosis ; Eating ; Headache ; Humans ; Intradermal Tests ; Lateral Ventricles ; Ocular Motility Disorders* ; Paragonimiasis* ; Paralysis ; Pinealoma ; Seizures ; Skin Tests ; Skull ; Tomography, X-Ray Computed

Computerized tomography has been proven to be of particular value in patients with head trauma. Neverthless, primary traumatic brainstem lesions are not always revealing even by the advent of brain CT. In two cases of head trauma, we identified midbrain hemorrhage by CT scan. One of them was hemorrhage in the quadrigeminal plate, the quadrigeminal cistern, and the vermis; the other small round isolated hemorrhage in the quadrigeminal plate. They were well correlated with the clinical findings. Those two patients got well with conservative treatment.
Brain ; Brain Stem* ; Craniocerebral Trauma ; Hemorrhage ; Humans ; Mesencephalon ; Tectum Mesencephali ; Tomography, X-Ray Computed

Angiofollicular lymph node hyperplasia is a relatively rare benign lesion. In 1954 Casteman described the first case of this process occurring in the anterior mediastinum. This lesion was subsequently described in a number of case reports under various names including Castleman's disease, lymph nodal hamartoma, follicular lympho-reticuloma, angiofollicular lymph-node hyperplasia, angiomatous lymphoid hamartoma, and benign giant lymphoma. Although the mediastinum is the most common location, they also occur in other areas of the body, usually where lymph nodes are normally found. However, intraspinal location has been seldom described in literatures. Recently, authors experienced a case of angiofollicular lymph node hyperplasia in the thoracic spinal canal, which was operated upon for paraparesis below T10, in a 17 year old male. The tumor was located between the levels of T8 to T10, and was encircling the subjacent spinal cord. This lesion was successfully removed. The patient is in good condition postoperatively. A brief review of pertinent literatures was made.
Adolescent ; Giant Lymph Node Hyperplasia* ; Hamartoma ; Humans ; Hyperplasia ; Lymph Nodes ; Lymphoma ; Male ; Mediastinum ; Paraparesis ; Spinal Canal* ; Spinal Cord

BACKGROUND: Necrotizing fasciitis is a life threatening severe soft tissue infection primarily involving the fascia and the subcutaneous tissue with thrombosis of the cutaneous microcirculation. The purpose of the study was to analyze the microbiological and clinical characteristics of necrotizing fasciitis in Korea and to suggest adequate antibiotic therapy. METHODS: We retrospectively reviewed medical records of three Soonchunhyang University Hospitals in Seoul, Bucheon and Cheonan. Patients admitted for skin graft or secondary treatment were excluded. Blood cultures were obtained at the time of admission and pus cultures were obtained at the time of first operative debridement. RESULTS: Twenty two patients (16 males, 6 females, 16~82 years old, median age: 59 years old) were enrolled for this study. Fourteen pateints underwent surgical treatment and 2 of them died of necrotizing fasciitis. Gram positive organisms were isolated in 13 cases and gram negative organisms were isolated in 11 cases. Third generation cephalosporin resistant gram negative organisms were isolated in 3 cases. CONCLUSIONS: This study suggest that characteristics of necrotizing fascitis in Korea were; high proportion of aged person, predominance of type 2 necrotizing fascitis and increasing tendency of third generation cephalosporin resistant gram negative bacterial infections. Consequently, initial choice of empirical antibiotics for necrotizing fasciitis should consider 3rd generation cephalosporin resistant gram negative organisms. Prompt surgical debridement and adequate antimicrobial therapy are mandatory for improved survival.
Anti-Bacterial Agents ; Cephalosporin Resistance ; Chungcheongnam-do ; Debridement ; Fascia ; Fasciitis, Necrotizing* ; Female ; Gram-Negative Bacterial Infections ; Gyeonggi-do ; Hospitals, University* ; Humans ; Korea* ; Male ; Medical Records ; Microcirculation ; Retrospective Studies ; Seoul ; Skin ; Soft Tissue Infections ; Subcutaneous Tissue ; Suppuration ; Thrombosis ; Transplants