No abstract available.
Animals ; Growth Hormone* ; Prolactin* ; Rats*

325 patients underwent emergency evacuation of traumatic intracranial hematomas over a 5-year period. Ten(3%) developed delayed contralateral epidural hematomas. These hematomas were not present on initial computed tomography(CT) scan, but repeat CT scan after craniectomy showed sizable hemorrhage. The authors analyzed 10 cases with delayed post-traumatic contralateral epidural hematoma according to their etiology, hematoma types on computerized tomography, initial Glasgow Coma Scale(GCS) & follow up Glasgow Outcome Scale(GOS). 1) Delayed development of post-traumatic contralateral epidural hematoma after evacuation of initial hematoma occurred in 10 of the 325 head injured patients, an incidence rate of 3%. 2) The important factors affecting patients outcome were the initial GCS & the time interval after surgery. 3) Eight patients were found to have a skull fracture at the site of delayed epidural hematoma formation(80%). 4) The results of delayed contralateral epidural hematoma was 50% good, 50% bad and had a mortality rate of 30%.
Coma ; Craniocerebral Trauma ; Emergencies ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Traumatic ; Mortality ; Skull Fractures ; Tomography, X-Ray Computed

OBJECTIVE: The aim of this study was to compare geometrically cross-sectional areas of two different laminoplasty techniques in same opening size. Some investigators have studied the expanded areas of the two different techniques using imaging study. Although it is unclear that postoperative spinal canal is correlated with the surgical outcome we just focused on mathematical and geometrical correlation of the expandable area with surgical opening size in different laminoplasty techniques. METHODS: To predict the expandable area by a midline splitting technique and a unilateral open door technique, we placed an imaginary isosceles triangle in the spinal canal and drew graphs for the equation of the expandable areas in same opening size using the Pythagorean theorem and mathematical program. To substitute the constant figures of mathematical formula we estimated the normal cervical spine CT scans of 50 Korean adults. RESULTS: We subtracted the imaginary triangle from the spinal canal and were left with the remaining area of the spinal canal that was not changed before and after surgery. In same opening size the expandable area by the midline splitting technique was same but slightly wider than the unilateral open door technique, irrespective of the triangular shape. For a normal isosceles triangle the results were the same. CONCLUSION: Using mathematical proof, the expandable area after the midline splitting technique was same but slightly larger than that after the unilateral open door technique, irrespective of the size of the lamina opening.
Adult ; Cervical Vertebrae ; Female ; Humans ; Ossification of Posterior Longitudinal Ligament ; Research Personnel ; Spinal Canal ; Spinal Cord Compression ; Spinal Osteophytosis ; Spine ; Tomography, X-Ray Computed

We report a case of pseudoaneurysm of the parietal division of the superficial temporal artery (STA) secondary to iatrogenic head injury due to Gardner traction. A 54-year-old man presented with a pulsatile, cystic, and painless mass in the right anterior temporal region which developed three weeks after head fixation via Gardner traction. At the time of discovery, the mass was 10 mm in diameter, compressible and disappeared after manual compression of the proximal STA. A bruit was audible over the mass, which was thought to be a pseudoaneurysm. A computed tomography angiogram (CTA) showed a pseudoaneurysm of the parietal division of the right STA. The tip of the pseudoaneurysm was thrombosed and was both red and tender. The pseudoaneurysm was thought to be filled with infected thrombus, and the mass was resected with ligation of the proximal and distal ends of the STA. A pseudoaneurysm of the STA should be suspected when there is a history of possible vessel injury, such as a history of head-pin fixation, and when a patient presents with a pulsatile, cystic mass near the temple. Pseudoaneurysms can be successfully treated by excision.
Aneurysm, False ; Craniocerebral Trauma ; Glycosaminoglycans ; Head ; Humans ; Ligation ; Middle Aged ; Temporal Arteries ; Thrombosis ; Traction

Sarcoidosis is a systemic disease of unknown etiology that may affect any organ in the body. The nervous system is involved in 5-16% of cases of sarcoidosis. Here, we report a case of intramedullary sarcoidosis presenting with delayed spinal cord swelling after laminoplasty for the treatment of compressive cervical myelopathy. A 56-year-old woman was admitted to our hospital complaining of upper extremity pain and gait disturbance. The patient had undergone laminoplasty for compressive cervical myelopathy 3 months previously. Follow-up magnetic resonance imaging revealed a large solitary intramedullary lesion with associated extensive cord swelling, signal changes, and heterogeneous enhancement of spinal cord from C2 to C7. Spinal cord biopsy revealed non-necrotizing granulomas with signs of chronic inflammation. The final diagnosis of sarcoidosis was based upon laboratory data, imaging findings, histological findings, and the exclusion of other diagnoses. Awareness of such presentations and a high degree of suspicion of sarcoidosis may help arrive at the correct diagnosis.
Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Gait ; Granuloma ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Middle Aged ; Nervous System ; Sarcoidosis* ; Spinal Cord Diseases* ; Spinal Cord* ; Upper Extremity

Charcot spinal arthropathy is a rare, progressive type of vertebral joint degeneration that occurs in the setting of any preexisting condition characterized by decreased afferent innervation to the extent that normal protective joint sensation in the vertebral column is impaired. The authors report on a case of Charcot arthropathy of the lower lumbar spine mimicking a spinal tumor following cervical cord injury.
Joints ; Preexisting Condition Coverage ; Sacrum ; Sensation ; Spinal Cord Injuries* ; Spinal Cord* ; Spine*

Aneurysmal bone cysts (ABCs) are benign, non-neoplastic, expansile lesions. We present a case of a male patient aged 46 presented with 4-month history of left hip and low back pain and left hip swelling. Lumbosacral magnetic resonance imaging (MRI) and computed tomography (CT) demonstrated a large multi-loculated hemorrhagic lumbosacral and retroperitoneal mass with spinal dysraphism and tethered cord. Curettage and Biopsy were performed with partially resected cystic wall which was histological confirmed with aneurismal bone cyst. Large cystic mass of the vertebrae, sacrum, and pelvic bone must be considered with ABCs.
Aged ; Aneurysm ; Biopsy ; Bone Cysts ; Bone Cysts, Aneurysmal ; Curettage ; Hip ; Humans ; Liposarcoma ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Pelvic Bones ; Sacrum ; Spinal Dysraphism ; Spine

OBJECTIVE: We sought to determine minimum 4 years of clinical outcomes including fusion rate, revision rate and complications of patients who underwent placement of rectangular stand-alone cages. METHODS: Thirty-three cases of degenerative spine that had been followed for at least 4-years were reviewed retrospectively. Cages were inserted at L4-L5 level or L5-S1 in 27 or in 6 cases respectively. Visual analogue scale (VAS), Odom's criteria, fusion rate, intervertebral disc height and lumbar lordosis were determined pre- and post-operatively on standing x-rays. Amount of intra- and postoperative blood loss, total volume transfused, duration of surgery and perioperative complications were also evaluated. RESULTS: The mean VAS score of back pain and sciatica were improved from 8.0 and 7.0 points to 3.4 and 2.4 during 1 years follow-up visit and the scores was raised gradually. Also, during the follow-up, 94% of patients showed excellent or good outcomes by the Odom's criteria. Intervertebral disc height was increased from 8.2+/-1.4mm to 9.2+/-1.9mm at the first year of follow-up, however, found to be decreased and stabilized to 8.3+/-1.8mm after 2 years. The fusion rate was approximately 91% after 4 year postoperative. The segmental angle of lordosis was increased significantly by two years but it was not maintained after four years. A statistically insignificant change in total lumbar lordosis was also observed. Three patients (9%) had experienced perioperative complications. CONCLUSION: The use of rectangular stand-alone cages for posterior lumbar interbody fusion (PLIF) resulted in a various degree of subsidence and demonstrate very low complication rate, high functional stability and improved clinical outcomes in patients with degenerative lumbar disc disease.
Animals ; Back Pain ; Follow-Up Studies* ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Lordosis ; Postoperative Hemorrhage ; Retrospective Studies ; Sciatica ; Spine

No abstract available.
Intracranial Hypotension*

No abstract available.