Primary malignant melanoma arising from the leptomeninges is a rare entity. We report two cases of primary intracranial melanoma developed in one aged 65 years female and the other 70 years male. One case died 2 years after the operation, and the other case is still living more than 1 year after operation. Both cases seems to have a relatively long survival. The literature on this subject is briefly reviewed.
Female ; Humans ; Male ; Melanoma*

No abstract available.
Brain Injuries* ; Child* ; Glasgow Coma Scale ; Humans

We examined the initial CT findings of the early(within on week) death after head injury, retrospectively. The patient population consisted of 182 patients who were admitted to the Soonchunhyand University Chonan Hospital, and were examined by CT, from August 1986 to May 1990 after head injury. We compared clinical features and radiological findings between the group of focal lesion and the group of diffuse lesion. The focal lesion was found in 47.8%, while the diffuse lesion was found in 45.6%. Statistically significant differences were found in the age, Glasgow Coma Score(GCS) on admission, injury Severity Score(ISS), hypotension, and hypoxia. The focal lesion was more common in the aged, while the diffuse lesion was common in the young(less than 40 years of age). Patients with high GCS(more than 8) constitued 25.3% of the focal lesion, while only 6.0% of the duffuse lesion had the high GCS. ISS was higher than 30 in 67.5% of the diffuse lesion, while 32.2% of the focal lesion had ISS of 30 or more. The causes of injury was pedestrian traffic accident in 46.5% and passanger's traffic accident in 31.8%. Midline shift(more than 3mm), compressed ventricles, and obliteration of the suprasellar cistern and quadrigeminal cistern were observed in 34.1%, 82.4%, 67.6%, and 58.2%, respectively. Lesions with severe midline shift were focal in 93.1% and lesions without midline shift were diffuse in 88.4%(P<0.005). Cranial vault fracture was noticed in 68.2%, and basal skull fracture was found in 28.8%. The frequency of basal skull fracture was high in the diffuse lesion(P<0.005). In this study, we could presumed that 17.2% to 25.3% of the patients with focal lesions could be saved, if proper treatment was given. Since the diffuse lesion was responsible for nearly half of the early death after head injury, proper treatment or prevention should be made. Prevention of the diffuse lesion seems to be possible by correction of hypotension and hypoxia for the diffuse lesions were intimately related to them. At any event, further studies on the diffuse brain injury are required.
Accidents, Traffic ; Anoxia ; Brain Injuries ; Chungcheongnam-do ; Coma ; Craniocerebral Trauma* ; Head* ; Humans ; Hypotension ; Retrospective Studies ; Skull Fractures

We report a unique case of a 12-year-old girl with unilateral proptosis form orbital extension of an extensive bilateral cephalhematoma. Loss of vision in the left eye due to severe proptosis was reversed by prompt aspiration and tarsorrhaphy.
Cerebral Hemorrhage/*complications/radiography ; Child ; Exophthalmos/*etiology/radiography ; Female ; Hematoma/*complications/radiography ; Humans

No abstract available.

No abstract available.
Fatigue* ; Sciatica*

No abstract available.
Cerebral Hemorrhage* ; Craniocerebral Trauma ; Fistula*

Differentiation between acute and old fractures in the thoracic and lumbar spine is often difficult. We have evaluated the intraobserver agreement and interobserver variability of interpretations. We have prepared 50 cases from 40 patients with thoracic or lumbar spine fracture for evaluation. At first, two radiologist interpreted each of the 50 cases, Only by using plain roentgenograms. Then, they interpreted the cases again using also spine CT, MRI, bone scintigrams and follow-up roentgenograms. Intraobserver agreement was found to be 78% in Doctor A, and 76% in Doctor B. Interobserver agreement was only 62% at first. It was 88%, when they used CT, MRI, bone scintigrams and follow-up roentgenograms. It was not easy to differentiate the old fractures from acute one only by plain roentgenograms. Differentiation was more difficult, when the patient was female or over 55 years old. Plain roentgenography in hyperextension posture seems to be a simple but useful method for the diagnosis of the acute fracture. MRI was more valuable than CT or bone scintigraphy to differentiate the old fractures from the acute ones.
Diagnosis ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Observer Variation ; Posture ; Radiography ; Radionuclide Imaging ; Spine*

No abstract available.
Humans ; Infant* ; Leukemia, Megakaryoblastic, Acute* ; Sarcoma, Myeloid*

The purpose of this study is to identify a group of mild head injury patients having lesions on computerized tomography(CT) and to investigate the risk factors affecting the abnormal findings on CT scan. The study was limited to patients 16 years of age and older with a initial Glasgow Coma Scale(GCS) scores of at least 13 at the time of admission. Of a total of 243 patients studied, 156(64.2%) had abnormal CT findings. 49 patients(20.2%) required neurosurgical intervention(craniotomies for hematoma in 33, hematoma in 1 and subdural hygroma in 3). Four patients(2.4%) died of their cranial injury and three died of extracranial causes. The incidence of CT abnormalities for each GCS score was 86.7% in GCS of 13, 68.6% in GCS of 14, and 58.6% in GCS of 5. The factors affecting GCS scores at the time of admission were the presence of loss of consciousness and posttraumatic amnesia. The factors affecting abnormal CT scans were the presence of posttraumatic amnesia and skull fracture. A new lesion of extension of the initial finding on follow-up CT scans was found in 9.3% of 75 patients who underwent follow-up CT scans. Even though routine CT scans for mild head injury patients are not always necessary, these result suggest that all patients admitted to hospital after mild head injury should undergo CT scanning to enable early detection of an intracranial lesion.
Amnesia ; Coma ; Craniocerebral Trauma* ; Follow-Up Studies ; Glasgow Coma Scale ; Head* ; Hematoma ; Humans ; Incidence ; Risk Factors ; Skull Fractures ; Subdural Effusion ; Tomography, X-Ray Computed* ; Unconsciousness