Three cases of giant pituitray adenoma are reported. Two cases were operated by transsphenoidal approach and a case by transcranial approach. Transsphenoidal approach showed satisfactory results despite of marked suprasellar extension of tumors. We report rare giant pituitary adenomas with review of relevant literatures.
Adenoma ; Pituitary Neoplasms*

No abstract available.
Communicable Diseases* ; Zinc*

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.
Carcinoma, Transitional Cell*

PURPOSE: The purpose of this study was to analyze the characteristic MR findings of childhood metachromatic leukodystrophy. MATERIALS AND METHODS: Five female patients (10--29 months old;mean age, 21.8 months) of biochemically confirmed metachromatic leukodystrophy were included in this study. We evaluated the extent of white matter degeneration, which was shown as high signal intensity on T2-weighted image, and the presence or absence of the enhancement. Result.' All 5 cases showed high signal intensity in periventricular deep white matter and centrum semiovale which were bilateral, symmetric and confluent. Posterior predominace, sparing of subcortical U fibers and immediate periventricular white matter, and the involvement of splenium of corpus callosum were also noted in all cases. There were other manifestations, such as 'tigroid pattern' in centrum semiovale (n=4), the involvement of genu of corpus callosum(n=4), posterior limb of internal capsule(n=4), descending pyramidal tracts (n=3), deep cerebellar white matter(n=1), claustrum(n=2), and diffuse brain atrophy(n=1). In three cases with Gd-infusion, contrast enhancement of the lesion was not seen. CONCLUSION: In childhood metachromatic leukodystrophy, MRI can clearly demonstrate the chracteristic extent of the white matter lesion and other associated findings, facilitating the differential diagnosis from other similar leukodystrophies.
Brain ; Corpus Callosum ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Leukodystrophy, Metachromatic* ; Magnetic Resonance Imaging* ; Pyramidal Tracts

Lesions with coronary artery aneurysm (CAA) can become complicated during percutaneous coronary intervention. Here, we report a case of a 78-year-old man who developed a rupture, and spontaneous sealing of the CAA occurred after stent implantation, as shown by computed tomography coronary angiography.
Aged ; Aneurysm ; Congenital Abnormalities ; Coronary Aneurysm ; Coronary Angiography ; Coronary Vessels ; Drug-Eluting Stents ; Ear ; Humans ; Percutaneous Coronary Intervention ; Rupture ; Stents

A case of rare symptomatic cerebellopontine angle lipoma treated by surgical decompression is described. In this 28-year-old male with intermittent facial pain 17 years, a mass was noted in the right cerebellopontine angle on C-T and MRI. Partial removal of the mass was made for decompression of the lesion from the trigeminal nerve root entry zone. The surgical biopsy results was lipoma. This represents, to our knowledge, the first lipoma in the cerebellopontine angle reportes in the Korean literature.
Adult ; Biopsy ; Cerebellopontine Angle* ; Decompression ; Decompression, Surgical ; Facial Pain ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Neuroma, Acoustic ; Trigeminal Nerve ; Trigeminal Neuralgia*

Neurological grade on admission is an important prognostic factor for aneurysmal patients. The decision for operation in comatose patients with ruptured aneurysm is difficult and remains controversial. Recent literatures tend to emphasize the benefit of operative treatment for these patients because of the higher mortality of the patients who were managed conservatively. We performed early surgery in ten comatose aneurysmal patients combining lumbar drainage, intravenous and cisternal nimodipine therapy, and intermittent brain retraction. Among these ten patients, four showed survival over three months. We suggest that early surgery with aggressive postoperative management should be considered in comatose aneurysmal rupture patients for life-saving.
Aneurysm ; Aneurysm, Ruptured ; Brain ; Coma* ; Drainage ; Humans ; Intracranial Aneurysm* ; Mortality ; Nimodipine ; Rupture

The authors analyzed and compared three prognostic factors of the intraparenchymal metastatic brain tumors, regardless of therapeutic modalities, to evaluate the value of time-interval between diagnosis of primary cancer and brain metastasis as a prognostic factor. Our of the 109 patients of metastatic brain tumor admitted to Kosin Medical College from 1984 to 1991, 93 patients were included in this retrospective study. The survival time of these patients was statistically evaluated according to each prognostic factor. The results were as follows. Patients with mild or no neurological deficits and patients with moderate neurological deficits showed longer survival than the patients with severe neurological deficits(P<0.001). The presence of systemic metastasis at the time of diagnosis also significantly shortened overall survival(P<0.0095). Primary-to-metastatic interval did not significantly affect overall survival(P<0.6164), but the patients with brain metastasis detected within 1 year after diagnosis of the primary cancer had a longer median survival than those detected after 1 year(P<0.001). We conclude that the primary-to-metastatic interval is not valuable as a prognostic factor for intraparenchymal metastatic brain tumor, and further prospective study tailored to each specific condition will be needed for more accurate evaluation of prognostic factors.
Brain Neoplasms ; Brain* ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Prognosis* ; Retrospective Studies

This study was performed in order to compare the functional imaging by 99m Tc-HMPAO brain SPECT with structural neuroimaging by CT or MRI. Eighteen patients with diffuse axonal injury underwent HMPAO brain SPECT(18), CT(9) and MR(14), and neurological status were then evaluated. Seventeen patients(94%) were revealed abnormal SPECT whereas nine patients(50%) demonstrated abnormal CT compared with ten patients(71%) demonstrated abnormal MRI. The neurololgical deficits correlated well with abnormal SPECT lesion except in one case. It is therefore concluded that brain perfusion SPECT is not only more sensitive than CT or MRI, it is also more cost effective and clinically well correlated in diffuse axonal injury patient.
Brain* ; Diffuse Axonal Injury* ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Perfusion ; Tomography, Emission-Computed, Single-Photon*