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Journal of Korean Neurosurgical Society.1999;28(8):1232-.

Two techniques are available for endovascular treatment of post-SAH vasospasm: mechanical angioplasty and phamacologic infusion(papaverine or other vasodilator). The advantages of papaverine infusion are simplicity, safety, and the ability to reach small distal vessels. The disadvantages are that the treatment results may be temporary and inconsistant. The advantages of balloon angioplasty are rapid, dramatic result and consistantly successful. It is important to treat vasospasm as soon as possible for two reasons: vascular response is better and permanant ischemic damage is minimized. If ischemic symptom have developed, it may already to be late. So, the treatment of vasospasm should be proreactive rather than reactive.
Angioplasty ; Angioplasty, Balloon ; Papaverine

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Prevention and Medical Management of Vasospasm.

Sung Don KANG

Journal of Korean Neurosurgical Society.1999;28(8):1226-1231.

Numerous approaches to the prevention and treatment of cerebral vasospasm have been made. Its etiology and pathogenesis are still not well understood, and there is no animal model that duplicates all of the key aspects of human cerebral vasospasm. It is therefore not surprising that most of the attempts to prevent or treat this condition have failed. Since 1980, there has been some progress toward the satisfactory management of this detrimental condition, but much remains to be done. In the present article, experimental therapies are examined in detail, followed by a review of promising new treatments presently in clinical trials and generally accepted management in reducing the ischemic complications related to cerebral vasospasm.
Humans ; Models, Animal ; Therapies, Investigational ; Vasospasm, Intracranial

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Controversies in the Coil Embolization of Intracranial Aneurysms.

Dong Youl RHEE ; Soo Young KIM

Journal of Korean Neurosurgical Society.1999;28(8):1220-1225.

GDC embolization has been performed selectively since 1991 in patients with intracranial aneurysms and made remarkable technical and clinical advances in recent years. But until now, this procedure lacks an adequate long-term follow-up study. Also, clear mechanism and evidence of electrothrombosis and endothelialization of aneurysm neck, the incidence of vasospasm after GDC embolization are still controversial. Here we critically reviewed the published literatures pertaining to the GDC embolization in order to gain a comprehensive understanding and knowledge of forementioned controversies. Also from November 1997 to April 1999, we treated 12 patients of intracranial aneurysms with GDC embolization. In conclusion, although certain shortcomings and controversies are still remain, the GDC embolization can be an alternative, supportive and attractive therapeutic modality in the treatment of intracranial aneurysms. Not only to improve outcome of intracranial aneurysms but also fulfill the patient's requirement, we need cooperations and cross-training with the interventional neuroradiology and rigorous academic evaluation on anatomy of cerebral vasculature and pathophysiology of cerebrovascular disorders.
Aneurysm ; Cerebrovascular Disorders ; Embolization, Therapeutic* ; Follow-Up Studies ; Humans ; Incidence ; Intracranial Aneurysm* ; Neck

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Hemodynamics of Poor-grade Subarachnoid Hemorrhage.

Dal Soo KIM ; Do Sung YOU ; Pil Woo HUH ; Kyung Suk CHO ; Joon Ki KANG

Journal of Korean Neurosurgical Society.1999;28(8):1215-1219.

Patients who are devastated neurologically or medically after aneurysmal subarachnoid hemorrhage(SAH) are described as 'poor grade' patients. More recent studies have documented that the initial hemorrhage is by far the most important determinant of outcome after aneurysmal subarachnoid hemorrhage. This review mainly includes hemodynamics and suspected mechanisms of acute brain injury after aneurysmal SAH, particularly in special reference to increased intracranial pressure and cerebral ischemia during and after SAH.
Aneurysm ; Brain Injuries ; Brain Ischemia ; Hemodynamics* ; Hemorrhage ; Humans ; Intracranial Pressure ; Subarachnoid Hemorrhage*

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Pathogenesis of Cerebral Vasospasm.

Chang Taek MOON

Journal of Korean Neurosurgical Society.1999;28(8):1208-1214.

Although cerebral vasospasm is the greatest cause of morbidity and mortality in patient who survive the ictus of subarachnoid hemorrhage(SAH), the pathogenesis of vasospasm remains unclear. However, recent advances in the research of vasospasm suggest that decreased vasodilator function and/or increased vasoconstrictor function are basic changes of cerebral vasculature after SAH. So, the present review will focus on the roles of nitric oxide(NO), cGMP, potassium channel, endothelin(ET), and protein kinase C(PKC) as they relate to SAH.
Endothelins ; Humans ; Mortality ; Nitric Oxide ; Potassium Channels ; Protein Kinase C ; Protein Kinases ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial*

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Occult Intrasacral Meningocele Associated with Arachnoid Cyst.

Ju Heon KIM ; Choong Hyun KIM ; Il Sung CHOI ; Koang Hum BAK ; Jae Min KIM ; Nam Kyu KIM

Journal of Korean Neurosurgical Society.1999;28(8):1203-1207.

case of occult intrasacral meningocele associated with arachnoid cyst in a 35-year-male is reported. The patient presented with a history of severe sacrococcygeal pain, constipation, and urinary incontinence for several months. Myelography revealed delayed filling of a meningocele. Computed tomographic(CT) myelography and magnetic resonance(MR) imaging showed huge intrasacral mass without neural elements. A favorable outcome was achieved by decompression of the cyst, obliteration of the conduit to subarachnoid space, and fenestration of arachnoid cyst into subarachnoid space.
Arachnoid* ; Constipation ; Decompression ; Humans ; Meningocele* ; Myelography ; Sacrum ; Subarachnoid Space ; Urinary Incontinence

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Thoracic Compression Fracture Following Electro-Convulsive Therapy.

Won Rim CHOI ; Jae Won DOH ; Hack Gun BAE ; Kyeong Seok LEE ; Il Gyu YUN ; Soon Kwan CHOI ; Bark Jang BYUN

Journal of Korean Neurosurgical Society.1999;28(8):1199-1202.

Spine fractures occur less than 1% after electro-convulsive therapy(ECT). We report a rare case of thoracic compression fracture due to seizure after ECT. The patient was a 37-year-old female who suffered from major depression disorder. She received ECT six times in total. She complained of back pain after fifth ECT. There was no history of trauma. On thoracic CT and MRI, compression fracture of T4 body was clearly shown, but cord injury was not evident. After one month of bed rest, her back pain was improved. We discuss the mechanism of vertebral fracture after ECT with literature review.
Adult ; Back Pain ; Bed Rest ; Depression ; Female ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging ; Seizures ; Spine

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Epithelioid Hemangioendothelioma.

Sung Rok HAN ; Chong Oon PARK ; Dong Keun HYUN ; Young Soo HA

Journal of Korean Neurosurgical Society.1999;28(8):1194-1198.

Epithelioid hemangioendothelioma is a rare vascular neoplasm characterized by epithelioid tumor cells and borderline biologic behavior. We present a case of grade III malignant epithelioid hemangioendothelioma of the skull and brain parenchyme in a 58-year-old female. The tumor consisted of loose aggregates of epithelioid cells with a focal small nest pattern and tumor cells displayed frequent intracytoplasmic vacuoles and contained areas with significant atypia and mitotic activity(more than 2/10 HPF). Immunohistochemically, the tumor cells showed positive staining for facor VIII-RGA and vimentin. Radiological and histopathologic characteristics of this tumor with a review of pertinent literature is presented.
Brain ; Epithelioid Cells ; Female ; Hemangioendothelioma, Epithelioid* ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Middle Aged ; Skull ; Vacuoles ; Vascular Neoplasms ; Vimentin

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Arterior-Venous Malformation of the Corpus Callosum : Microsurgical Treatment.

Dal Soo KIM ; Joon Ki KANG ; Jin Un SONG

Journal of Korean Neurosurgical Society.1987;16(4):1005-1012.

The authors had seven patients with arteriovenous malformation(AVM) of the corpus callosum of which five involved the genu and/or the body and two occupied the splenium. The common presenting features were headache and neck stiffness due to bleeding from the malformed vessels. The AVMs of the corpus callosum are supplied mainly by pericallosal arteries and occasionally branches of the posterior cerebral artery, the damage is by septal veins, the internal cerebral veins and the superior sagittal sinus. There was only minimal morbidity without operative mortality due to radical excision of these AVMs with microsurgical technique.
Arteries ; Cerebral Veins ; Corpus Callosum* ; Headache ; Hemorrhage ; Humans ; Mortality ; Neck ; Posterior Cerebral Artery ; Superior Sagittal Sinus ; Veins

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Clinical Applications of Visual Evoked Potentials.

Kwang Hwi OK ; Heung Sup CHUNG ; Jung Keun SUH ; Hoon Kap LEE ; Jeong Wha CHU

Journal of Korean Neurosurgical Society.1987;16(4):995-1004.

Visual evoked potentials were elicited by flash in 29 patients with a variety of cerebral lesions and in 10 normal controls. In 12 patients with focal brain lesions, no wave form could be recorded in one side. Of the remaining 23 sides, the average P1 latency showed no difference from that of the normal controls. In 17 patients with diffuse brain lesions no wave form could be elicited in 12 sides. Average P1 latency of remaining 22 sides showed statistlcally significant difference from that of normal controls. In this study it appears that delayed P1 latencies are associated with diffuse cerebral lesions rather than with localized lesions.
Brain ; Evoked Potentials, Visual* ; Humans

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