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Rapid Growing Eosinophilic Granuloma in Skull after Minor Trauma.

Korean Journal of Neurotrauma.2015;11(1):22-25. doi:10.13004/kjnt.2015.11.1.22

The authors present a case of rapidly progressing eosinophilic granuloma (EG) of the skull without hemorrhage after minor trauma. A 6-year-old boy presented with a soft mass on the midline of his forehead. He had a surgery for EG 19 months ago. One month earlier, computed tomography (CT) and bone scans were performed to evaluate the possible recurrence of EG, and there was no evidence of recurrence in CT. However, a slightly increased uptake in the bone scan was noted on the midline of the forehead. A rapid growing mass developed in a new spot after a minor trauma 7 days before the patient arrived at the clinic. His physical examination was unremarkable, except for a non-tender, soft, and immobile mass. A plain skull X-ray and CT showed a lytic bony defect on the midline of the frontal bone. Magnetic resonance imaging showed a 1.4 cm sized enhancing mass. Surgical resection and cranioplasty were done. The role of trauma in the development of EG is unclear. However, our case suggests that minor trauma is an aggravating factor for EG formation. Careful observation with regular follow-up is necessary in patients with EG after minor trauma.
Child ; Craniocerebral Trauma ; Eosinophilic Granuloma* ; Forehead ; Frontal Bone ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Recurrence ; Skull*

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Pyogenic Intradural Abscess of Lumbar Spine: A Case Report.

Jeong Eun CHEON ; Hee Jin YANG ; You Nam CHUNG ; Sung Bae PARK

Korean Journal of Neurotrauma.2015;11(1):18-21. doi:10.13004/kjnt.2015.11.1.18

We report a case of spinal intradural abscess which shows serial changes on magnetic resonance imaging (MRI). Well-encapsulated, rim-enhancing lesion with mass effect was visualized at ventral side of lumbar spinal canal on 17 days after initial negative MRI, which was thought to be epidural abscess. It was revealed to be intradural in location on operation and successfully treated by drainage and antibiotics. Follow-up MRI showed resolution of abscess. Clinical significance and pathogenesis of this case was briefly discussed.
Abscess* ; Anti-Bacterial Agents ; Drainage ; Epidural Abscess ; Follow-Up Studies ; Magnetic Resonance Imaging ; Spinal Canal ; Spine*

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Results of Isotope Cisternography in 175 Patients with a Suspected Hydrocephalus.

Kyeong Seok LEE ; Sang Mi LEE ; Jae Joon SHIM ; Seok Mann YOON ; Hack Gun BAE ; Jae Won DOH

Korean Journal of Neurotrauma.2015;11(1):11-17. doi:10.13004/kjnt.2015.11.1.11

OBJECTIVE: Normal pressure hydrocephalus (NPH) is a syndrome characterized by gait disturbance, memory impairment and urinary incontinence. The isotope cisternography (ICG) became less useful because of low accuracy and complications. We tried to evaluate the safety and value of the ICG. METHODS: We retrospectively collected data on ICG of 175 consecutive patients with a suspected hydrocephalus. We classified the ICG into four types by the ventricular reflux and circulation time. The ventricular size was measured by Evans index and the width of the third ventricle. RESULTS: There were three complications including one case of paraplegia. Type 4 was the most common type, observed in 53%. Type 3 (33%), type 2 (7%), and type 1 (7%) were observed less often. Type 4 was more common in patients with large ventricles. Types of the ICG were not related to the causes of hydrocephalus, gender, or age of the patients. Shunting was more frequently performed in type 4 (71%), compared to type 1 (17%), type 2 (33%), and type 3 (46%). Surgery was more common when the cause was vascular. After the shunt surgery, 33.0% were graded as the improved. Although there were some improvements even in the not-improved patients, they still needed many helps. The improvement was related to the preoperative state. CONCLUSION: ICG may bring a serious complication, however the incidence is very low. Although the predictability of response rate on the shunting is doubtful, ICG is a cheap and useful tool to select surgical candidates in NPH.
Diagnosis ; Gait ; Humans ; Hydrocephalus* ; Hydrocephalus, Normal Pressure ; Incidence ; Malpractice ; Memory ; Meningitis, Aseptic ; Paraplegia ; Radionuclide Imaging ; Retrospective Studies ; Third Ventricle ; Urinary Incontinence

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Serial Mini-Mental Status Examination to Evaluate Cognitive Outcome in Patients with Traumatic Brain Injury.

Chung Nam LEE ; Young Cho KOH ; Chang Taek MOON ; Dong Sun PARK ; Sang Woo SONG

Korean Journal of Neurotrauma.2015;11(1):6-10. doi:10.13004/kjnt.2015.11.1.6

OBJECTIVE: This study was aimed at finding out the changes in cognitive dysfunction in patients with traumatic brain injury (TBI) and investigating the factors limiting their cognitive improvement. METHODS: Between January 2010 and March 2014, 33 patients with TBI participated in serial mini-mental status examination (MMSE). Their cognitive functions were statistically analyzed to clarify their relationship with different TBI status. Patients who developed hydrocephalus were separately analyzed in regards to their cognitive function depending on the placement of ventriculoperitoneal shunt (VPS). RESULTS: Bi-frontal lobe injury (beta=-10.441, p<0.001), contre-coup injury (beta=-6.592, p=0.007), severe parenchymal injury (beta=-7.210, p=0.012), temporal lobe injury (beta=-5.524, p=0.027), and dominant hemisphere injury (beta=-5.388, p=0.037) significantly lowered the final MMSE scores. The risk of down-grade in the prognosis was higher in severe parenchymal injury [odds ratio (OR)=13.41, 95% confidence interval (CI)=1.31-136.78], temporal lobe injury (OR=12.3, 95% CI=2.07-73.08), dominant hemisphere injury (OR=8.19, 95% CI=1.43-46.78), and bi-frontal lobe injury (OR=7.52, 95% CI=1.31-43.11). In the 11 post-traumatic hydrocephalus patients who underwent VPS, the final MMSE scores (17.7+/-6.8) substantially increased from the initial MMSE scores (11.2+/-8.6). CONCLUSION: Presence of bi-frontal lobe injury, temporal lobe injury, dominant hemisphere injury, and contre-coup injury and severe parenchymal injury adversely influenced the final MMSE scores. They can be concluded to be poor prognostic factors in terms of cognitive function in TBI patients. Development of hydrocephalus aggravates cognitive impairment with unpredictable time of onset. Thus, close observation and routine image follow-up are mandatory for early detection and surgical intervention for hydrocephalus.
Brain Injuries* ; Cognition Disorders ; Contrecoup Injury ; Humans ; Hydrocephalus ; Neuropsychological Tests ; Prognosis ; Temporal Lobe ; Ventriculoperitoneal Shunt

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Bone Flap Resorption Following Cranioplasty after Decompressive Craniectomy: Preliminary Report.

Ji Sang KIM ; Jin Hwan CHEONG ; Je Il RYU ; Jae Min KIM ; Choong Hyun KIM

Korean Journal of Neurotrauma.2015;11(1):1-5. doi:10.13004/kjnt.2015.11.1.1

OBJECTIVE: Resorption of autologous bone flap grafts is a known long-term complication of cranioplasty following decompressive craniectomy (DC). We analyzed our data to identify risk factors for bone flap resorption (BFR) following cranioplasty. METHODS: A total of 162 patients who underwent cranioplasty following DC due to life-threatening elevated intracranial pressure between October 2003 and December 2012, were included in our investigation. Follow-up exceeded one year. RESULTS: BFR occurred as a long-term complication in 9 of the 162 patients (5.6%). The affected patients consisted of individuals who had undergone DC for traumatic brain injury (TBI; n=4), for subarachnoid hemorrhage (SAH; n=3), for cerebral infarction (n=1), and intracerebral hemorrhage (n=1). Logistic regression analysis identified no significant risk factors for BFR. CONCLUSION: TBI and SAH as initial diagnoses are more often associated with BFR than other diagnoses. This finding may influence future surgical decision making, especially in patients with possible risk factors for BFR. A prospective study with a large number of patients is needed to identify potential predictors of BFR such as bone flap sterilization and preservation.
Bone Resorption ; Brain Injuries ; Cerebral Hemorrhage ; Cerebral Infarction ; Decision Making ; Decompressive Craniectomy* ; Diagnosis ; Follow-Up Studies ; Humans ; Intracranial Hypertension ; Logistic Models ; Risk Factors ; Sterilization ; Subarachnoid Hemorrhage ; Transplants

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Erratum: Risk Factor Analysis for the Recurrence of Chronic Subdural Hematoma: A Review of 368 Consecutive Surgical Cases.

Chang Wan OH

Korean Journal of Neurotrauma.2017;13(1):61-61. doi:10.13004/kjnt.2017.13.1.61

Unfortunately, an error occurred during production of our paper, and we didn't catch it while reviewing the page proofs.

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Spontaneous Acute Subdural Hemorrhage in a Patient with a Tick Borne Bunyavirus-Induced Severe Fever with Thrombocytopenia Syndrome.

Jihwan YOO ; Ji Woong OH ; Chang Gi JANG ; Ju Hyung MOON ; Eui Hyun KIM ; Jong Hee CHANG ; Sun Ho KIM ; Seok Gu KANG

Korean Journal of Neurotrauma.2017;13(1):57-60. doi:10.13004/kjnt.2017.13.1.57

We report the first case of severe fever with thrombocytopenia syndrome (SFTS) and a spontaneous acute subdural hematoma (SDH) in Korea. A 79-year-old male presented with fever and thrombocytopenia. On the third day of hospitalization, his mental changed from drowsy to semi-coma. Brain computed tomography indicated an acute subdural hemorrhage on the right convexity. He was given early decompressive craniectomy, but did not survive. Real-time reverse transcription polymerase chain reaction analysis of a blood sample indicated the presence of SFTS virus (SFTSV). This is the first reported case with intracranial hemorrhage and SFTS. This case report describes our treatment of a patient with acute SDH and an infection from a tick-borne species of Bunyaviridae.
Aged ; Brain ; Bunyaviridae ; Decompressive Craniectomy ; Fever* ; Hematoma, Subdural* ; Hematoma, Subdural, Acute ; Hospitalization ; Humans ; Intracranial Hemorrhages ; Korea ; Male ; Orthobunyavirus ; Polymerase Chain Reaction ; Reverse Transcription ; Thrombocytopenia* ; Ticks*

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Adjacent Bilateral Stress Pedicle Fractures after Instrumented Lumbar Fusion: A Case Report.

Hak Sung KIM ; Sang Woo HA ; Chang Il JU ; Seok Won KIM

Korean Journal of Neurotrauma.2017;13(1):54-56. doi:10.13004/kjnt.2017.13.1.54

Bilateral pedicle stress fractures are rare even in the elderly. Bilateral pedicle fractures are due to post-surgical complications at the level of fusion or stress related activities in most cases. The authors describe a unique case of adjacent L4 bilateral pedicle fractures, which developed 4 years after anterior lumbar interbody fusion with bone cement augmented screw fixation at the L5-S1 level. As far as the authors' knowledge, no similar case has been previously reported in the literature. The pathophysiological mechanism of this rare entity is discussed with review of relevant literature.
Aged ; Fractures, Stress ; Humans ; Lumbar Vertebrae ; Spinal Fusion

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Severe Retrolisthesis at the Adjacent Segment after Lumbar Fusion Combined with Dynamic Stabilization.

Min Chan KIM ; Hui Sun WANG ; Chang Il JU ; Seok Won KIM

Korean Journal of Neurotrauma.2017;13(1):50-53. doi:10.13004/kjnt.2017.13.1.50

Lumbar fusion using the pedicle screw system is a popular operative procedure, with favorable clinical results and high fusion rates. However, the risk of adjacent segment disease after lumbar fusion is problematic. We report a complicated case of severe retrolisthesis at L3-4 level following dynamic interspinous process stabilization at L2-3 level and a fusion at L4-5 level. The radiological and clinical findings of this complication are discussed, and a review of the literature is presented.
Lumbar Vertebrae ; Pedicle Screws ; Spinal Diseases ; Spinal Fusion ; Surgical Procedures, Operative

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Incomplete Isolated C7 Root Injury Caused by Gunshot Wound: A Case Report.

Ulvi CIFTÇI ; Ahmet Tolgay AKINCI ; Emre DELEN ; Doğan GÜÇLÜHAN

Korean Journal of Neurotrauma.2017;13(1):45-49. doi:10.13004/kjnt.2017.13.1.45

Gunshot wounds to the spine cause severe neurological and/or internal organs damages. Although most of publications in the literature are realized on military injuries, increased civilian arming which raises civilian gunshot injuries is a new social danger causing serious health problems. In gunshot injuries to the spine; vertebral column, spinal cord and nerve roots are damaged with direct, indirect and transient cavitation related mechanisms. In this case report, we present 24 years old male patient who had severe pain and monoparesis in left upper extremity followed by gunshot injury to the spine with clinical, radiological and postoperative follow-up findings.
Arm ; Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Male ; Military Personnel ; Paresis ; Radiculopathy ; Spinal Cord ; Spine ; Upper Extremity ; Wounds, Gunshot*

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