A case of sudden paraplegia as the first symptom of a ruptured internal carotid artery bifurcation aneurysm is reported. Sudden appearance of paraparesis or paraplegia is an exceptional event in patients with intracranial aneurysms. The various pathogenic mechanisms are briefly discussed. Insufficient blood perfusion of both paracentral areas was the cause of paraplegia in this case.
Aneurysm* ; Carotid Artery, Internal ; Humans ; Intracranial Aneurysm ; Paraparesis ; Paraplegia ; Perfusion

Topographic electroencephalographic study(CME) is a newly developed method using a microcomputer system that displays the scalp topograph as the square roots of the average power spectra over each EEG frequency band on a color television screen. CME were applied to thirty patients, Fifteen patients out of them with focal neurologic deficit were analysed about CT scan and conventional EEG. The results of the study were as follows : 1) Comparing the results of CME and conventional EEG reading, CME revealed to be slightly more sensitive in detecting asymmetrical depression of background activity than the conventional reading of the EEG. 2) Topograph EEG study was more accurate than conventional EEG in lateralization of the lesion. 3) CME is very useful in topographic and objective diagnosis of functional lesion, although the source of the data is the same as that from the conventional EEG.
Depression ; Diagnosis ; Electroencephalography ; Humans ; Microcomputers ; Neurologic Manifestations ; Scalp ; Television ; Tomography, X-Ray Computed

184 paraplegics and tetraplegics of Korean male(159 alive and 25 dead) subjected to spinal cord injury during 1950~1976 were followed up for 10~36 years. The 38 patients were interviewed individually and for the other 146 patients, various records of Korean Patriots and Veteran Affairs Agency were analysed. 95.1% out of 1984 patients were service men and 86.9% were second decade. Among 159 living patients, survival rate after injury markedly reduced at 15 years after injury in cervical cord injury group and at 20 years in lumbar cord injury group, thereafter it had gradually reduced in both groups. The changes of survival rate in the thoracic cord injury group showed intermediate form of cervical and lumbar cord group. Of 25 patients dead (thoracic and lumbar cord injuries), survival rate reduced markedly from 20 years after trauma. In 38 patients who were interviewed individually, 55.2% and 76.3 of patients were recovered to get in the wheel-chair within 1 year and 2 year after trauma respectively and in 45.8% the decubitus were not healed after 2 years of trauma. The 39.4% out of 38 patients were able to urinate involuntarily, if any, with voiding desire. And the penile erection and ejaculation were possible or occasionally possible in the 55% and 34% respectively.
Ejaculation ; Follow-Up Studies* ; Humans ; Male ; Penile Erection ; Sexual Behavior ; Spinal Cord Injuries ; Spinal Cord* ; Survival Rate ; Veterans

Craniopharyngiomas are usually considered to arise from the pituitary stalk and upper aspect of the pituitary gland. However, they very rarely develop from the floor of the third ventricle or the lamina terminalis, and are intrinsically confined to the third ventricle ; about 40 cases have been reported in the literatures. We have recently experienced a case of intrinsic intraventricular craniopharyngioma with the density a little higher than cerebrospinal fluid on the brain CT.
Brain ; Cerebrospinal Fluid ; Craniopharyngioma* ; Hypothalamus ; Pituitary Gland ; Third Ventricle

There are several methods in the surgical treatment of hypertensive intracerebral hemorrhage, such as craniotomy and hematoma removal, stereotaxic aspiration of hematoma and external ventricular drainage with maintaining physiologic ventricular pressure(over-pressure EVD). In spite of all these methods, surgical treatment yields unsatisfactory results when the patient is comatous and show herniation signs preoperatively. We treated 9 cases of hypertensive intracerebral hemorrhage with ventricular rupture by hematoma removal and continuous free external ventricular drainage instead of over-pressure drainage. In 4 cases, during the drainage, obstruction of the drainage catheter by blood clots or clamping resulted in immediate deterioration of the patient's condition, which was reversed by maintaining the patency suggesting that postoperative control of ICP was essential in treating hypertensive intracerebral hemorrhage in addition to hematoma removal. 7 out of 9 cases regained consciousness and improved gradually with mild to serve neurologic deficit. One patient died of rebleeding in the midbrain and one was discharged by family's will.
Brain Edema ; Catheters ; Cerebral Hemorrhage ; Consciousness ; Constriction ; Craniotomy ; Drainage* ; Hematoma ; Humans ; Hypertension ; Intracranial Hemorrhage, Hypertensive* ; Mesencephalon ; Neurologic Manifestations ; Rupture*

The lysing capability urokinase(UK) and streptokinase (SK) in intracerebral hematoma were examined in vitro and in a rabbit model. Intracerebral-intraventricular(IC-IV) hematomas were created by stereotaxically injecting 0.2ml of clotted human blood into the frontal lobe and lateral ventricle of a total of 87 house rabbits(weighing 1.5-2.7kg). Control animals received 0.2ml of physiologic saline infused into the clot, and the experimental group received an equal volume of UK solution(50,000units/ml), SK solution(50,000units/ml), UK-SK mixture(0.1ml of UK solution, 0.1ml of SK solution) respectively after the clot infusion. Forty two animals were sacrificed at 3 hours and 45 animals at 24 hours after infusion, The results obtained were as follows: 1) At 3 hours, clot lysis had been achieved in 8(67%) of 12 UK-infused animals, 5(36%) of 14 SK-infused animals and 6(60%) of 10 UK-SK-infused animals as compared to zero of 6 controls. 2) At 24 hours, clots had been lysed in 11(73%) of 15 UK-infused animals, 8(67%) of 12 SK-infused animals, 8(67%) of 12 UK-SK-infused animals and in 2(33%) of 6 controls. 3) There was mild inflammatory reaction by the clotted blood, but no additional histologic abnormality by thrombolytic agents(UK,SK) on microscopic examination. 4) Therefore we suggest that UK, SK or UK-SK mixture may be effectively used for the lysis of clotted intracerebral hematoma in the rabbit model and UK, UK-SK mixture are more effective than SK at 3 hours.
Animals ; Fibrinolytic Agents* ; Frontal Lobe ; Hematoma* ; Humans ; Lateral Ventricles ; Streptokinase ; Urokinase-Type Plasminogen Activator

The changes of total ascorbic acid level in the spinal cord tissues following experimental spinal cord injury were observed in the 20 cats. Three small areas (2x1.5cm sized) in the thoracic cord following laminectomy were made and the specimens were removed in one control and the other two areas after 5 & 30 minutes following impact injury respectively in each cat. The significant decrease of the total ascorbic acid level after 5 & 30 minutes following experimental spinal cord injury was found.
Animals ; Ascorbic Acid* ; Cats ; Laminectomy ; Spinal Cord Injuries* ; Spinal Cord*

Four cases of delayed post-traumatic epidural hematoma which had not been present on initial CT scan were found on repeated CT scan. The delayed epidural hematoma was developed after evacuation of a hematoma in all cases. And a skull fracture was present at the site of the delayed hematoma in two cases. The neurologic deterioration heralded the onset of delayed epidural hematoma after decompressive therapy by either surgical or medical means. Repeated CT scan is indicated if anticapated improvement from does not occur after decompression by either surgical or medical means, recovery from shock, or whenever there is evidence of even minimal bleeding under a skull fracture on the initial CT scan.
Decompression ; Hematoma* ; Hemorrhage ; Shock ; Skull Fractures ; Tomography, X-Ray Computed

Fracture involving the sella turcica is a rare complication of head injury but draws attention of neurosurgeon because it can result in serious neurological, vascular and endocrine complications. Anatomically the sella being located central within the extensive basal dural attachments to the cranial vault, shearing force is transmitted directly to this structure and results in isolated complications. We recently experienced a case of fractured dorsum sellae complicated with cranial nerve palsy and report here with some references.
Cranial Nerve Diseases ; Craniocerebral Trauma ; Sella Turcica

The Clinical analysis of 130 spontaneous intracebral & cerebellar hematoma confirmed by brain CT & admitted to this neurosurgical clinic past years & 5 months were made with literature review. 1) The age incidence showed increase over fourth decade and male to female ratio was 56.1:43.9. 2) 50.4% of total patients showed hypertension but 40.3% did not checked their B.P. & 9.3% had normal B.P. before cerebral hemorrhage. Among 50.4% of hypertension cases, 72% received antihypertensive treatment intermittently, 2.9% regularly and the rest 24.3% did not. 3) 69.7% of hematoma located in basal ganglia & thalamus. In nonoperated patients, the morbidity & mortality showed no marked difference in their location except pontine & cerebellar hematomas. In operated patients the morbidity & mortality was prominent in putaminal hemorrhage than in thalamus and cerebellum. Most of putaminal hematoma had semicomatose or comatose mental state and ventricular hemorrhage in 87.5%. 4) The morbidity & mortality increased in proportion to size of hematomas, grade of unconsciousness in admisson and state of intraventricular hemorrhage. 5) About time interval from ictus to operation, the patients within first 24 hours are 29 cases(51.1%) and the next 24 hours are 13 cases(26.5%). The mortality rate of two groups were 55.1% & 53.8% respectively but no death in the patients with operation performed after 48 hours. 6) The morbidity & mortality rate were as follows. In the non operated patients (90 patients), no or mild neurological deficits:22.2% moderate:21.1% severe:20% and moribund or death:36.6%. In the operated patients no or mild neurological deficits:16.3% moderate:18.4% severe:18.4% and moribund or death:46.9%. The results of total patients showed no or mild neurological deficits:20.1%, moderate:20.1%, severe:19.4% and moribund or death:40.2%.
Basal Ganglia ; Brain ; Cerebellum ; Cerebral Hemorrhage ; Coma ; Female ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Putaminal Hemorrhage ; Thalamus ; Unconsciousness