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1.
Article de Anglais | WPRIM | ID: wpr-1043212

RÉSUMÉ

Objective@#Double microcatheter technique (dMC) can be the alternative to Single microcatheter technique (sMC) for challenging cases, but there is lack of studies comparing dMC to sMC especifically for small ruptured aneurysms. Our objective was to compare the safety and efficacy of dMC to sMC in treating small (≤5 mm) and tiny (≤3 mm) ruptured aneurysms. @*Methods@#This study focused on 91 out of 280 patients who had ruptured aneurysms and underwent either single or double microcatheter coil embolization. These patients were treated with either single or double microcatheter coil embolization. We divided the patients into two groups based on the procedural method and evaluated clinical features and outcomes. Subgroup analyses were conducted specifically for tiny aneurysms, comparing the two methods, and within the dMC group, we also examined whether the aneurysm was tiny or not. In addition, univariate logistic regression analysis was performed to assess the impact of coil packing density. @*Results@#The mean values for most outcome measures in the dMC group were higher than those in the sMC group, but these differences did not reach statistical significance (coil packing density, 45.739% vs. 39.943%; procedural complication, 4.17% vs. 11.94%; recanalization, 8.3% vs. 10.45%; discharge discharge modified Rankin Scale (mRS), 1.83 vs. 1.97). The comparison between tiny aneurysms and other sizes within the dMC group did not reveal any significant differences in terms of worse outcomes or increased risk. The only factor that significantly influenced coil packing density in the univariate logistic regression analysis was the size of the aneurysm (OR 0.309, 95% CI 0.169–0.566, p=0.000). @*Conclusions@#The dMC proved to be a safe and viable alternative to the sMC for treating small ruptured aneurysms in challenging cases.

2.
Article de Anglais | WPRIM | ID: wpr-999757

RÉSUMÉ

The World Health Organization (WHO) updated the classification of pituitary tumors in 2022. The new classification presents detailed histological subtyping of a pituitary neuroendocrine tumor (PitNET) based on the tumor cell lineage, cell type, and related characteristics. The immunohistochemistry for pituitary transcription factors (PIT1, TPIT, SF1, GATA3, and ERα) is routinely needed in this classifica-tion. The controversy regarding the change of behavior code of all PitNET/pituitary adenoma from “0” for benign tumors to “3” for primary malignant tumors is a topic of debate among experts, nowadays. Some authors represent that pituitary adenoma has a tendency for hemorrhage and necrosis and frequent invasion of the cavernous sinus. However, most small PitNET/pituitary adenoma do not need any treatment because of benign biologic behavior or less than 5% recurrence after gross total removal. Pituitary apoplexy is also benign nature but has a tendency of cranial nerve compression or panhypopituitarism. Most of cavernous invasion is compression of the cavernous sinus. Aggressive PitNET/ pituitary adenoma with malignant biological behavior is less than 1%.

3.
Article de Anglais | WPRIM | ID: wpr-717588

RÉSUMÉ

Meningioma is relatively common, benign, and extra-axial tumor accounting for about 20% of primary brain and spinal cord tumors. The World Health Organization (WHO) classified these tumors into Grade I (benign), Grade II (atypical), and Grade III (anaplastic) meningioma. Grade I meningioma which is slowly growing tumor and have some rare subtypes. Among them, metaplastic subtype is defined as a tumor containing focal or widespread mesenchymal components including osseous, cartilaginous, lipomatous, myxoid or xanthomatous tissue, singly or in combinations. We report a rare metaplastic meningioma overspreading nearly whole cerebral convexity from main extra-axial tumor bulk in the parietal lobe.


Sujet(s)
Encéphale , Tumeurs du cerveau , Méningiome , Lobe pariétal , Anatomopathologie , Tumeurs de la moelle épinière , Organisation mondiale de la santé
4.
Article de Anglais | WPRIM | ID: wpr-714857

RÉSUMÉ

OBJECTIVE: Cerebral microbleeds (CMBs) are known as the neuroimaging markers of risk in stroke and dementia. Many studies on CMBs in elderly patients with hemorrhagic or ischemic stroke have been reported; however, reports on CMBs in young populations with intracerebral hemorrhage (ICH) are lacking. MATERIALS AND METHODS: A total of 272 patients aged 18–54 years presented to our hospital with ICH between December 2009 and August 2017. Among these, CMB presence, count, and topography with respect to ICH were evaluated on magnetic resonance imaging (MRI) gradient echo images (GREs). We also evaluated the prevalence and risk factors of CMBs. RESULTS: Among 272 patients, only 66 underwent GRE T2-weighted MRI. CMBs were detected in 40 patients (61%), with 29 (73%) being of the multifocal type. Among the 219 CMBs, 150 (68.5%) were of the deep type and 69 (31.5%) of the lobar type. CMB prevalence was higher in men. In multivariate logistic regression analysis, history of hypertension (adjusted odds ratio [aOR], 4.048; 95% confidence interval [CI], 1.14–14.32; p = 0.030), and male sex (aOR, 4.233; 95% CI, 1.09–16.48; p = 0.037) were independently associated with CMBs. CONCLUSION: In young patients who presented with spontaneous ICH, CMBs were highly prevalent in 61% of patients and strongly associated with history of hypertension and male sex.


Sujet(s)
Sujet âgé , Humains , Mâle , Jeune adulte , Hémorragie cérébrale , Démence , Hypertension artérielle , Hémorragies intracrâniennes , Modèles logistiques , Imagerie par résonance magnétique , Neuroimagerie , Odds ratio , Prévalence , Facteurs de risque , Accident vasculaire cérébral
5.
Article de Anglais | WPRIM | ID: wpr-64798

RÉSUMÉ

OBJECTIVE: To evaluate the effectiveness and efficacy of delayed burr hole surgery in relation to the reduction of postoperative subdural hematoma (SDH) volume in patients with acute SDH. METHODS: We retrospectively analyzed patients with acute SDH who received delayed burr hole surgery at our institute. Age, sex, Glasgow coma scale, maximal SDH thickness, volume of SDH, midline shifts, hounsfield unit (HU), and medical history of anticoagulant agent usage were recorded. Outcome measures were delayed operation day, reduction of SDH volume after operation, and the Glasgow outcome scale (GOS) score at discharge. The patients were divided two groups according to the post-operative reduction of volume of SDH (≥50%, group A; <50%, group B). We also analyzed variables and differences between two groups. RESULTS: Eighteen patients were available for this analysis. The mean delayed of surgery was 13.9±7.5 days. Maximal thickness of SDH was changed from 10.0±3.5 mm to 12.2±3.7 mm. Volume of SDH was changed from 38.7±28.0 mL to 42.6±29.6 mL. Midline shifts were changed from 5.8±3.3 mm to 6.6±3.3 mm. HU were changed from 66.4±11.2 to 53.2±20.6. Post-operative reduction of SDH volume was 52.1±21.1%. Eleven patients (61%) had a discharge GOS score of 1 (good recovery). Ten patients (56%) were enrolled in group A. Midline shifting was greater in group A than in group B (7.4±3.3 vs. 3.0±2.4 mm; p<0.02). The delay of surgery was shorter for group A than group B (9.2±2.3 vs. 19.8±7.7 days; p<0.0008). CONCLUSION: Among well selected patients, delayed burr hole surgery in patients with acute SDH may be effective for reduction of SDH volume. Further studies will be necessary to establish the effectiveness and safety of delayed burr hole surgery in patients with acute SDH.


Sujet(s)
Humains , Échelle de coma de Glasgow , Échelle de suivi de Glasgow , Hématome subdural , Hématome subdural aigu , 29918 , Études rétrospectives
6.
Article de Anglais | WPRIM | ID: wpr-204837

RÉSUMÉ

Primary intracranial malignant melanoma is a very rare and highly aggressive tumor with poor prognosis. A 66-year-old female patient presented a headache that had been slowly progressing for several months. A large benign pigmented skin lesion was found on her back. A brain MRI showed multiple linear signal changes with branching pattern and strong enhancement in the temporal lobe. The cytological and immunohiostochemical cerebrospinal fluid examination confirmed malignant melanoma. A biopsy confirmed that the pigmented skin lesion on the back and the conjunctiva were benign nevi. We report a case of primary intracranial malignant melanoma and review relevant literatures.


Sujet(s)
Sujet âgé , Femelle , Humains , Biopsie , Encéphale , Liquide cérébrospinal , Conjonctive , Céphalée , Imagerie par résonance magnétique , Mélanome , Naevus , Pronostic , Peau , Hémorragie meningée , Lobe temporal
7.
Korean Journal of Spine ; : 109-112, 2014.
Article de Anglais | WPRIM | ID: wpr-148291

RÉSUMÉ

OBJECTIVE: Cervical radicular pain is defined as pain arising in the arm caused by irritation of a cervical spinal nerve or its roots. Although many treatment modalities are described in the literature, the available evidence for efficacy is not sufficient to allow definitive conclusions. The goal of this study was to establish the benefits and prognostic factors of pulsed radiofrequency (PRF) on the adjacent cervical dorsal root ganglia (DRG) of cervical radicular pain patients. METHODS: A retrospective study of PRF treatment of patients with cervical radicular pain was carried out. Two times diagnostic block of cervical DRG were performed before PRF. PRF was applied for 2 minutes at a setting of 2 Hz and 45 V by two times on the same targets, with the end point being an electrode tip temperature 42degrees C. Numerical rating scale (NRS) score was evaluated post-treatment 2 week, 1 month, 3 months and 6 months, which were compared with pretreatment value. A successful outcome was defined that NRS change was improved more than 50% at 6 months. RESULTS: The mean age was 54 years. The success rate was 68%(15/22) after six months of follow-up. PRF induced complications were not observed. Between success and failure group, we do not find any positive outcome prognostic factor. Interestingly, PRF treatment on foraminal stenosis is better outcome than herniated cervical disc. CONCLUSION: PRF on adjacent cervical DRG is effective and safe treatment option for cervical radicular pain patients. However, more long-term follow up and larger patients are needed to establish effectiveness PRF treatment on cervical radicular pain patients.


Sujet(s)
Humains , Bras , Sténose pathologique , Groupes homogènes de malades , Électrodes , Études de suivi , Ganglions sensitifs des nerfs spinaux , Traitement par radiofréquence pulsée , Études rétrospectives , Nerfs spinaux
8.
Article de Anglais | WPRIM | ID: wpr-179138

RÉSUMÉ

Lymphomatosis cerebri is considered a diffuse form of primary central nervous system lymphoma and very rare. It is not well recognized and may be misdiagnosed with infiltrating tumors, degenerative disorders, ischemic diseases, and infectious diseases developed in the brain. Awareness of the possibility of this rare disease and early biopsy are required for differential diagnosis and preventing poor clinical outcomes. We report a case with lymphomatosis cerebri who presented with rapid neurological deteriorations and review the relevant literatures.


Sujet(s)
Biopsie , Encéphale , Système nerveux central , Maladies transmissibles , Diagnostic différentiel , Lymphomes , Maladies rares
9.
Article de Anglais | WPRIM | ID: wpr-84961

RÉSUMÉ

Acute subdural hematoma is usually a neurological emergency that requires hematoma evacuation or close observation. However, spontaneous resolutions of an acute subdural hematoma without surgical interventions have been reported rarely. We report on a case who showed rapid resolution of an acute subdural hematoma with neurological improvement and review the relevant literatures.


Sujet(s)
Urgences , Hématome , Hématome subdural , Hématome subdural aigu
10.
Article de Anglais | WPRIM | ID: wpr-90157

RÉSUMÉ

Intracranial aneurysms in the neonate are very rare and their clinicopathological findings remain unclear. We report a 26-day-old premature neonate who underwent microsurgical clipping on the ruptured middle cerebral artery bifurcation aneurysm successfully with a review of relevant literature.


Sujet(s)
Humains , Nouveau-né , Anévrysme , Anévrysme intracrânien , Artère cérébrale moyenne
11.
Article de Coréen | WPRIM | ID: wpr-12568

RÉSUMÉ

Reduction malarplasty (RMP) to reshape the facial contour is one of the most popular aesthetic surgical procedures in Asia. Here we report a case of intracerebral hematoma (ICH) after RMP. A 31-year-old woman was referred to our hospital following RMP. On arrival at our emergency room, she presented with deep drowsy mentality and right hemiparesis. Computed tomographic scan demonstrated an ICH. We conducted stereotactic aspiration of the blood clots. Because of increased ICH after the operation, the patient underwent craniotomy and hematoma evacuation. After removal of hematoma, intraoperatively a defect of the middle cranial fossa dura, a skull base bony defect, and a bony fragment were noticed. We think that these lesions have been caused by aggressive manipulation of surgical instruments. To our knowledge, ICH after RMP was not reported. The radiologic features of this case and suggested mechanism of the complication are described.


Sujet(s)
Femelle , Humains , Asie , Hémorragie cérébrale , Hémorragie cérébrale traumatique , Fosse crânienne moyenne , Craniotomie , Urgences , Hématome , Parésie , Base du crâne , Instruments chirurgicaux
12.
Article de Anglais | WPRIM | ID: wpr-100452

RÉSUMÉ

In the paper by Lee et al., the name of the corresponding author was given incorrectly. The correct name should be Chan-Young Choi as given above.

13.
Article de Anglais | WPRIM | ID: wpr-38036

RÉSUMÉ

Spinal angiolipomas are rare lesions usually found in the epidural space of the thoracic spine. The infiltrating type of spinal angiolipomas is extremely rare. This report presents the case and reviews the related literature. A 58-year-old man was presented with a 7-month history of progressive weakness and sensory change of lower extremities. Magnetic resonance images showed a well-enhanced mass infiltrating the vertebral foramen at the T4-5 level. Resection of the tumor was performed. Histological study revealed the tumor as an angiolipoma. The patient was relieved from symptoms after tumor resection.


Sujet(s)
Humains , Adulte d'âge moyen , Angiolipome , Espace épidural , Membre inférieur , Spectroscopie par résonance magnétique , Rachis
14.
Article de Anglais | WPRIM | ID: wpr-38041

RÉSUMÉ

Intraventricular cavernous hemangiomas are uncommon. Among them, those occurred at the foramen of Monro in the third ventricle may be of particular interest because of its rarity, development of hydrocephalus, being differentiated from other brain lesions. We present a rare case of intraventricular cavernous hemangioma at foramen of Monro which was resected through microsurgery and also review the relevant literatures.


Sujet(s)
Malformations artérioveineuses , Encéphale , Grottes , Ventricules cérébraux , Hémangiome caverneux , Hydrocéphalie , Microchirurgie , Troisième ventricule
15.
Article de Anglais | WPRIM | ID: wpr-22517

RÉSUMÉ

It is well known that spontaneous thrombosis in giant cerebral aneurysm is common. However, spontaneous obliteration of a non-giant and unruptured cerebral aneurysm has been reported to be rare and its pathogenic mechanism is not clear. We describe a case with rare vascular phenomenon and review the relevant literatures.


Sujet(s)
Anévrysme intracrânien , Thrombose
16.
Article de Anglais | WPRIM | ID: wpr-22518

RÉSUMÉ

The anterior choroidal artery has several kinds of variations. Among them, the transposition of anterior choroidal artery and posterior communicating artery origins has been extremely rare. We report a case with cerebral aneurysm arising from posterior communicating artery which origin was distal to the anterior choroidal artery and review the relevant literature.


Sujet(s)
Artères , Choroïde , Anévrysme intracrânien
17.
Article de Anglais | WPRIM | ID: wpr-9047

RÉSUMÉ

OBJECTIVE: Endovascular treatment of cerebral aneurysms with detachable coils has proved to be a safe and effective. However, long term result was not satisfactory in less than 30% for regrowth or coil compaction. This paper highlighted the safety and technique of microsurgical clipping and coil removal in previously coiled aneurysms showing recurrence or remnant growth. METHODS: Sixty two patients from 2007 to 2010 were treated by endovascular coiling. Among them, six patients (9.6%) showed recurrence, who had near complete obliteration initially. We retrospectively analyzed the clinical data and radiographic images of these patients (male 2, female 4, mean age 46.6) who underwent microsurgical clipping with partial (4 cases) or complete (2 cases) coil removal. Computerized tomographic angiogram (CTA) was performed soon after microsurgical clipping for the evaluation. RESULTS: Four aneurysms were located at anterior circulation and two were at the posterior circulation. Four patients were detected by routine followed CTA or angiography and one had recurrent subarachnoid hemorrhage and another one had severe eyeball pain. Microsurgical treatment were performed about 12.9 months (range: 2~26) after coiling. Complete coil removal was done in two patients. Complete obliteration was performed in all, which were confirmed by postoperative CTA with less coil artifact. All patients attained the same neurological state presented prior to surgery (the Glasgow Outcome Scale (GOS) 4~5). CONCLUSION: Microsurgical clipping and coil removal following a previous endovascular coil embolization are not so common. However, these would be permanent treatment options without any morbidity in properly selected patients. These are challenging and risky procedure, but necessary to avoid postoperative coil artifact on the follow-up radiologic evaluation.


Sujet(s)
Femelle , Humains , Anévrysme , Angiographie , Artéfacts , Études de suivi , Échelle de suivi de Glasgow , Anévrysme intracrânien , Récidive , Études rétrospectives , Hémorragie meningée
18.
Korean Journal of Spine ; : 63-65, 2011.
Article de Anglais | WPRIM | ID: wpr-213556

RÉSUMÉ

Tumors of the brachial plexus are relatively rare. The most common intrinsic tumors involving the brachial plexus are benign schwannomas and neurofibromas. Neurofibromas are usually associated with neurofibromatosis-1 (NF-1). Solitary neurofibromas unassociated with NF-1 are very uncommon. We report a 56 year-old man with brachial plexus solitary neurofibroma and reviews of literatures.


Sujet(s)
Plexus brachial , Neurinome , Neurofibrome , Neurofibromatoses
19.
Article de Anglais | WPRIM | ID: wpr-199082

RÉSUMÉ

A rare case of intraventricular meningioma that arose in the atrium of the left lateral ventricle was identified in a 51-year-old woman. Gross total removal was performed by transcortical approach. Histopathological findings showed meningothelial meningioma with a focal atypical area which had 8% of Ki-67 labeling index (LI). A large recurrence extending into the ipsilateral quadrigeminal cistern and opposite medial occipital lobe developed approximately 41 months after the first operation. The specimens obtained from the second resection showed atypical meningioma with 20% of Ki-67 LI but there were no anaplastic area. The patient underwent fractionated stereotactic radiotherapy. However, multiple local distant metastases were found in the occipital and cerebellar cortex suggesting cerebrospinal fluid dissemination apparently 24 months after the second operation. This report presents chronological progression of a rare intraventricular atypical meningioma with more aggressive transformation.


Sujet(s)
Femelle , Humains , Adulte d'âge moyen , Cortex cérébelleux , Ventricules latéraux , Méningiome , Métastase tumorale , Lobe occipital , Récidive
20.
Article de Anglais | WPRIM | ID: wpr-149318

RÉSUMÉ

Cortical laminar necrosis appears as hyperinense lesions with a laminar pattern on T1 weighted magnetic resonance (MR) imaging, without signs of hemorrhage or calcification on T2 weighted MR imaging or computed tomography. It has been reported to be associated with hypoxia, metabolic disturbances, drugs, and infections. We present a 12 month-old male infant who suffered diffuse brain injuries following car accident and showed laminar necrosis of cortex.


Sujet(s)
Humains , Nourrisson , Mâle , Hypoxie , Lésions encéphaliques , Hémorragie , Spectroscopie par résonance magnétique , Nécrose
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