A Case of the Redundant Nerve Root Syndrome Mimicking Intradural Spinal Tumor

The redundant nerve root syndrome is not common and demonstrates a large, elongated, and tortuous nerve roots of cauda equina. Usually, the diagnosis of this syndrome is not difficult with the radiological finding and clinical symptom. The authors report a case of the redundant nerve root syndrome mimicking intradural spinal tumor in view of the symptom and radiological findings. Magnetic resonance imaging revealed a globular intradural mass just above canal stenosis. Decompressive laminectomy and durotomy improved back pain and radicular pain. From the experience of this case, the relief of nerve root compression is recommended as early as possible in the redundant nerve root syndrome.

Surgical Treatment for the AVM Feeding Mainly from PCA

Among 51 intractanial AVM patients, 30 patients(58.8%) with AVM supplied mainly with PCA were studied for the relationship with feeding vessels, location and the size of AVM in connection with hemorrhage and also results in 20 surgical patients were analyzed. On cerebral angiogram, 56.7% accounted for AVM supplied only by PCA, 16.7% together with MCA and 26.6% with MCA and ACA. By location, 36.7% were for subcortical AVM and 63.3% were for deeply located paraventricular. 53.3% were large AVM and of them, 6.5% bleeded 30.0% accounted for small AVM, of which 88.9% bleeded. The total bleeding rate was high at 73.3%. Complete removal by surgery was available for 90.0%, and post operative improvement was at 75.0% with a mortality rate of 10.0%. 50.0% showed disappearance of seizure following total removal and 33.3% improved. 5.0%, however, had seizure for the first time following the surgery.

Posterior Approach for Cervical Spondylosis with Radiculomyelopathy

Of the 68 cervical spondyltic patients showing symptoms of radiculomyelopathy, assessments were made on 29 patients who underwent neural decompressive surgery with cervical laminectomy through posterior approach for the results of surgery. Analyses were also made on the anterior-posterior diameters of cervical canal on the plain film of cervical spine. The mean values of anterior-posterior diameters measured on the levels of cervical C3-7 were 16.5+/-1.83 mm in the normal adult and 7.3+/-1.08 mm in the cervical spondylotic patients with radiculomyelopathy, which is far narrower than that of the normal. In cervical spondylotic patients, the anterior-posterior diameters of directly upper and lower parts of the lesions were 11.9+/-1.20 mm and 12.1+/-1.61 mm respectively, also much narrower mean values than those of the normal control group. The results of the 29 patients who received cervical laminectomy by posterior approach were much improved for 51.7% and improved for 44.8%.

Rebleeding of Intracranial Aneurysm with SAH

The followings were evaluated as subjects of this study on 79 rebleeding cases of the 312 ruptures aneurysmal patients : incidence, time of rebleeding, location of rebleeding aneurysm, together with clinical grade and results of rebleeding. The incidence of rebleeding was 25.3% without prominent distinction between sexes. In the rebleeding rats by location, MCA aneurysm was found to be highest(30.8%) with no statistical significance. The 36.7% rebleeded in a week after initial bleeding, which indicates a daily average incidence of 5.3%. From one week on, the bleeding rate tapered off. Favorable risk patients showed a significantly higher rate(36.8%) compared with poor risk patients(6.7%). The mortality rate by rebleeding was 6.3%.

Results of Surgical Treatment in Nontraumatic Deep Intracerebral Hematomas

140 patients of nontraumatic deep intracerebral hematoma, admitted at Kyungpook National University Hospital for 2 years, were evaluated through analysis for their therapeutic results. Two operative methods were adopted ; emergency craniotomy and burr hole aspiration applied each method to the patients occupied 35.7% of whole cases respectively and the remaining 28.6% went without operation. Most of the craniotomy was done within 24 hours after bleeding attack with a result of 82% of complete removal of hematoma. Burr hole aspiration was done within and around one to two weeks for perfect removal. Consciousness after removal of hematoma showed a remarkable improvement while motor weakness improved rather slowly. Therapeutic results of the whole patients at the time of discharge were following ; Good-15%, doing enough for daily life, Fair-56.4%, possible for carrying out daily routine in near future, and total death was 12 patients(8.6% of the whole) ; 7 patients(58.3%) due to direct effect by the hematoma and 5 patients(41.7%) due to infection and renal failure.