Pub Date : 2019-10-28DOI: 10.21129/nerve.2019.5.2.33
Jae-Seong Kang, S. Oh, P. Cho
Corresponding author: Pyung-Goo Cho Department of Neurosurgery, Ajou University Medical Center, Ajou University College of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon 16499, Republic of Korea Tel: +82-31-219-7808 Fax: +82-31-210-5236 E-mail: nsdrcpg@ajou.ac.kr Objective: Zero-profile device (Zero-P) has generally been used as a stand-alone cage in anterior cervical discectomy and fusion (ACDF). However, using Zero-P has been reported to be associated with a high subsidence rate. The present study evaluates the factors that influence the subsidence of ACDF. Methods: Records of a total of 29 patients with degenerative spondylosis resulting in radiculopathy or myelopathy between C2 and C7 who underwent ACDF with Zero-P were retrospectively reviewed. The participants received 1 or 2 level ACDF with Zero-P in our clinic from December, 2011 to December, 2017. A total of 35 treatment levels were included in the analysis. Subsidence was defined when anterior segmental heights decreased by more than 2 mm during the follow-up period. The patients were divided into the subsidence and non-subsidence groups. The following factors were investigated in relation to the occurrence of subsidence: age, gender, body mass index, diabetes mellitus, cage height, perioperative distraction, segmental lordosis, pain score, fusion grade, anterior/posterior segmental height ratio, and cage distance. Results: Cage subsidence was observed in 15 cases (15/35, 42%). Cage distance at immediate postoperation was significantly different between the 2 groups; specifically, while the group with subsidence had 2.66±1.62 mm distance, the group without subsidence had 1.24±1.13 mm distance (p=0.008). Conclusion: This study confirms that the more deeply titanium part is inserted at the anterior edge, the more subsidence occurs. In order to decrease the occurrence of cage subsidence, Zero-P cages should be located the closest possible to the anterior rim of vertebral body at operation.
{"title":"Subsidence after Anterior Cervical Interbody Fusion Using a Zero-Profile Device","authors":"Jae-Seong Kang, S. Oh, P. Cho","doi":"10.21129/nerve.2019.5.2.33","DOIUrl":"https://doi.org/10.21129/nerve.2019.5.2.33","url":null,"abstract":"Corresponding author: Pyung-Goo Cho Department of Neurosurgery, Ajou University Medical Center, Ajou University College of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon 16499, Republic of Korea Tel: +82-31-219-7808 Fax: +82-31-210-5236 E-mail: nsdrcpg@ajou.ac.kr Objective: Zero-profile device (Zero-P) has generally been used as a stand-alone cage in anterior cervical discectomy and fusion (ACDF). However, using Zero-P has been reported to be associated with a high subsidence rate. The present study evaluates the factors that influence the subsidence of ACDF. Methods: Records of a total of 29 patients with degenerative spondylosis resulting in radiculopathy or myelopathy between C2 and C7 who underwent ACDF with Zero-P were retrospectively reviewed. The participants received 1 or 2 level ACDF with Zero-P in our clinic from December, 2011 to December, 2017. A total of 35 treatment levels were included in the analysis. Subsidence was defined when anterior segmental heights decreased by more than 2 mm during the follow-up period. The patients were divided into the subsidence and non-subsidence groups. The following factors were investigated in relation to the occurrence of subsidence: age, gender, body mass index, diabetes mellitus, cage height, perioperative distraction, segmental lordosis, pain score, fusion grade, anterior/posterior segmental height ratio, and cage distance. Results: Cage subsidence was observed in 15 cases (15/35, 42%). Cage distance at immediate postoperation was significantly different between the 2 groups; specifically, while the group with subsidence had 2.66±1.62 mm distance, the group without subsidence had 1.24±1.13 mm distance (p=0.008). Conclusion: This study confirms that the more deeply titanium part is inserted at the anterior edge, the more subsidence occurs. In order to decrease the occurrence of cage subsidence, Zero-P cages should be located the closest possible to the anterior rim of vertebral body at operation.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124640775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-28DOI: 10.21129/nerve.2019.5.2.72
K. Koo, Sung-Kyun Hwang
Corresponding author: Sung-Kyun Hwang Department of Neurosurgery, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea Tel: +82-2-2650-2872 Fax: +82-2-2650-2652 E-mail: nshsg@ewha.ac.kr Objective: The incidence of subarachnoid hemorrhage (SAH) in women increase after menopause. Estrogen hormone had been implicated in cerebral aneurysm formation, growth and rupture. The aim of this study was to examine the association between estrogen hormone and presence of aneurysmal SAH in premenopausal women. Methods: Between February 2015 and December 2016, 40 patients at consecutive premenopausal women (mean age, 41 years) with aneurysms SAH, were treated in our hospital. The data of patients with clinical and gynecological history were analyzed and compared with control group with age matched, case-control study. Results: Single and multivariate analysis showed that estrogen hormone (estradiol) had a lower trend towards at premenopause age comparing with control group, statistically was significant (p<0.001). No significant association of SAH was found with gynecological and clinical factors (p>0.05). Conclusion: In our study, there is a trend showing that an earlier age at menopause relating to estrogen hormone deficiency is associated with the aneurysmal SAH. These data may help to identify a risk factor for pathogenesis of cerebral aneurysm and also a potential target for future therapies.
{"title":"Relationship between Estrogen Hormone and Rupture of Cerebral Aneurysm in Premenopausal Women","authors":"K. Koo, Sung-Kyun Hwang","doi":"10.21129/nerve.2019.5.2.72","DOIUrl":"https://doi.org/10.21129/nerve.2019.5.2.72","url":null,"abstract":"Corresponding author: Sung-Kyun Hwang Department of Neurosurgery, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Republic of Korea Tel: +82-2-2650-2872 Fax: +82-2-2650-2652 E-mail: nshsg@ewha.ac.kr Objective: The incidence of subarachnoid hemorrhage (SAH) in women increase after menopause. Estrogen hormone had been implicated in cerebral aneurysm formation, growth and rupture. The aim of this study was to examine the association between estrogen hormone and presence of aneurysmal SAH in premenopausal women. Methods: Between February 2015 and December 2016, 40 patients at consecutive premenopausal women (mean age, 41 years) with aneurysms SAH, were treated in our hospital. The data of patients with clinical and gynecological history were analyzed and compared with control group with age matched, case-control study. Results: Single and multivariate analysis showed that estrogen hormone (estradiol) had a lower trend towards at premenopause age comparing with control group, statistically was significant (p<0.001). No significant association of SAH was found with gynecological and clinical factors (p>0.05). Conclusion: In our study, there is a trend showing that an earlier age at menopause relating to estrogen hormone deficiency is associated with the aneurysmal SAH. These data may help to identify a risk factor for pathogenesis of cerebral aneurysm and also a potential target for future therapies.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125387732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.21129/NERVE.2019.5.1.7
Min Woo Kim, S. B. Lee, D. Kwon, Jeong Hoon Kim, Chang Jin Kim, Young Hyun Cho, Hyun Jung Kim, Do Hee Lee
Corresponding author: Do Hoon Kwon Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea Tel: +82-2-3010-3550 Fax: +82-2-476-6738 E-mail: dhkwonasan@gmail.com Objective: Vestibular schwannoma (VS) is a benign, slow-growing tumor originating from Schwann cells of the cranial nerve. Many studies have reported short-term follow-ups of patients with VS undergoing gamma knife radiosurgery (GKR). This study analyzed factors affecting the treatment and prognosis of patients over a 10-year period who underwent GKR at a single center by 1 surgeon. Methods: Between 1990 and 2003, we used GKR as a primary treatment or after prior surgical tumor removal for patients with VS. During this period, a single surgeon in 1 center treated more than 700 patients. Of these, 182 patients available for long-term follow-up via the outpatient department were included in the study. Among them, 156 patients were available for radiological imaging follow-up; patients who were not available for radiological follow-up were excluded. Initial tumor volume, initial prescription dose, prior surgery, neurological symptom improvement, and tumor control by individual status were assessed to analyze the factors associated with treatment outcomes. Results: Analysis revealed that a smaller initial volume led to better outcomes of tumor control. Conclusion: At more than 10years’ follow-up, GKR for VS was effective for tumor control in 91.0% of cases and there were few complications associated with GKR. With improvements in the technology and precision of gamma knife systems, planning programs, and other treatment protocols such as fraction and low marginal dose, we should continuously study following results. Our study results suggest the need for more effective methods for tumor control and fewer neurological and GKR-associated complications.
{"title":"Clinical and Radiologic Results from the Long-Term Follow-Up of More than 10 Years in Patients Undergoing Gamma Knife Radiosurgery for Vestibular Schwannoma","authors":"Min Woo Kim, S. B. Lee, D. Kwon, Jeong Hoon Kim, Chang Jin Kim, Young Hyun Cho, Hyun Jung Kim, Do Hee Lee","doi":"10.21129/NERVE.2019.5.1.7","DOIUrl":"https://doi.org/10.21129/NERVE.2019.5.1.7","url":null,"abstract":"Corresponding author: Do Hoon Kwon Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea Tel: +82-2-3010-3550 Fax: +82-2-476-6738 E-mail: dhkwonasan@gmail.com Objective: Vestibular schwannoma (VS) is a benign, slow-growing tumor originating from Schwann cells of the cranial nerve. Many studies have reported short-term follow-ups of patients with VS undergoing gamma knife radiosurgery (GKR). This study analyzed factors affecting the treatment and prognosis of patients over a 10-year period who underwent GKR at a single center by 1 surgeon. Methods: Between 1990 and 2003, we used GKR as a primary treatment or after prior surgical tumor removal for patients with VS. During this period, a single surgeon in 1 center treated more than 700 patients. Of these, 182 patients available for long-term follow-up via the outpatient department were included in the study. Among them, 156 patients were available for radiological imaging follow-up; patients who were not available for radiological follow-up were excluded. Initial tumor volume, initial prescription dose, prior surgery, neurological symptom improvement, and tumor control by individual status were assessed to analyze the factors associated with treatment outcomes. Results: Analysis revealed that a smaller initial volume led to better outcomes of tumor control. Conclusion: At more than 10years’ follow-up, GKR for VS was effective for tumor control in 91.0% of cases and there were few complications associated with GKR. With improvements in the technology and precision of gamma knife systems, planning programs, and other treatment protocols such as fraction and low marginal dose, we should continuously study following results. Our study results suggest the need for more effective methods for tumor control and fewer neurological and GKR-associated complications.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"314 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133796548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.21129/NERVE.2019.5.1.22
Kyung-Min Kim, Joonho Yoon, J. Kwon, H. Gwak
Corresponding author: Ho-Shin Gwak Department of Cancer Control, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Republic of Korea Tel: +82-31-920-1666 Fax: +82-31-920-2798 E-mail: nsghs@ncc.re.kr Herein we reported 2 cases of vertebroplasty (VP) via the transoral route for osteolytic painful odontoid (C2) metastasis from non-small cell lung cancer. A 52-year-old man, who was diagnosed with non-small cell lung cancer a year ago, presented neck pain, which was aggravated on swallowing in September, 2015. Neuroimaging revealed osteolytic metastasis of C2 with atlanto-axial joint invasion and of C4 without compression. The metastatic cancer of multiple bone and soft tissues progressed despite the chemotherapy; hence, minimally invasive palliative therapy was needed for immediate relief of the patient’s pain. Another patient, 54-year-old man, also diagnosed non-small cell lung cancer revealed neck pain in May, 2018. He had stopped systemic chemotherapy 6 months ago due to lack of effective available regimen and received stereotactic radiosurgery for multiple brain metastases 3 months ago. Spinal computed tomography revealed C2 osteolytic lesion and we performed transoral VP for pain control. Based on our experience, transoral VP for C2 osteolytic metastasis could be performed safely and resulted in significant and immediate pain relief.
{"title":"Transoral Vertebroplasty for Osteolytic C2 Metastasis: Report of 2 Cases","authors":"Kyung-Min Kim, Joonho Yoon, J. Kwon, H. Gwak","doi":"10.21129/NERVE.2019.5.1.22","DOIUrl":"https://doi.org/10.21129/NERVE.2019.5.1.22","url":null,"abstract":"Corresponding author: Ho-Shin Gwak Department of Cancer Control, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Republic of Korea Tel: +82-31-920-1666 Fax: +82-31-920-2798 E-mail: nsghs@ncc.re.kr Herein we reported 2 cases of vertebroplasty (VP) via the transoral route for osteolytic painful odontoid (C2) metastasis from non-small cell lung cancer. A 52-year-old man, who was diagnosed with non-small cell lung cancer a year ago, presented neck pain, which was aggravated on swallowing in September, 2015. Neuroimaging revealed osteolytic metastasis of C2 with atlanto-axial joint invasion and of C4 without compression. The metastatic cancer of multiple bone and soft tissues progressed despite the chemotherapy; hence, minimally invasive palliative therapy was needed for immediate relief of the patient’s pain. Another patient, 54-year-old man, also diagnosed non-small cell lung cancer revealed neck pain in May, 2018. He had stopped systemic chemotherapy 6 months ago due to lack of effective available regimen and received stereotactic radiosurgery for multiple brain metastases 3 months ago. Spinal computed tomography revealed C2 osteolytic lesion and we performed transoral VP for pain control. Based on our experience, transoral VP for C2 osteolytic metastasis could be performed safely and resulted in significant and immediate pain relief.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123425218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.21129/NERVE.2019.5.1.1
P. Tsung, S. Sung, D. Son, Sang Weon Lee, G. Song
Corresponding author: Soon Ki Sung Department of Neurosurgery, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan 50612, Republic of Korea Tel: +82-55-360-2126 Fax: +82-55-360-2156 E-mail: soonkisung@pusan.ac.kr Objective: Diffusion tensor imaging (DTI) was used to study motor function prognosis in stroke and intracerebral hemorrhage (ICH) patients. In this study, we investigated the correlation between DTI and computed tomography (CT) and compared the predictability of clinical outcome in patients with stoke, ICH, brain tumor, and traumatic brain injury. Methods: We retrospectively reviewed 22 patients with brain injury who underwent DTI and CT. Motor weakness was assessed using the Medical Research Council (MRC) grade scores. The fractional anisotropy (FA) of the region of interest (ROI) of DTI was compared between the injured and non-injured sites. Results: The differences in the encephalomalacic changes of corticospinal tract injury between DTI and CT were not statistically significant in patients with motor weakness (p=0.09). Neither modality could predict the motor recovery rate (CT, p=0.89; DTI, p=0.86). However, DTI showed a significant difference in initial MRC grade (p=0.003). We evaluated the possibility of more accurate evaluation of MRC grade change using DTI. FA ROI in injured (450.73±105.32) and non-injured (582.18±99.68) sites showed a significant difference (p=0.00). Pearson’s correlation coefficient showed that FA ROI ratio had a significant correlation with initial (p=0.43) and follow-up (p=0.012) MRC grades, but not with MRC grade change (p=0.67). Conclusion: DTI is more accurate than CT for evaluating motor deficit. It aids the treatment and rehabilitation plans in patients with brain injury. However, the prediction of motor function recovery is still insufficient.
通讯作者:Soon Ki Sung釜山国立大学梁山医院神经外科，梁山区锦锦路20号电话:+82-55-360-2126传真:+82-55-360-2156 E-mail: soonkisung@pusan.ac.kr目的:应用弥散张量成像(DTI)研究脑卒中和脑出血(ICH)患者的运动功能预后。在这项研究中，我们研究了DTI和计算机断层扫描(CT)之间的相关性，并比较了中风、脑出血、脑肿瘤和创伤性脑损伤患者临床结果的可预测性。方法:回顾性分析22例颅脑损伤患者行DTI和CT检查。运动无力采用医学研究委员会(MRC)评分进行评估。比较了损伤部位和非损伤部位DTI感兴趣区(ROI)分数各向异性(FA)。结果:运动无力患者DTI与CT对皮质脊髓束损伤的脑空性改变差异无统计学意义(p=0.09)。两种方法均不能预测运动恢复率(CT, p=0.89;DTI, p = 0.86)。然而，DTI在MRC初始分级上有显著差异(p=0.003)。我们评估了使用DTI更准确评估MRC分级变化的可能性。损伤部位的FA ROI(450.73±105.32)与非损伤部位的FA ROI(582.18±99.68)差异有统计学意义(p=0.00)。Pearson相关系数显示，FA ROI与初始(p=0.43)和随访(p=0.012) MRC等级有显著相关，与MRC等级变化无显著相关(p=0.67)。结论:DTI比CT更准确地评价运动功能障碍。它有助于脑损伤患者的治疗和康复计划。然而，对运动功能恢复的预测仍然不足。
{"title":"Prediction of Motor Function Outcome in Patients with Brain Injury Using Computed Tomography and Diffusion Tensor Image","authors":"P. Tsung, S. Sung, D. Son, Sang Weon Lee, G. Song","doi":"10.21129/NERVE.2019.5.1.1","DOIUrl":"https://doi.org/10.21129/NERVE.2019.5.1.1","url":null,"abstract":"Corresponding author: Soon Ki Sung Department of Neurosurgery, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan 50612, Republic of Korea Tel: +82-55-360-2126 Fax: +82-55-360-2156 E-mail: soonkisung@pusan.ac.kr Objective: Diffusion tensor imaging (DTI) was used to study motor function prognosis in stroke and intracerebral hemorrhage (ICH) patients. In this study, we investigated the correlation between DTI and computed tomography (CT) and compared the predictability of clinical outcome in patients with stoke, ICH, brain tumor, and traumatic brain injury. Methods: We retrospectively reviewed 22 patients with brain injury who underwent DTI and CT. Motor weakness was assessed using the Medical Research Council (MRC) grade scores. The fractional anisotropy (FA) of the region of interest (ROI) of DTI was compared between the injured and non-injured sites. Results: The differences in the encephalomalacic changes of corticospinal tract injury between DTI and CT were not statistically significant in patients with motor weakness (p=0.09). Neither modality could predict the motor recovery rate (CT, p=0.89; DTI, p=0.86). However, DTI showed a significant difference in initial MRC grade (p=0.003). We evaluated the possibility of more accurate evaluation of MRC grade change using DTI. FA ROI in injured (450.73±105.32) and non-injured (582.18±99.68) sites showed a significant difference (p=0.00). Pearson’s correlation coefficient showed that FA ROI ratio had a significant correlation with initial (p=0.43) and follow-up (p=0.012) MRC grades, but not with MRC grade change (p=0.67). Conclusion: DTI is more accurate than CT for evaluating motor deficit. It aids the treatment and rehabilitation plans in patients with brain injury. However, the prediction of motor function recovery is still insufficient.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132220483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.21129/NERVE.2019.5.1.15
Ji-Hoon Park, Hyuk-Jin Oh, D. Yeo, Jae-Sang Oh, Seok-Mann Yoon, Jai-Joon Shim
Corresponding author: Jai-Joon Shim Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea Tel: +82-41-570-3650 Fax: +82-41-572-9297 E-mail: jjshim@sch.ac.kr Osteoma is the most common benign tumor in the craniofacial bone. We present a case of osteoma, a rare site in a patient with palpable mass on suboccipital area. A 54-year-old woman presented with palpable mass in the right occipital area. Brain computed tomography scan indicated that the mass was starting from the outer table of the occipital bone. The mass was separated well from the cortical bone. Histopathology report presented osteoma diagnosis composed of a compact bone. After the operation, the patient was discharged without any complications and follow-up was done for 8 years without incidences of recurrence. It is very rare for osteoma to occur in the occipital bone. We reported a case of a huge osteoma of the occipital bone that grew without invasion of the inner table of the cranial bone.
{"title":"Huge Osteoma on Suboccipital Region: A Case Report","authors":"Ji-Hoon Park, Hyuk-Jin Oh, D. Yeo, Jae-Sang Oh, Seok-Mann Yoon, Jai-Joon Shim","doi":"10.21129/NERVE.2019.5.1.15","DOIUrl":"https://doi.org/10.21129/NERVE.2019.5.1.15","url":null,"abstract":"Corresponding author: Jai-Joon Shim Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Republic of Korea Tel: +82-41-570-3650 Fax: +82-41-572-9297 E-mail: jjshim@sch.ac.kr Osteoma is the most common benign tumor in the craniofacial bone. We present a case of osteoma, a rare site in a patient with palpable mass on suboccipital area. A 54-year-old woman presented with palpable mass in the right occipital area. Brain computed tomography scan indicated that the mass was starting from the outer table of the occipital bone. The mass was separated well from the cortical bone. Histopathology report presented osteoma diagnosis composed of a compact bone. After the operation, the patient was discharged without any complications and follow-up was done for 8 years without incidences of recurrence. It is very rare for osteoma to occur in the occipital bone. We reported a case of a huge osteoma of the occipital bone that grew without invasion of the inner table of the cranial bone.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"233 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123737174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.21129/NERVE.2019.5.1.18
Junhyung Kim, U. Choi, Kyung Hyun Kim
{"title":"Posterior Vertebral Column Resection for Pediatric Congenital Kyphosis: A Case Report and Technical Concerns","authors":"Junhyung Kim, U. Choi, Kyung Hyun Kim","doi":"10.21129/NERVE.2019.5.1.18","DOIUrl":"https://doi.org/10.21129/NERVE.2019.5.1.18","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128846746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-31DOI: 10.21129/NERVE.2018.4.2.120
Hee Jun Yoo, Jaewoo Chung, J. Ahn
Corresponding author: Jae Sung Ahn Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea Tel: +82-2-3010-3550 Fax: +82-2-476-6738 E-mail: jsahn@amc.seoul.kr Intracranial aneurysms associated with atrial myxoma have been reported and termed “myxomatous aneurysms.” We present a case of cerebral myxomatous aneurysms treated by M2-M2 bypass surgery. A 20-year-old woman was admitted for evaluation and management of multiple cerebral aneurysms found incidentally. She had a history of right middle cerebral artery (MCA) territory infarction with MCA total occlusion. At that time, cardiac myxoma was incidentally found and surgically removed. In cerebral angiography, multiple cerebral aneurysms were identified. Among them, a right MCA fusiform aneurysm was the largest, with a diameter of 19.5 mm; notably, this developed at the site of previous MCA occlusion. Through surgical exploration, an MCA bifurcation aneurysm was observed, with a permanently occluded inferior trunk toward the temporal lobe. M2-M2 end-to-end anastomosis with resection of aneurysm was successfully performed, and biopsy showed dilation and thickening of the aneurysmal wall without any evidence of tumor invasion. The outcome of this case shows that surgical resection with bypass surgery is a useful option for the treatment of cerebral myxomatous aneurysms.
{"title":"Cerebral Myxomatous Aneurysm Treated by M2-M2 Bypass: A Case Report","authors":"Hee Jun Yoo, Jaewoo Chung, J. Ahn","doi":"10.21129/NERVE.2018.4.2.120","DOIUrl":"https://doi.org/10.21129/NERVE.2018.4.2.120","url":null,"abstract":"Corresponding author: Jae Sung Ahn Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea Tel: +82-2-3010-3550 Fax: +82-2-476-6738 E-mail: jsahn@amc.seoul.kr Intracranial aneurysms associated with atrial myxoma have been reported and termed “myxomatous aneurysms.” We present a case of cerebral myxomatous aneurysms treated by M2-M2 bypass surgery. A 20-year-old woman was admitted for evaluation and management of multiple cerebral aneurysms found incidentally. She had a history of right middle cerebral artery (MCA) territory infarction with MCA total occlusion. At that time, cardiac myxoma was incidentally found and surgically removed. In cerebral angiography, multiple cerebral aneurysms were identified. Among them, a right MCA fusiform aneurysm was the largest, with a diameter of 19.5 mm; notably, this developed at the site of previous MCA occlusion. Through surgical exploration, an MCA bifurcation aneurysm was observed, with a permanently occluded inferior trunk toward the temporal lobe. M2-M2 end-to-end anastomosis with resection of aneurysm was successfully performed, and biopsy showed dilation and thickening of the aneurysmal wall without any evidence of tumor invasion. The outcome of this case shows that surgical resection with bypass surgery is a useful option for the treatment of cerebral myxomatous aneurysms.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116123147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-24DOI: 10.21129/NERVE.2018.4.2.104
Min-Gi Lee, J. Hur, S. Ahn
Corresponding author: Jung-Woo Hur Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea Tel: +82-2-2258-6353 Fax: +82-2-594-4248 E-mail: neurotique79@gmail.com Myeloid sarcoma is a rare extramedullary tumor of immature myeloid cells. It more often develops with the underlying acute myeloid leukemia, but it can also occur with chronic myeloid leukemia (CML), myelodysplastic syndrome and rarely even with the absence of marrow involvement. Spinal epidural myeloid sarcoma is uncommon, and intramedullary presentation is exceptionally rare. In this report the authors report an unusual case of spinal intramedullary myeloid sarcoma after completer remission from CML several years ago. He was mistakenly diagnosed as acute transverse myelitis and treated with high-dose steroid and plasmaparesis without improvement. Magnetic resonance imaging revealed intramedullary mass-like lesion with hyper-intensity in T2-weighted image and mild homogeneous enhancement. Myeloid sarcoma should be considered as a possible differential diagnosis when patient with history of myeloid leukemia present intramedullary tumor and pathologic confirmation with open biopsy is mandatory for the exact diagnosis.
{"title":"Rare Intramedullary Myeloid Sarcoma Mistaken as Acute Transverse Myelitis","authors":"Min-Gi Lee, J. Hur, S. Ahn","doi":"10.21129/NERVE.2018.4.2.104","DOIUrl":"https://doi.org/10.21129/NERVE.2018.4.2.104","url":null,"abstract":"Corresponding author: Jung-Woo Hur Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea Tel: +82-2-2258-6353 Fax: +82-2-594-4248 E-mail: neurotique79@gmail.com Myeloid sarcoma is a rare extramedullary tumor of immature myeloid cells. It more often develops with the underlying acute myeloid leukemia, but it can also occur with chronic myeloid leukemia (CML), myelodysplastic syndrome and rarely even with the absence of marrow involvement. Spinal epidural myeloid sarcoma is uncommon, and intramedullary presentation is exceptionally rare. In this report the authors report an unusual case of spinal intramedullary myeloid sarcoma after completer remission from CML several years ago. He was mistakenly diagnosed as acute transverse myelitis and treated with high-dose steroid and plasmaparesis without improvement. Magnetic resonance imaging revealed intramedullary mass-like lesion with hyper-intensity in T2-weighted image and mild homogeneous enhancement. Myeloid sarcoma should be considered as a possible differential diagnosis when patient with history of myeloid leukemia present intramedullary tumor and pathologic confirmation with open biopsy is mandatory for the exact diagnosis.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"71 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123527623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-24DOI: 10.21129/NERVE.2018.4.2.111
Soung Bin Yim, Yeongu Chung, Y. Won
Corresponding author: Yu Sam Won Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea Tel: +82-2-2001-2450 Fax: +82-2-2001-2157 E-mail: yusam.won@samsung.com A 59-year-old man, who had a ventriculoperitoneal shunt (VPS) operation for the treatment of hydrocephalus due to cysticercosis 26 years prior, visited our hospital with increasing abdominal distention. An abdominal computed tomography (CT) scan showed well enhanced demarcated fluid collection about 20×18 cm around the distal catheter tip. We performed exploratory laparoscopy and inserted a drainage catheter into the abdominal cyst. All cyst fluid analyses and cultures were negative. Over the course of the next eight weeks, abdominal CT demonstrated that the pseudocyst decreased. Following removal of the drainage catheter, abdominal CT showed that the pseudocyst increased again. A drainage catheter was re-inserted and Taurolin (Taurolidine) solution irrigation was performed for 3 months. Upon the completion of this 3 months, the patient complained of abdominal distension and abdominal CT found both that the pseudocyst was increased and doubted cystic infection. Eventually, an exploratory laparotomy and cyst resection were performed. Although the occurrence of pseudocyst following VPS surgery is a rare complication, it can cause additional complications such as obstruction and infection. If a patient has gastrointestinal symptoms, pseudocyst should be considered as one of the complications of VPS surgery.
通讯作者:Yu Sam Won韩国首尔钟路区新门南路29号成均馆大学医学院江北三星医院神经外科电话:+82-2-2001-2450传真:+82-2-2001-2157 E-mail: yusam.won@samsung.com一名59岁男性，26年前因囊虫病脑积水行脑室-腹膜分流术(VPS)治疗。腹部计算机断层扫描(CT)显示，导管远端尖端周围约20×18 cm处有明确的液体收集。我们进行了探查性腹腔镜检查，并将引流导管插入腹腔囊肿。所有囊肿液分析和培养均为阴性。在接下来的八周内，腹部CT显示假性囊肿缩小。取下引流管后，腹部CT显示假性囊肿再次增大。重新插入引流管，并行Taurolin (Taurolidine)溶液冲洗3个月。3个月后，患者主诉腹胀，腹部CT提示假性囊肿增大，怀疑为囊性感染。最终行剖腹探查和囊肿切除术。虽然VPS手术后假性囊肿的发生是一种罕见的并发症，但它可以引起其他并发症，如阻塞和感染。如果患者有胃肠道症状，假性囊肿应考虑为VPS手术的并发症之一。
{"title":"Delayed Abdominal Pseudocyst after Ventriculoperitoneal Shunt Surgery: A Case Report","authors":"Soung Bin Yim, Yeongu Chung, Y. Won","doi":"10.21129/NERVE.2018.4.2.111","DOIUrl":"https://doi.org/10.21129/NERVE.2018.4.2.111","url":null,"abstract":"Corresponding author: Yu Sam Won Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea Tel: +82-2-2001-2450 Fax: +82-2-2001-2157 E-mail: yusam.won@samsung.com A 59-year-old man, who had a ventriculoperitoneal shunt (VPS) operation for the treatment of hydrocephalus due to cysticercosis 26 years prior, visited our hospital with increasing abdominal distention. An abdominal computed tomography (CT) scan showed well enhanced demarcated fluid collection about 20×18 cm around the distal catheter tip. We performed exploratory laparoscopy and inserted a drainage catheter into the abdominal cyst. All cyst fluid analyses and cultures were negative. Over the course of the next eight weeks, abdominal CT demonstrated that the pseudocyst decreased. Following removal of the drainage catheter, abdominal CT showed that the pseudocyst increased again. A drainage catheter was re-inserted and Taurolin (Taurolidine) solution irrigation was performed for 3 months. Upon the completion of this 3 months, the patient complained of abdominal distension and abdominal CT found both that the pseudocyst was increased and doubted cystic infection. Eventually, an exploratory laparotomy and cyst resection were performed. Although the occurrence of pseudocyst following VPS surgery is a rare complication, it can cause additional complications such as obstruction and infection. If a patient has gastrointestinal symptoms, pseudocyst should be considered as one of the complications of VPS surgery.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"250 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125779973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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