뇌교부 출혈의 예후에 대한 임상분석

채권병,하영수,박종운,김영,이상돈,전호규,김재중 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.8

Pontine hematoma would be diagnosed and made its follow-up readily as the extent of hematoma could be clearly defined since the CT scan was available, especially with MRI in recent. Authors attemped to analyse 20 cases of pontine hematoma clinically, considering factors to influence their prognosis, admitted in Inha hopital from March 1989 to February 1992. Classification of pontine hematoma was made out according to the findings of brain CT scan taken on admission : 2 cases of Type T1 to the hematoma localized in the tegmentum unilaterally, 1 case of Type T2 to those in the tegmentum bilaterally with some extent into the 4th ventricle, 12 in Type T3 to those in the tegmentum, midbrain and mostly the 4th ventricle, and 5 in Type B to those in the basis pontis mainly with tegmentum and midbrain. Of 219 spontaneous intracerebral hematoma, pontine hematoma was 9.1%. 17 hypertension and 11 previous CVA episodes including 7 cerebral infarction and 4 ICH were encountered. Age distribution was 50% in 6th decade and male to female ratio was 3:2. On admission 14 cases were under 6 in Glassgow coma scale, 16 small reactive pupils and 1 ocular bobbing. Particularly, nuclear facial paralysis was 14 in initial bilateral type, of which 7 dead within 10 days, 5 fixed in left facial paralysis and 1 case into right paralysis later. Four surgical interventions were 1 simple EVD, 1 Urokinase irrigation through EVD, 1 steretactic aspiration and 1 direct hematoma removal. Prognosis was related to various factors : GCS on entry, volume and classification of hematoma, in addition to laterality of nuclear facial paralysis. Clinical course was better in cases over 10 GCS on entry, volume and classification of hematoma, in addition to laterality of nuclear facial paralysis. Clinical course was better in cases over 10 GCS. Type T1 and T2, and unilateral facial paralysis in which the ratio of left to right was 2:1, while it was very poor in patients who were GCS below 6. Type B and bilateral facial paralysis. On the contrary, 7 of 20 cases were dead within 10 days, 13 patients alive for more 3 months after the hemorrage were observed with fixed facial paralysis in nuclear type, 1 bilateral, 4 right, and 8 left side. It is suggested and requested for further careful follow-up that the hemorrage may occur from the border zone between paramedian, short and long circumferential arteries supplying transection area of the pons unilaterally, near on around the facial nucleus, more frequent in left side.

안-안면부 및 간뇌부에 발생한 동정맥기형 1례 보고 : Bonnet-Dechaume-Blanc 증후군의 변형 A Variant of Bonnet-Dechaume-Blanc Syndrome

채권병,하영수,박종운,김영 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.6

Authors experienced a rare case of ophthalmofacial-diencephalic arteriovenous malformation, named Bonnet-Dechaume-Blanc syndrome in 12 year-old girl. Clinically patient had an episode of frequent bleeding from the nose and gingiva. Also she was left blindness of which the ophthalmologist gave the warning for cerebral hemorrhage because of the tangled, engorged vessels in left fundus. The multiple nidus on angiography revealed on left intraorbital, maxillopalatal, hypothalamic and basal ganglia area. Surgery underwent for huge intracerebral hematoma. The patient passed away due to rebleeding 15 month after initial hemorrage.

소아 두뇌외상에 대한 임상적 관찰

박종운,채권병,이상돈,전호규,김영,하영수 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.2

A clinical analysis was carried out with 400 cases of head injuries under 15 years of age admitted at the Department of Neurosurgery. Inha University Hospital during 4 years from 1987 to 1990. The material was classified into three groups according to main lesions, i.e. 1) simple cerebral contusion without skull fractures. 2) various types of skull fractures. 3) intracranial hemorrhagic lesions, representing such lesions as follows ; a) epidural hematoma, b) subdural hematoma, c) intracerebral hematoma, intraventricular and subarachnoid hemorrhage. The results were as follows; 1) The age incidence was greatest in 7 years of age, and 188 cases(47%) were included in the age group between seven and ten. The accident occurred mostly from March to May, especially in April. 2) The head injuries were caused by traffic accident(203 cases: 51%), fall down(152 cases : 38%), etc. In clinical pictures, neck sprain(52.8%), nausea and vomiting(47.5%), and early epilepsy (9%) were developed. 3) The linear skull fracture was higher than other type fractures(74.6%) and the locations of skull fractures were parietal, occipital, temporal and frontal bone in order of frequency. 4) Among the intracranial hemorrhagic lesions, EDH was most common lesion, 73 cases (79%) of the patients with intracranial hemorrhagic lesions were accompanied by skull fractures but of the patients with skull fracture, 51.4% were accompanied by hemorrhagic lesion. Lucid interval was observed in 15 of the cases with intracranial hemorrhagic lesions and contre-coup injury was developed in 19(12%). 5) In the GOS, the high scored cases on the GCS were better than the low scored cases. 4 cases of 23 people scored under 8 on the GCS died, 14 cases of them were included in the age between 6 and 10(61%). 6) Associated injuries were found in about 16% of the total patient, the most common injury was clavicle fracture and most frequent sequala was post traumatic syndrome. The late epilepsy was occurred in about 13% of the early epilepsy cases except the cases had pre-traumatic epilepsy history.

Alveolar Soft Part Sarcoma의 두개강내 전이 : 증례 보고

박종운,채권병,김영,하영수 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.7-12

Alveolar Soft Part Sarcoma (ASPS) in an unusual tumor of soft tissue, it has invariably ended in death from disseminated disease, and the lung has been the most common site of metastasis, but the brain was the 3rd most common site of metastasis. That proportion seems 0.4% of all soft tissue sarcoma. Clinical, pathological, and radiological features of metastatic cerebral lesions resulting from ASPS are presented. Angioarchitecture, and radiotherapic finding and chemotherapy are discussed. The unusual juxtaposition of the tumor cells to the endothelium seems responsible for the highly vascular appearance of the lesion on angiography, the frequency of hematogenous spread, and the grave, although delayed, prognosis. The purpose of this paper is to reported ASPS which has never been reported in Korea yet, with some referances.

두개골에 전이된 거대 갑상선포상암 1례 : Case Report

박종운,채권병,김영,하영수 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.7-12

A rare and tremendous skull metastasis from the follicular thyroid carcioma is reported with review of the articles. Follicular carcinoma of the thyroid with distant metastasis is considered a relatively progressive tumor associated with poor five-year survival rate. The insidious character of the primary growth of the thyroid carcinoma is the long latent period which supervenes between the recognition of the primary growth and its secondary metastasis. The clinicopathological features, plain X-ray and C-T findings are discussed.

한국정상인의 뇌전산화단층촬영에 의한 전두뇌실직경과 뇌직경간의 비율

박종운,채권병,이상돈,김영,하영수 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.5

The study was undertaken to assess the ventricular system of the brain in normal Korean, using the computed tomography (CT). The CT examination of 1000 normal patients between the ages of 1 to 83 years, performed at Inha hospital, were evaluated. Determination of the ratio between the width of the brain and a dimension representing the distance between the outer borders of the lateral ventricles was made at two levels. The ratio, the cerebroventricular index(CVI), seems to be a reliable, easier indicator of ventricular size. The standards vary with the age of the patients. The results are as follows ; 1) There was no significant difference with sex. 2) The cerebroventricular indexes of the lateral ventricle at the widest bifrontal(CVI) and narrowest bicaudate diameters(CCI) were 0.300±0.033, and 0.105±0.022. 3) There was correlation between cerebroventricular ratio and age with increase of age, cerebroventricular ratio increased slightly. 4) There was slight correlation between cerebroventricular index(CVI) and cephalic index (CI). 5) The CVI appears to be more sensitive than the CCI in the detection of changes in ventricular size. 6) Our suspected hydrocephalic indexes(HI) are as follows: CVI≤1/3 : within normal range 1/3<CVI≤0.4 : mild hydrocephalus 0.4<CVI≤0.5 : moderate hydrocephalus 0.5<CVI : severe hvdrocephalus

원발성 시상부 혈종의 임상적 분석

김영,이상돈,채권병,박종운,하영수 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.5

Forty eight cases of spontaneous thalamic hemorrhage diagnosed by brain CT scan, were analyzed clinically. The age incidence was highest in the 6th decade. We have classified the thalamic hemorrhage by location of hematoma and arterial blood supply. The anteromedial types were 12cases(25%) and the posterolateral types were 14cases(29%), the superomedial types were 10cases(21%), the posteromedial types were 5cases(10%), the global types were 7cases (15%). The sites of hemorrhage were highest in the thalamogeniculate artery territories. In the aspect of clinical symptoms, ocular signs were more common in the posteromedial and the global type. Motor weakness and sensory symptoms were developed in the all types, almostly. Speech involvements were developed in 14% of Lt. side thalamic hemorrhages. Mental symptoms(confusion, disorientation) appeared in the large amount of hemorrhage exclusively. The mortality rate was 10.4%. Prognosis was correlated with the extent of involvement and the amount of hematoma, not the location.

간 세포암의 두개골 전이 : A Case Report

박종운,이상돈,채권병,김영,하영수 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.2

Skull metastasis of hepatocelluar carcinoma are rarely reported, even in the Orient and the Africa where this carcinoma is one of the relatively common malignancies. One case with the skull metastasis of the hepadtocelluar carcinoma, which no literature was found about the distant metastasis to the skull bone only in Korea, is reported with the histochemical stain and the relevant literatures are reviewed.

원시성 신경외배엽 종양의 임상적 경험

전호규,하영수,박종운,김영,채권병,이상돈,김재중,진태경 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.8

Primitive neuroectodermal tumors(PNETs) are composed of undifferentiated cells resembling germinal matrix cells of the embryonic neural tube. The concept of the primitive neuroectodermal tumors is controversial due to indistinct clinicopathologic entities. While some neuropathologists believe that the PNET concept should be applied to all these tumors with the addition of qualifying terms, the opponents of this approach believe this concept to be too simplistic and that well-established diagnostic entities should not be grouped together as a single entity. Four patients with PNET were reviewed. Although the PNETs bear some differences to posterior fossa medulloblastomas, we should be grouped together as a single pathologic entity because of their primitive nature. The purpose of this study is to review the similarities and differences between two tumors from their histologic and embryologic features.

소아에서 Takayasu 동맥염을 동반한 뇌동맥류 : 증례 보고 Case Report

전호규,하영수,박종운,김영,채권병,이상돈,김재중 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.3

The authors present a case of intracranial aneurysm with Takayasu's arteritis. A 10-year-old boy was admitted with complaints of sudden bursting headache and vomiting. Computed tomographic(CT) scan showed subarachnoid hemorrhage and measured blood p m sum between in each side did differ significantly. Aortoangiogram showed narrowing of the abdominal aorta and stenosis at their origins of the renal arteries. An angiogram of the right carotid artery revealed a saccular aneutysm located at the proximal portion of the middle cerebral artery. Intracranial aneurysm with Takayasu's arteritis is a rare entity, evenmore in children.