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내경동맥 분지부 동맥류에 관한 임상적 연구 : 30례의 임상분석 Clinical Analysis of 30 Cases
고원일,전신수,이상원,정철구,김문찬,강준기 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.11
Aneurysms arising from ICA bifucation are relatively rare. But they are paticulary difficult to treat surgically because of perforating arteries surrounding and adherent to the aneurysm. In an effort to determine their best management policy, and to improve their surgical outcome, a retrospective clinical analysis of 30 patients who underwent direct surgery from ICA bifucation aneurysm between January, 1984 and December. 1994 was performed. In the same period, total 990 patients with intracranial aneurysms were admitted in our department. The result of carotid bifucation aneurysm surgery was worse than the total surgical result. Motality and morbidity rates were 3/30(10%), 5/30(16%). Surgical complications in this group of aneurysms usually came from injury of perforating arteries, and the causes of death were intraoperative premature rupture and vasospasm. The surgical treatment of aneurysms of internal carotid bifucation is discussed, emphasizingng the importance of avoiding damage to perforating vessels and premature rupture. A classification of these aneurysms, according to angiographic and anatomical considerations, is proposed. We suggest that four types of aneurysmal orientation at the bifucation of the internal carotid artery be distinguished either projecting superiorly, anteriorly, inferiorly, or posteriorly. Posterior orientation was found in 13 cases(43.3%). Superior orientation was found in 11 cases(36.7%), inferior orientaton was found in 4 cases(13.3%). and anterior orientation was found in 2 cases(6.7%). From an analysis of these cases and a review of the literature, some characteristics of these aneurysms and their surgical strategies are described.
흉추부에 발생한 간엽성 연골육종 : 증례보고 Case Report
고원일,박춘근,정철구,이연수,김병기,강준기 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12
Messnchymal chondrosarcoma is a rare tumor occurring in both bone and soft tissues and exhibits characteristics of a highly malignant tumor. The authors experienced a case of mesenchymal chondrosarcoma occurring in a 39-year-old man, which had invaded the soft tissues of the chest wall and had been incompletely removed, and recurred in the adjacent 710 vertebra 4 years later. The patient presented with severe back pain and paraparesis at admission. Radiographic studies of the vertebra showed an aggressive osteolysis of the vertebral body, pedicle, lamina, compression of the spinal cord, and soft tissue invasion. The tumor was totally removed by an anterior and posterior combined approach. The removed vertebral body was replaced with a titanium mesh cage, and the thoracic spine was stabilized by both anterior and posterior fixations with instruments. The pathological and the clinical characteristics of mesenchymal chondrosarcoma are discussed.