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조관국,김형일,이민철,김근수,김연희,정창오,Neto, Pedro R. 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12
Corticai Dysplasia(CD) is increasingly recognized as a cause of intractable epilepsy since it can be easily diagnosed with high resolution magnetic resonance imaging(MRI). We analyzed 24 consecutive cases with cortical dysplasia who underwent resective surgery at our institute between September. 1992 and December. 1995. MRI was demonstrated to be a decisive tool to identify CD in 16 cases(66.7%). However, the remaining 8 cases(93.9%) were confirmed to have CD based on histological examination. Location of the lesion included temporal(n=9), central(n=5), multilobar(n=5), and frontal(n=5). Intracranial EEG recording was performed to delineate the epileptogenic zons in 16 cases : subdural grid(10 cases) and depth electrode(6 cases). Resection was performed in temporal(n=9), frontal(n=7), central(n=5). parietal(n=1), and muitilobar(n=1). Complete resection was possible in 15(62.5%) and partial resection in 9(37.5%). Histological examination revealed dyslamination of cortical layers only(n=9), additional dysplastic neurons(n=7), and additional balloon cells(n=8). Surgical outcome was graded as seizure free(n=14 : 58.3%), rare seizures(n=3 : 12.5%). <50% reduction of seizure frequency(n=2 : 8%), and no change(n=5 : 20.8%) after mean follow-up of 12.7 months. The most influencing factor on the surgical outcome was the degree of completeness of resection(p<0.05). However. detectability of CD on MRI, severity of histological findings, age of seizure onset, and duration of seizure were not significantly related with the surgical outcome High suspicion is required to detect the CD among the patients with intractable epilepsy and surgical strategies should be well-planned to improve the surgical outcome in the patients with CD.
조관국(Kwan Kook Cho),김철진(Chul Jin Kim),이성규(Sung Gyu Lee),김영기(Young Kee Kim) 전북대학교 의과학연구소 1997 全北醫大論文集 Vol.21 No.2
뇌기저동맥 체간부에 존재하는 동맥류는 매우 희귀하며 그 수술적 치료는 복잡한 해부학적 구조와 근접해 있는 중요한 신경혈관구조 때문에 수술적 접근이 매우 어려운 부위이다. 전산화단층촬영과 자기공명영상의 발달은 두개저 병변을 정확히 진단할 수 있게 하였고 , 두개저 부위의 수술적 접근에 많은 발전을 가져오게 하였다. 뇌기저동맥 체간부에 존재하는 동맥류의 수술법증의 한 방법으로서 저자들은 소뇌와 측두엽의 견인이 적어 소뇌부종을 극소화 할 수 있고 와우 , 미