척수원추(脊髓圓錐)에 발생한 척수내 농양(脊髓內膿瘍)1례 보고

강준기,이영근,송진언 최신의학사 1970 最新醫學 Vol.13 No.11

A case of intramedullary abscess on the conus medullaris was reported and the literature was reviewed. This 25-year-old Korean male who suffered from paraparesis and urinary difficulty following back pain and spastic weakness in the lower limbs of 7 year's duration, was admitted to the Catholic Medical Center on Dec. 18, 1969. On admission, neurological examination revealed spastic paresis of the left leg, sensory loss below the Til level, urinary difficulty and positive ankle clonus & Babinski sign. Plain X-ray of the spine showed widening of the interpedicular distance of the 1st and 2nd lumbar vertebrae with sclerotic change of the pedicle of the 1st lumbar vertebra on A-P view. Pantopaque myelogram revealed round partial obstruction with expanding cord shadow at the lower border of the 1st lumbar vertebra. Total laminectomy extending from T12 to L3 was performed and a dorsal median incision into conus medullaris was made and evacuated caseous necrotic discharge 30cc in amount so conus medullaris was seen to be surrounded with thin external membrane as if it is hollow tubular appearance. Following operation, neurological deficits did not improved.

Ⅱ. 뇌수종의 외과적 치료 : Shunt System의 특성 및 선택 Characteristics and Selection of Shunt System

강준기 대한신경외과학회 1988 Journal of Korean neurosurgical society Vol.17 No.2

Most patients suffering from hydrocephalus have been treated by insertion of differential pressure valves that have fairly constant resistance. The number of shunting procedures for hydrocephalus has increased significantly with the advent of more sophisticated diagnostic tools such as computed tomographic scanning and with rapid technical advances in shunt equidment. Since intracranial pressure is a variable parameter depending on the factors as patients position and since cerebrospinal fluid(CSF) secretion is almost constant, it may be assumed that some shunt complication are related to too much or too little CSF drainage. As a result, there has been a proliferation of shunt systems that differ in their component parts, particularly their valve mechanisms. To minimize complications and to maintain proper shunt functions, the shunt system optimal to each pathological condition must be selected out of variety of systems. To effect this, it is imperative to have an accurate knowledge of the structure and characteristics of each shunt is currently available. The author reviews some of the devices currently in use for the purposes of clarification and comparison. Also clinical results of 33 padiatric patients shunted with a valve which was selected out of a variety of shunt system, are reported.

두부손상의 응급처치

강준기,조경석,정철구,조병일 한국의학사 1990 診斷과治療 Vol.10 No.2

高血壓性 腦實質內 出血의 手術適應症

姜俊基 한국의학사 1984 診斷과治療 Vol.4 No.1

末梢 및 中樞前庭性 眩氣症과 治療劑

姜俊基 藥業新聞社 1978 醫藥情報 Vol.1978 No.1

혈우병 유아에서 발생된 뇌경막하혈종을 동반한 뇌내혈종 치험 1예 보고

강준기 주식회사 녹십자 1979 녹십자의보 Vol.7 No.2

시각전도계 국소적 병소에 대한 시각유반전위 반응

강준기,조병일,정철구,김문찬,이상원,이재수,하영수,송진언,김영배 대한신경외과학회 1985 Journal of Korean neurosurgical society Vol.14 No.3

A visual stimulus elicits a complicated series of potentials from the human cortex. The visual evoked potential test has advantages in detecting lesions that alter electrophysiology but do not produce detectable alterations of radiodensity displace surrounding structures or change vascular supply. A sequence of four wave component(Ⅰ Ⅱ, Ⅲ, Ⅳ) that occured in the 100 msec following the flash stimulation can be recorded from scalp electrodes in 20 patients with focal lesions of the visual conducting system using computer averazing techniques. 1) 20 patients presenting with visual symptoms were classified as foul groups according to the locations of the lesions in visual pathway: optic nerve lesion (8 cases), chiasmatic lesion (5 cases), optic tract or radiation lesions (4 cases) and visual cortical lesion (3 cases). 2) In optic neuritis, wave patterns of VEP was suppressed markedly in Ⅰ(P_(30-40) msec) an Ⅱ(N_(50-60) msec) wave components and in the optic nerve injuries, flat wave patterns were noted. 3) In chiasmatic lesions, VEP showed mild prolongation of latency (wave Ⅱ, N_(50-60)msec) throughout and mild supperssion of the amplitudes of the wave components presented. On stimulation of one eye, latency and amplitude of the contralateral sided eye were markedly delayed and suppressed. 4) VEP of optic tract and optic radiation lesions showed marked prolongation and suppression of wave pattern in late components (wave Ⅱ, Ⅲ). In multiple sclerosis, VEP abnormality was presented in early state (N_(80-90)msec). 5) In the visual cortical lesions, the wave patterns of the VEP were almost symmetrically flat on both side. Serial evaluation of the VEP could provide good informations for the evaluation of visual pathway lesions and functional recovery marker.

시신경 하방 수평 내측으로 향한 Carotid-Ophthalmic Aneurysm의 Technical Consideration : 수술치험 2예 보고 Report of Two Operative Cases

강준기,송진언 대한신경외과학회 1981 Journal of Korean neurosurgical society Vol.10 No.1

The introduction of the operating microscope improved not only the immediate operative management of cerebral aneurysms, but also the knowlege of their topography. The origin and projection of an aneurysm and its relation to the arteries concerned, identification and sparing of small functionally important arteries in the vicinity of the aneurysm, and the recognition of less known anomalies of the vascular system became as important as the dissection and clipping of the neck itself. We have presented 2 patients with aneurysms arising from the carotid artery in the origin of the ophthalmic artery. The origins and projections of aneurysms were analyzed with the aid of angiography, magnification technique, operative drawing and photographs. To facilitate the surgical procedures and results in lowered morbidity we have discussed the technical considerations for medialward directing aneurysm under the optic nerve in the view point of the surgical anatomy. We emphasized preoperatively defined plans concerning the origin, direction and size of the aneurysms, as well as, constant awareness of topographic relations.

Narrow Spinal Canal에 대한 임상적 관찰

강준기,윤석훈,이춘장,송진언 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.2

Authors analysed 25 cases of the narrow spinal canal in cervical and lumbar region, who admitted to the Catholic Medical Center, Seoul from Jan. 1970 to August 1976. Correlation between neurologic feature and radiologic finding was attempted and compared the measurements of narrow cervical and lumbar spinal canal with that of the healthy Korean. The mean anteriorposterior diameter of the cervical canal in healthy Korean was 16.2㎜. at C4, 16.4㎜. at C5, 16.6㎜. at C6, and 16.4㎜. at C7. The ratio of canal to vertebral "body in the plain lumbar spine was 1:3.9 at L3, 1 : 3.8 at L4 and 1 : 3.8 at L5. The measurements of 25 cases of narrow spinal canal were significantly reduced comparing with the healthy one. The clinical symptoms were closely related to the severity of the narrow spinal canal while there was intermittent or insidious course of symptom in the group of mild narrow spinal canal. Symptom of root compression or neurogenic claudication is frequent manifestation in the severe narrow spinal canal, and the symptom is correlated to the severity of the narrowing. Urinary disturbance and pyramidal tract sign were evident in the cervical narrow canal. The characteristic myelographic feature was multiple constrictive defect at the level of the narrow canal. Common findings in laminectomy were the thickened laminae and hypertrophied ligamentum flavum in the narrow canal. Herniated disc was not found but in one case in the cervical narrow canal at surgery. The recovery of the symptom was better in the group of the narrow canal who had mild degree of narrowing or who had the symptom in short duration rather than prolonged course.

척추골 동맥 조영술에 의한 뇌 병소의 진단

강준기,허춘웅,최창락,송진언,신경섭 대한신경외과학회 1976 Journal of Korean neurosurgical society Vol.5 No.1

The authors analysed radiologic findings of the posterior fossa lesions as will as incisural and supratentorial lesions in 40 patients who were diagnosed by transfemoral serial vertebral angiography at Cantholic Medical Center since October 1972 to April 1976. We also attempted to evaluate the diagnostic value in the diagnosis of the lesions according to the site of involvement. The tumors of the fourth ventricle or vermis demonstrated abnormal findings corresponding to the area of involvement, however the lesions could not be defined accurately with the study. Cerebellar hemispheric or tentorial tumors were diagnosed with considerable accuracy by vertebral angiography. Infratentorial vascular lesions were clearly demonstrated with serial vertebral angiography but the accuracy of diagnosis was argumented with subtraction technique. The evidence of compression of the brain stem was demonstrated with considerable accuracy by serial vertebral angiography. Furthermore exact site and direction of the compression could be outlined with the study. For the posterior temporal or occipital tumors which were not able to diagnose definitely with carotid angiography, considerable diagnostic accuracy was carried by the vertebral angiography. Definite diagnosis of the posterior third ventricle tumors or thalamic lesion was able to obtain with serial vertebral angiography.