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RISS 인기검색어
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- 저자 : 방재승 ( Jae Seung Bang ) (검색결과 4 건)
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방재승,오창완,김명수,최기영,조병규,홍승관,한대희,Bang, Jae Seung,Oh, Chang-Wan,Kim, Myoung Soo,Choe, Ghee Young,Cho, Byung-Kyu,Hong, Seung-Koan,Han, Dae Hee 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.7
Intraventricular arachnoid cyst has been rarely reported. Here we present two cases of symptomatic intraventricular arachnoid cysts in the fourth ventricle and right lateral ventricle. The first patient was a 38-year-old female who complained of headache and left facial hypesthesia. Computed tomography and MR scan revealed large cystic lesion in the fourth ventricle. After cyst wall removal, facial hypesthesia disappeared immediately and headache improved slowly. The second patient was a 9-year-old girl who complained of headache, vomiting and paresthesia in her right low extremity. Cystic lesion in the right lateral ventricle was detected in the CT and MR scan. The symptoms improved after cyst wall removal. Surgical findings of these two cases showed that the cyst walls were attached firmly to the choroid plexus. Symptomatic intraventricular arachnoid cyst must be treated appropriately and we recommend complete cyst wall removal.
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방재승,정희원,김동규,곽호신,백선하,정영섭,홍승관,Bang, Jae Seung,Jung, Hee-Won,Kim, Dong Gyu,Gwak, Ho-Shin,Paek, Sun Ha,Chung, Young Seob,Hong, Seung-Koan 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4
Objectives : The authors present a retrospective analysis of 100 consecutive adult patients harboring craniopharyngiomas who underwent microsurgical resection between 1981 and 1999 to assess the long-term outcome of surgical treatment and to determine the most optimal management strategy. Methods : The extent of surgical removal was divided into four categories ; GTR(gross total removal), RSTR(radical subtotal removal), STR(subtotal removal),and PR(partial removal). The median follow-up period was 50 months(4-198). CT scan and/or MR imaging and hormonal status were evaluated to the last follow-up. Results : Visual disturbance was the most common presentation, which was improved in 42 cases and aggravated in 19 cases following the operation. Hypopituitarism was detected in 56 patients preoperatively, 82 during the immediate postoperative period, and 76 at the last follow-up. Improvement of pituitary function was not observed in any of these patients. Twenty of 100 patients showed recurrence at the mean of 27 months(3 to 196). The median progression-free survival(PFS) time of all patients was 145 months and 5-year PFS rate was 74%. Five-year PFS rate of GTR or RSTR group(71%) was significantly higher than that of STR or PR group(30%)(p=0.01). Postoperative radiation therapy significantly prolonged the PFS from 94 months in non-radiation group to 182 months(p=0.002). However, there was no statistical difference in number of patients who required hormonal replacement therapy between radiation and non-radiation group. Conclusion : Visual disturbance can be improved by early diagnosis and surgical decompression. GTR or RSTR in selected patients is considered a proper surgical strategy. Post-operative radiation therapy for residual tumors must be considered, although the ideal timing of radiation therapy is to be determined.
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반복적인 두개내 감염에서 유리대망피판을 이용한 경질막 재건
이훈영(Hoon Young Lee),은석찬(Seok Chan Eun),한정호(Jung Ho Han),방재승(Jae Seung Bang),김재용(Chae Yong Kim),박도중(Do-joong Park),백롱민(Rong Min Baek) 대한두개저학회 2011 대한두개저학회지 Vol.6 No.1
Purpose : Postoperative cerebrospinal fluid (CSF) leakage after neurosurgery could lead to potentially lethal complications. Reoperations, multiple operations, cranial radiotherapy and poor vascularization of the dura graft may lead to delayed healing of the suture site and resultant persistent CSF leaks. In this report, we present a technical experience of duroplasty with omental free flap. Methods : Between 2007 and 2011, the authors performed duraplasty in nine patients with recurrent subdural empyema and intracranial infection. The omental free flap transfer was intended for patients who could not be cured with conventional surgical debridement and lyophilized dura appliance. Patient ages ranged from 14 to 47 years (mean, 31.5 yr). There were five men and four women. Treatment was required for malignant tumors (n=4), cerebral hematomas (n=3) and the result of traumas (n=2). After harvesting the omentum laparoscopically, the flap was sutured to the dural defect in a watertight fashion. The most commonly used recipient vessels were the superficial temporal artery and vein. Results : The postoperative course was uneventful and flap survival was excellent in all patients. Cerebrospinal fluid leaks were controlled successfully. Patients were discharged with no evidence of wound discharge and there were no reports of infection or CSF leakage recurrence. Conclusion : Duraplasty using omental flap is an effective technique to control CSF leaks, especially when dura is poorly vascularized and less viable. The delicate nature and great pliability of the omental flap make it unique and competent for reconstructions of dural defects.
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뇌동맥류 결찰술 직후 발생한 중추성 요붕증과 동반된 SIADH 1 예
고성준 ( Sung Jun Ko ),김현숙 ( Hyunsuk Kim ),신나라 ( Nara Shin ),한미연 ( Miyeun Han ),김효진 ( Hyo Jin Kim ),최홍미 ( Hong Mi Choi ),허혁 ( Hyeok Heo ),황기환 ( Kihwan Hwang ),방재승 ( Jae Seung Bang ),김세중 ( Sejoong Kim ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.2
이상나트륨혈증은 뇌동맥류로 인한 지주막하출혈의 수술적 치료 후 나타나는 흔한 합병증 중 하나이다. 저자들은 뇌동맥류의 직접 결찰술 후 발생한 일시적인 중추성 요붕증 및 동반된 항이뇨호르몬 부적절분비증후군(SIADH)을 성공적으로 치료하였기에 보고하는 바이다. 60세 여자 환자가 오른쪽 이측의 시야 결손을 주소로 내원하였고 검사에서 발견된 상상돌기주변동맥류로 인한 것으로 생각되었다. 수술 중 동맥류의 목 부위가 파열되었으나 성공적으로 결찰되었다. 수술 직후 환자는 다뇨와 함께 고나트륨혈증이 발생하였으며 함께 시행된 검사 결과 중추성 요붕증이 의심되었다. 고나트륨혈증의 치료 후 저나트륨혈증이 발생하였고 검사 결과 SIADH가 의심되었으며 수분 제한 후 호전되었다. 이는 뇌동맥류 수술 후에 급격한 고나트륨혈증의 발생을 주의 깊게 관찰해야 하며, 회복 후에 나타날 수 있는 저나트륨혈증을 고려해야 함을 시사한다. Dysnatremia is one of common medical complications after surgical treatment of subarachnoid hemorrhage (SAH) due to cerebral aneurysm. We report a case of transient central diabetes insipidus (DI) followed by syndrome of inappropriate antidiuretic hormone secretion (SIADH), after direct clipping of ruptured cerebral aneurysm. A 60-year-old woman presented visual defect of right temporal area due to large paraclinoid aneurysm. During operation, the neck of aneurysm was ruptured, but successfully clipped. Just after the operation polyuria and hypernatremia developed and biochemical findings revealed that the patient presented central DI. A few days after recovery from hypernatremia, hyponatremia occurred and laboratory work revealed SIADH, and after free water restriction the patient was recovered from hyponatremia. Therefore, we suggest to monitor abrupt hypernatremia after operation and to implement rigorous fluid therapy, considering hyponatremia after recovery.
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