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Primary Spinal Cord Astrocytoma Presenting as Intracranial Hypertension: A Case Report
임성룡,이승주,임승철 대한척추신경외과학회 2012 Neurospine Vol.9 No.3
Increased intracranial pressure (IICP) is rarely seen in association with primary spinal tumors. We describe a 58-year-old man who was diagnosed with a primary spinal cord astrocytoma, who first presented with hypesthesia, followed by intracranial hypertension, papilledema and blurred vision. On first admission, he presented with hypesthesia but without paraparesis, headache or blurred vision. Spinal MRI showed a relatively well-enhanced solid mass with a cystic portion at the cervico-thoracic level, shown histologically to be a grade I pilocytic astrocytoma. After gross total resection of the tumor, the patient had no significant neurological changes. Nine months later, the patient was admitted with headache, blurred vision and paraparesis. An ophthalmologic examination showed papilledema and lumbar tapping revealed IICP. A spinal MRI showed recurrence of the tumor which was found to be a glioblastoma after reexplorative debulking surgery. After resection, his headaches and blurred vision improved, but his paraparesis did not. These findings show that a primary spinal cord astrocytoma may cause IICP. Increased intracranial pressure (IICP) is rarely seen in association with primary spinal tumors. We describe a 58-year-old man who was diagnosed with a primary spinal cord astrocytoma, who first presented with hypesthesia, followed by intracranial hypertension, papilledema and blurred vision. On first admission, he presented with hypesthesia but without paraparesis, headache or blurred vision. Spinal MRI showed a relatively well-enhanced solid mass with a cystic portion at the cervico-thoracic level, shown histologically to be a grade I pilocytic astrocytoma. After gross total resection of the tumor, the patient had no significant neurological changes. Nine months later, the patient was admitted with headache, blurred vision and paraparesis. An ophthalmologic examination showed papilledema and lumbar tapping revealed IICP. A spinal MRI showed recurrence of the tumor which was found to be a glioblastoma after reexplorative debulking surgery. After resection, his headaches and blurred vision improved, but his paraparesis did not. These findings show that a primary spinal cord astrocytoma may cause IICP.
혈전성 뇌경색 환자의 뇌혈관 촬영 소견과 위험 인자에 관한 연구
홍도권,김상진,임성룡,허경,김응규,조효근 인제대학교 1996 仁濟醫學 Vol.17 No.3
허혈성 뇌혈관 질환의 병변 부위는 동양인은 서양인에 비해 두개내 혈관 병변이 많고 서양인에서와 같은 내경동맥 근위부의 폐색성 혈관 병변은 드문 것으로 알려져 있다. 저자들은 임상 소견 및 뇌전산화단층촬영과 자기공명영상를 통하여 뇌경색으로 진단된 환자들에서 뇌혈관조영술을 실시하여 경동맥 및 추골-기저 동맥영역의 뇌혈관 폐쇄나 협착의 양상과 각종 위험 인자와의 관련성을 분석하였다. We studied the relationship between cerebrovascular angiographic finding and risk factors such as age, hypertension, smoking, diabetes mellitus, hyperlipidemia, or ischemic heart disease in 104 atherothrombotic infarction diagnosed by clinical features, computed tomography, and MRI. Hypertension was significantly frequent in the patients with distally stenosed or occuluded artery than in the patients with proximally affected artery(P<0.05), but there was no relation between the smoking, diabetes mellitus, hyperlipidemia, or ischemic heart disease and the site of stenosis or occulusion of artery. Hypertension was significantly frequent in the patients with the atherosclerosis or multiple arterial stenosis than in the patients with mono arterial involement without atherosclerosis(P<0.05). Age of the patients wish mono arterial stenosis without atherosclerosis was signifcantly younger than the patients with atherosclerosis or multiple arterial stenosis (P<0.05).