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Fusiform Aneurysm of Proximal Anterior Cerebral Artery- Case Report -
좌철수,Jae Min Kim,Koang Hum Bak,Choong Hyun Kim 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.33 No.2
The authors report a case of fusiform aneurysm in the proximal anterior cerebral artery(ACA). A 44-year-old woman presented with severe headache after subarachnoid hemorrhage. The right carotid angiography demonstrated a fusiform aneurysm in the A1 segment of right ACA with vasospasm. Clipping of a fusiform right A1 aneurysm was performed via the right pterional approach. The postoperative cerebral angiography demonstrated complete occlusion of the fusiform aneurysm and moderate degree of vasospasm with preservation of A1 segment. The postoperative course was uneventful. We report a case of fusiform aneurysm of A1 segment that was successfully clipped with the fenestrated aneurysmal clip. Key words:Aneurysm;Fusiform;Anterior cerebral artery;Fenestrated clip.
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좌철수,Hyeong-Joong Yi,Tai-Ho Im,Hyun-Jong Hong 대한신경외과학회 2003 Journal of Korean neurosurgical society Vol.34 No.5
Objective:The informed consent, in literal sense, is a medicolegal process that requires full explanation and clear disclosure about the illness, and thorough comprehension and autonomous consent to the respective medical services of the competent recipient. The authors review the theoretical background of the informed consent and investigate pertinent problems encountered in medical practice. Methods : We gathered 153 consecutive cases of written form of the informed consent regarding diagnosis and treatment from Mar 2001 to Jun 2002. The authors evaluate the completeness of the process by looking into the possible omitted components in whole cases and degree of recall for the explained risk by telephone questionnaire in 128 available cases. Results : In a total 153 cohort, 21 emergency operation cases invariably showed structural deficiencies of free-ended discussion due to short of time. Thorough past history taking and physical examination was necessary to perform reoperation for the postoperative hematoma in 3 cases and solid intimate relationship was necessary to treat previously disclosed complication in 7 cases of invasive diagnostic and minimum operative procedures, respectively. Among the available 128 patients, only 33(25%) ones could recall the given risks addressed at the consent approximately 6 weeks later. Conclusion : The informed consent is a process that dictates the free dialogue between the patient and the physician, not a simple paper expressed in published characters. However, to enhance the effectiveness of the consent process, both free discussion and writing down contents are prerequisite. Key words:Discussion;Informed consent;Medical practice;Theoretical background;Write down.
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급성 경막하 혈종에 대한 감압술 후 발생한 반대편의 천막 상, 하 급성 경막외 혈종
이정식 ( Jeong Shik Lee ),좌철수 ( Cheol Su Jwa ),심숙영 ( Sook Young Sim ),김강현 ( Gang Hyun Kim ) 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2
A postoperative contralateral supra- and infratentorial epidural hematoma after decompressive surgery is an extremely rare event. We describe a 38-year-old male with a contralateral supra- and infratentorial acute epidural hematoma just after decompressive surgery for an acute subdural hematoma. A contralateral skull fracture involving a lambdoidal suture and an intraoperative brain protrusion may be warning signs. The mechanisms, along with relevant literature, are discussed. (J Korean Soc Traumatol 2010;23:188-191)
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배인석,문병관,강희인,김재훈,좌철수,김덕령 대한척추신경외과학회 2022 Neurospine Vol.19 No.2
Objective: We retrospectively analyzed patients with osteoporotic vertebral compression fracture (OVCF) undergoing vertebral augmentation to compare the Cobb angle changes in the supine and standing positions and the clinical outcomes. Methods: We retrospectively extracted the data of OVCF patients who underwent vertebral augmentation. Back pain was assessed using a visual analogue scale (VAS). Supine and standing radiographs were assessed before treatment to determine the Cobb angle and compression ratio. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff to predict favorable outcomes after vertebral augmentation. Results: A total of 249 patients were included. We observed a statistically significant increase in the VAS score change with increasing Cobb angle and compression ratio (p < 0.001), and multivariate logistic regression analysis showed that a difference in the Cobb angle (odds ratio [OR], 1.27) and compression ratio (OR, 1.12) were the independent risk factors for predicting short-term favorable outcomes after vertebral augmentation. In addition, we found that the difference in the Cobb angle (OR, 1.05) was the only factor for predicting midterm favorable outcomes after vertebral augmentation. The optimal cutoff value of the difference in the Cobb angle for predicting midterm favorable outcomes was 35.526°. Conclusion: We found that the midterm clinical outcome after vertebral augmentation was better when there was a difference of approximately 35% or more in the Cobb angle between the standing and supine positions. Surgeons should pay attention to the difference in the Cobb angle depending on the posture when deciding to perform vertebral augmentation in patients with OVCFs.
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