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김흥치,이헌재 대한신경외과학회 1973 Journal of Korean neurosurgical society Vol.2 No.2
A series of 53 verified various sellar and parasellar lesions exclusive of aneurysms and inflammatory lesions was reviewed as to history, development and progression of the neurological features, spontaneous and steroid induced remission, endocrine disturbances, other laboratory findings, reontgenograms, differential diagnosis, operative methods and findings, and pathologic findings of the lesion. The author has only emphasized some interesting points illustrated in our cases because other results do not differ greatly from previous authors' reports. 1. No direct correlation was found to exist between the amount of the sellar destruction and the occurrence of endocrine disturbances. However, it was likely that marked endocrine changes were due to cystic formation in pituitary adenomas. 2. On angiograms of sellar and parasellar lesions, opening of the siphon and lateral displacement of the supraclinoid portion of the internal carotid artery were important in the diagnosis, and the event of nonvisualization of the posterior communicating and posterior cerebral arteries was observed in the majority of pituitary tumors. 3. In pituitary cystic adenomas, intracapsular bleeding was very hard to control on occasions because of rupturing vascular network or trabeculae in the cyst. 4. Definition of the empty sella was always obscure in intracranial exploration under the diagnosis of pituitary tumor when no definite lesion was found. 5. In a hydrocephalic patient with raised intracranial pressure and a markedly enlarged third ventricle extending into the sella turcica, third ventriculostomy still seems to be the choice of treatment.
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TRIGEMINAL NEURINOMAS : Report of 2 cases
Kim, Heung Chi,Park, Tae Sung,Kim, Soo Hyu,Choi, Joong Uhn,Chung, Sang Sup,Hahn, Yoon Sun,Lee, Soo Ik,Lee, Hun Jae 대한신경외과학회 1973 Journal of Korean neurosurgical society Vol.2 No.2
두개강내 신경초종의 대다수는 청신경에 발생하며 삼차신경절 또는 신경근에 생기는 초종은 비교적 희귀한 병소라 할 수 있다. 대개 30대 및 40대에서 호발하며 특정적 증상으로는 그 병소가 삼차 신경절이나 중두개와에 국한되어 있을 경우에는 동측 안면에 동통을 동반하는 지각장애와 저작근의 위축 도는 마비증 등이 나타나며 이것이 후두개와내로 신장되면 다발성 뇌신경장애 소뇌증상 등을 동반하기도 한다. 경동맥 및 척추동맥 촬영상에서 주뇌동맥들과 그들의 분지들이 현저한 전위를 보이며 이따금 종양의 음영을 볼 수 있으며 그 외 뇌저액조 조영술 및 뇌실조영술 등이 진단에 도움이 된다. 본 교실에서는 2례의 삼차신경초종을 치험한 바 있는데 그 중 1례는 주로 후두개와에 신장되어 있어 심한 두통과 소뇌증상 들을 주소로 하여 검사결과 상기증으로 의심, 후두개두술을 실시 확인하였으면 나머지 1례는 안면동통과 심한 저작근의 위축을 보이고 있었으며 뇌동맥촬영상 중도개와에 위치한 종양의 음영을 확인하고 측두부 개두술을 시행 비록 저작근의 위축은 호전되지 아니하였지만 두통과 안면동통이 현저히 호전되었다. 이상의 소경험을 통하여 삼차신경초종의 수술경유법 선택은 그 임상증상과 검사결과에 의존하겠지만 이 부위에 발생하는 신경초종은 그가 위치한 해부학적 특수성과 병리조직학적 성질을 고려하여 볼 때 우리는 항상 Dumbbell양 종양을 염두에 두면서 중도개와 및 후두개와에 걸친 경유법이 권장되리라 생각되며 아울러 문헌을 고찰하여 보았다. Two cases of trigeminal neurinomas are reported. The pertinent literature revealed the incidence of 0.2 per cent of all intacranial tumors. The characteristic symptoms are paresis of the fifth nerve and involvement of other cranial nerves, the cerebellum, and the cerebral peduncle with the growth of tumor into the posterior fossa. We like to stress the value of the carotid and vertebral arteriographies disclosing the typical displacement of the major cerebral vessels. The suboccipital craniectomy should be considered although in the majority of these tumors, the temporal craniotomy is advantageous.
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金榮水,金興治,李揆彰,李憲梓 中央醫學社 1972 中央醫學 Vol.22 No.1
Among metastatic intracranial neoplasm’s, the percentage of cases of malignant melanoma has been reported to be as high as 15%12). The pial melanoblast may be the cell of origin for a primary melanoma in the central nervous system 1,6). it can be also argued that the primary central nervous system melanoma could actually be a metastasis from an occult primary site in the skin, retina, esophagus, rectum or other site5). We have experienced a case of malignant melanoma involving the optic chiasm, scllar and parasellar regions. The metastatic primary site seemed to be the lesion in the right orbit.
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최중언,김흥치,정상섭,한윤선,이헌재 대한신경외과학회 1973 Journal of Korean neurosurgical society Vol.2 No.2
The radiofrequency has been used for percutaneous cordotomy in patient having intractable pain. Recently the use of this radiofrequency has been extended to include other neurosurgical procedures, which in the past were done with chemical agents or mechanical methods etc. We treated one case of trigeminal neuralgia with the radiofrequency. The gasserian ganglion was punctured through the foramen ovale using a modified Ha¨rtel technique and the radiofrequency lesion was made in the second and third branches of the right trigeminal nerve selectively. The postoperative result was satisfactory. We reviewed the literature and described the technical procedures and complications.
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한용표,김흥치,김상철,정상섭,이헌재 대한신경외과학회 1974 Journal of Korean neurosurgical society Vol.3 No.1
Though non-tumoral stenosis of the aqueduct has long been described as a common cause of hydrocephalus in infants and young children, its occurrence in adults has been recorded infrequently. In adults, the general picture of the clinical features is of chronic hydrocephalus such as impaired memory, epilepsy, unsteady gait, headache and other features of increased intracranial tension and endocrine disorders and features indicative of hypothalamic involvement. Plain skull X-rays show the signs of increased intracranial tension. The diagnosis is confirmed by ventriculography with or without lumbar encephalography. Recently cerebral angiography is stressed in diagnosis of aqueductal stenosis. We have seen two cases of aqueductal stenosis which can be regarded as non-tumoral origin. They were females and 29 and 34 years old respectively. Their symptoms were similar. It was headache for several months' duration which were aggrevated as time progress and combined with convulsions. Bilateral papilledema was the only finding in neurological examination. In conray ventriculography, the third ventricles were markedly enlarged and involved the salla tursica, and conray was not filled the caudal part of the aqueduct in two cases. The frist case, following Torkildsens ventriculocisternal shunt did well for several days, however, patient died in spite of massive antibiotic therapy and ventriculostomy after removal of shunt tube which was regarded as infective. Autopsy showed periaqueductal gliosis without neoplasmic infiltration. Second case was improved with anterior third ventriculostomy.
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