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동맥분지와 무관한 내경동맥류 : 배측 및 내측 내경동맥류 Dorsal and Medial ICAA
성정남,오창완,이상형,한대희 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.11
Aneulysms arising remote from arterial divisions are rare. From January 1981 to December 1993, we operated on 271 internal carotid a k r y aneurysms(1CAA). Among them, we found nine of such unusual aneurysms protruding from the dorsal(six cases) or medial wall(three cases) of the internal carotid artery. Angiographically, they were often misdiagnosed as the posterior communicating artery aneurysm or carotid artery bifurcation aneurysm due to small size and flat shape with broad neck On operation, all three medial wall aneurysms showed severe atherosclerosis, and moderate to minimal atherosclerosis was found in four dorsal wall aneurysms. In four cases, we experienced intraoperative premature rupture of the aneurysm, one during retraction of the frontal lobe due to adhesion of the aneurysmal dome to the base of frontal lobe, two during aneurysmal neck dissection and the other one during clip application. These aneurysms were difficult to operate on because of their fragility(thin or atherosclerotic wall) and relatively broad aneurysmal neck. In conclusion, these aneurysms presented with difficulties in preoperative diagnosis by angiography due to small size and flat shape. In operation, special care should be taken to avoid premature rupture of the aneurysm due to thin or atherosclerotic fragile wall. ,
Neurofibromatosis Type 2와 무관하게 발생된 척추 경막내 다발성 신경초종 - 증 례 보 고 -
김정태,성정남,박봉진,조맹기,김영준,Kim, Jung Tae,Sung, Jung Nam,Park, Bong Jin,Cho, Maeng Ki,Kim, Young Joon 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.4
Most extracranial schwannomas are solitary, but neurofibromas are frequently associated with other manietations of neurofibromatosis. Schwannomas that occur within the context of neurofibromatosis tend to be multiple, but multiple schwannomas without manifestation of neurofibromatosis type 2 are very rare. The authors report a very rare case of multiple spinal intradural schwannomas in the absence of neurofibromatosis Type 2 maniestations. A 40-year-old man suffered from longstanding low back pain and left side sciatica which was treated with two stage operations. MRI showed multiple intradural mass lesions extending from L1 vertebral segment to S1 vertebral segment. There were no clinical and radiological manifestations of Type 2 neurofibromatosis. Histologically confirmed diagnosis was schwannoma.
권영이,박봉진,성정남,김영준,조맹기,Kwon, Young-Yi,Park, Bong-Jin,Sung, Jung-Nam,Kim, Young-Joon,Cho, Maeng Ki 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.10
Germinomas of the central nervous system are rare embryonal tumors(accounting for less than 1% of intracranial neoplasms) that may be located in the pineal region, in the floor of the third ventricle, or in the suprasellar area. We report a case of germinoma developed in periventricular deep white matter without pineal region tumors or suprasellar masses. The 19-year-old male patient presented with slowly progressing headache, dizziness, photophobia, and dysarthria. Initial brain MRI revealed a irregular and dense enhancement from lateral ventricles to 4th ventricle. The stereotactic biopsy of tumor and histologic examination revealed the germinoma. Craniospinal axis radiation therapy was performed. After radiation therapy patient was improved and no neurologic sequelae was seen at discharge. Periventricular germinomas without pineal or suprasellar lesion are very rare. The radiation therapy, as in our case, is beneficial as with other intracranial germinomas. Stereotactic biopsy of periventricular germinoma provides precise pathologic diagnosis and thus allows more specific management.