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황형식,심영보,송준호,박용기,조맹기,오세문,최선길,강성구 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.5
SPECT(single photon emission computed tomography) using 99m-Tc-HMPAO is a current method of identifying the relative condition of cerebral blood perfusion in pathologic conditions of the brain such as TIA, complete cerebral infarction, dementia, and psychologically ill states. The purpose of this article is to evaluate the significance of SPECT in head injuries. According to the other previous reports, there are several drawbacks in SPECT to evaluate the victims of head injury such as uncooperability of the patient, long scanning time, poor patient monitoring during the scanning time, poor availability, etc. The authors analyzed 54 cases of head injury patients, studying SPECT and CT in regard to the comparison of CT and SPECT, the relation of SPECT and the severity of the head injury, the duration of admission and the SPECT findings. The results were as follows: 1) In focal lesion, CT was more available for the quick evaluation of the location, size, and rapid decision making, and SPECT was available for the adjuvant method of postoperative follow-up. 2) In diffuse brain lesion, CT showed only the diffuse brain swelling and SPECT was available for more fine localization of the lesion. 3) In mild head injury, CT could not identify the location of the lesion and SPECT showed focal perfusion defects(55%).
김용한,안경순,심영보,송준호,최선길,강성구 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.8
Retrospective analysis for reoperation and complication was made for 186 patients with lumbar herniated disc. The results showed complication rate of 7%(13 cases) and reoperation rate of 10.2%(19 cases). The primary complications were infections(9 cases), technical errors(2 cases), and sores(2 cases). Rate of discitis was 1.6%(3 cases). The outcomes of reoperation resulted in excellent recovery of 16%(3 cases) and good recovery of 58%(11 cases). The most common intraoperative findings of reoperation were inadequate disectomy or missed disc fragments 31.6% or 6 cases ; epidural fibrosis 26.3% or 5 cases ; and new herniation at other level 15.8% or 3 cases. Excellent and good results could be achieved in patients operated within 1 month or more than 6 months after while the patients who underwent reoperation between 1 month and 6 months showed poor results. The delicate perioperative management and complete discectomy, adequate bleeding control and laminectomy were considered to be essential in reducing the chance of complication and reoperation.
비와상성 추골동맥 해리성 동맥류 2례 : Case Report
정병주,안경순,김용한,심영보,송준호,오세문,최선길,강성구 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.7
We present two cases with dissecting aneurysm of intracranial vertebral artery. One of them had brain stem infarction and the other one developed subarachnoid hemorrhage. Cerebral angbgram revealed fusiform dilatation with proximal and distal narrowing of the affected vesseL Magnetic resoliance imaging showed subacute blood clot in the right vertebral artery which suggested dissection. Differentiation from vasospasm and from atherosclerosis is critical. At surgical exposure, the aneurysms were appeared as dark-purplish sausage like masses. The pmxhnal portions of the intracranial vertebral arteries were clipped. The post-operative courses were benign and at present they regained their normal daily lives.
안경순,김성민,김용한,심영보,송준호,오세문,최선길 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.6
The authors have dealt with six cases of spontaneous intracranial vertebral artery dissection during the past 3 years. Most of the patients were in their fourth or fifth decade of life, and men predominated. All except one patient had severe antecedent headache and half of the 6 cases were hypertensive. The presenting clinical features were subarachnoid hemorrhage. Wallenberg's syndrome, brain stem RIND (reversible ischemic neurologic deficit) and cerebellar infarct. The locations of the dissection were right vertebral artery in four patients, right vertebral and basilar artery in one and left vertebral artery in another one. Most of the patients showed typical intramural hematoma or double lumen on the MRI. On the MR angiography, irregular segmental narrowing of vertebral artery or invisible pathologic vertebral artery were demonstrated. The angiographic findings included alternating irregular stenotic and dilated segment(pearl and string sign), aneurysmal dilatation occulusion etc. Four patients were treated medically while the other two were treated surgically by proximal vertebral artery clipping of the affected artery. Upon follow-up, the outcome were excellent in two good in two and fair in two.