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권오기,한대희,정영섭,오창완,한문희,Kwon, O-Ki,Han, Dae Hee,Chung, Young Seob,Oh, Chang Wan,Han, Moon Hee 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8
Objective : The authors reviewed 280 cases with intracranial arteriovenous malformations(AVMs) to identify risk factors of hemorrhage. Patients and Methods : From 1983 to 1997, a total 280 patients with AVMs were treated. Among them, 64% had a history of hemorrhage. Angiograms were retrospectively analyzed with particular attention to the size of the AVM, venous drainage, the location of the AVM and presence of associated aneurysm or varix. These characteristics were statistically analysed in relation to occurrence of hemorrhage. Results : A single variate analysis demonstrated that small size(p=0.0003), deep venous drainage(p=0.025) and periventricular location(p<0.0001) had a strong positive correlation. Associated aneurysms and varices were not found as hemorrhagic risk factors. A multivariate analysis revealed that the size of the AVM was most significant hemorrhagic factor(p=0.0003) followed by deep venous drainage(p=0.025). AVMs with small size and deep venous drainage bled more frequently regardless of their locations. Conclusion : These data would be useful in identifying patients at higher risk for developing hemorrhage of intracranial AVMs.
김재용,오창완,정영섭,권오기,한대희,Kim, Chae-Yong,Oh, Chang-Wan,Chung, Young Seob,Kwon, O-Ki,Han, Dae Hee 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.3
Objective : Stroke is leading cause of death and more importantly it is cause of serious disability. The effective treatment of acute ischemic stroke still remains a challenge to modern medicine. Recent clinical trials have shown that carotid endareterctomy(CEA) provide overwhelming benefits compared with medical therapy in preventing subsequent stroke for symptomatic carotid stenosis. For the asymptomatic ones, the data are less compelling, but highly suggestive that CEA do have benefits in properly selected patients. Materials and Methods : To investigate the clinical manifestations of carotid stenosis and results of CEAs, authors analyzed retrospectively 19 CEAs in 16 patients from June 1986 to June 1999. Age of patients ranged from 55 to 76 years(median, 66) and male to female ratio was 14 to 2. The duration of follow-up was 1 to 144 months (median, 26). All of CEAs were done on the side of stenosis more than 80% and bilateral CEAs were done in three. Six CEAs were performed in asymptomatic patients. Results : Seventeen of 19 CEAs showed excellent results and complication rate was low although ipsilateral ischemic stroke occurred in two. Conclusion : CEA may be a valuable surgical treatment for ischemic stroke caused by carotid stenosis and also for prevention of stroke of asymptomatic patients with carotid stenosis.
고영초 ( Young Cho Koh ),유헌 ( Heon Yoo ),권오기 ( O Ki Kwon ),김용만 ( Yong Man Kim ),주미 ( Mee Joo ),이기재 ( Ghi Jai Lee ) 대한뇌종양학회 2002 대한뇌종양학회지 Vol.1 No.1
The authors report unusual presentation of a vestibular schwannoma in a 53-year-old man, who presented with sudden onset of severe headache and, vomiting followed by left peripheral type facial palsy two weeks prior to admission. He had been well except for a longstanding left hearing difficulty, which had been considered as an aging process. In addition, he had mitral valve replacement surgery two years prior to admission , for which he had taken anticoagulant(Warfarin 2mg) everyday with regular monitoring of coagulability. Plain CT scan on admission demonstrated a 3×4×3cm sized high density mass at the left cerebellopontine angle with erosion and widening of the left internal auditory meatus. Brain MRI showed a heterogenous signaled mass with high signal on T1WI with little contrast enhancement and low signal on T2WI suggestive of multistaged hematomas within the peripherally enhancing tumor. Under the impression of intratumoral repeated bleeding in a patient with preexisting vestibular schwannoma, left suboccipital craniectomy was undergone to remove a large extraaxial tumor, mixed with large amount of hemorrhages. Postoperative course was uneventful except for persistent left facial palsy and hearing loss. Postoperative anticoagulation was started on the 5th postoperative day.
전두엽 상내측 신경교종의 수술 수 발생하는 운동보조영역 증후군
김재현,고영초,이채혁,권오기,최우진,박효일 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objective : This retrospective study was aimed to correlate characteristic neurologic deficits of transient contralateral motor weakness with or without speech disturbance(Supplementary Motor Area, SMA syndrome) after the resection of the gliomas in the superior frontal gyrus, especially with the extent of resection of the tumors. Method : Ten patients with medial superior frontal glioma, who underwent gross total or subtotal resection of the tumor, as well as, partial or complete resection of the spolementary motor area were studied. The following parameters were evaluate 1) tumor location 2) extent of resection 3) degree and duration of postoperative deficits. Result : Postoperative neurologic deficits were transient contralateral motor weakness with or without motor dysphasia. As a whole, postsurgical SMA syndrome occurred in 3 patients out of 10 patients with medial superior frontal gliomas(30%), who underwent gross total or subtotal resection of the tumors. Motor deficits were present in 3 out of 10 patients and speech disturbances in 2 out of 3 left frontal gliomas. Recovery of neurological dysfunction was rapid occurring between the 5th 14th POD and their neurological function returned almost normal in two patients. In the remaining one patient, who had preoperative mild motor weakness showed incomplete recovery of the worsened motor weakness and newly developed speech disturbance till 1yr postoperatively. Conclusion : The postsurgical SMA syndrome in patients with glioma in the medial superior frontal gyrus was not so uncommon phenomenon and well correlated with the extent of surgical resection of the supplementary motor area. Thus, preoperative awareness and warning about the possibility of the development of this charicteristic SMA syndrome is necessary.