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Is Magnetic Resonance Image Alone Sufficient for Detecting Disc Cyst?
홍현종,이형중,백광흠,오성훈 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.35 No.3
Disc cyst is an exaggerated form of disc degeneration that requires discography to confirm diagnosis. A case of 25-yearold man with back pain and left thigh numbness is described. A juxtaradicular extradural cyst at the upper lumbar spine, straddled the intervertebral foramen and migrated superiorly, was depicted as a bean-shaped high signal lesion that connected to the corresponding disc via a low signal stalk on T2-weighted magnetic resonance images. Gadoliniumenhanced images showed faint peripheral enhancement. Surgical specimen was histologically confirmed as a pseudocyst and he made a full recovery. We are able to detect a disc cyst with magnetic resonance imaging, particularly Gadolinium-enhanced and sagittal T2-weighted images, which was possible in the past only with invasive discography.
Cystic Non-enhancing Vestibular Schwannoma with Unusual Clinical Presentation
홍현종,이형중,오석전,고용 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.35 No.2
We present a case of large cystic vestibular schwannoma in a 60-year-old woman who complained of facial palsy and tinnitus. Magnetic resonance images revealed signals of long T1 and T2, suggesting its cystic architectures. Enhanced images showed marginal enhancement at the peripheral wall and multiple internal septa, but not at the intracanalicular portion. An epidermoid cyst was presumed owing to its insinuating growth and lack of enhancement, but cystic degeneration of vestibular schwannoma was confirmed histopathologically. She had an unremarkable postoperative course. After thorough review of our case together with pertinent literatures, we emphasise the importance of differential diagnosis of cystic lesions in the cerebellopontine angle.
요추간반 탈출증에 있어 MED(Microendoscopic Discectomy) System을 이용한 수술의 효율성과 수기
홍현종,오성훈,백광흠,김재민,김충현,김영수,고용,오석전,김광명,이상구,김남규,Hong, Hyun Jong,Oh, Seong Hoon,Bak, Kwang Hum,Kim, Jae Min,Kim, Choong Hyun,Kim, Young Soo,Ko, Yong,Oh, Suck Jun,Kim, Kwang Myung,Lee, Sang Gu,Kim, Nam Kyu 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.1
Objective : Percutaneous lumbar approaches such as arthroscopic discectomy, laser discectomy, and nucleotome remain controversial and have technical limitations to free fragment disc, bony pathology and access to L5-S1, The purpose of this study was to determine efficacy of this new endoscopic system and to report techniques and tactics. Methods : From July 1997 to May 1998, we treated 40 consecutive patients(43 levels) with the MED system. Mean age was 32 years(range ; 18 to 62). There were 30 males and 10 females. All patients had sciatica with SLRT limitation. There were 23 patients with disc herniation at L4-5 and 14 patients at L5-S1. Three patients had 2 level disc herniations. There was one far lateral disc herniation at L4-5. Results : Using modified MacNab criteria, there were 37 excellent results and 3 good result. Most patients were discharged within 3-4 days except 2 patients with dural tearing. There were no other complications. Mean operation time was 1.5 hours(range : 40 minutes to 2.5 hours). Conclusion : The MED system is a reliable approach to lumbar disc herniations. This system combines the advantages of conventional open surgery and a minimally invasive technique. As tactics for the doctors who wish to attempt, "palpate" the lamina by first dilator, identification of interlaminar space by removal of overlying soft tissue and confirmation of the shoulder portion of nerve root before discectomy are important to this procedure. We conclude that lumbar disc herniations can be successfully treated with MED approach.
맥락렬의 해부학적 구조 및 미세수술 접근법에 대한 고찰
홍현종,권정택,박관,이원복,김영백,민병국,황성남,최덕영,석종식 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.5
The authors had studied the microsurgical anatomy of the choroidal fissure and the operative approaches directed through the fissure. In this study. eight formalin fixed cadaveric hemispheres were examined. In four hemispheres. the intracranial vessels were perfused with colored silicone latex. The choroidal fissure is divided into three portions : (a) body portion. (b) atrial portion. and (c) temporal portion. Dissection through the body portion of the choroidal fissure exposes the velum interpositum. internal cerebral vein. and third ventricle. The quadrigeminal cistern. pineal region, and posterior part of the ambient cistern can be exposed through the atrial portion of the choroidal fissure. Opening through the temporal portion of the choroidal fissure exposes the structures in the ambient cistern. which include the basal vein. posterior cerebral artery. anterior and lateral posterior choroidal arteries, and hippocampal formation. This study provides valuable knowledges of microsurgical approaches to the third ventricle and basal cistern by demonstrating the neural and vascular relationship around the choroidal fissure.
드문 혈관 압박에 의한 삼차신경통과 Tic Convulsif
홍현종,김한식,권정택,박관,민병국,석종식 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.5
Trigeminal neuralgia is a cranial rhizopathy characterized by paroxysms of hyperactivity strictly limited to the anatomical distributions of the fifth cranial nerve. One of a documented cause is vascular cross-compression at the root entry zone of the fifth cranial nerve near the brain stem. The offending vessels are the superior core-bellar artery. anterior inferior cerebellar artery small arteriole. vein only. and vertebrobasilar artery in order of frequency. When trigeminal neuralgia and hemifacial spasm occur together in the same patient in rats occasions. they are termed "tic convulsif" We have recently experienced three cases of trigeminal neuralgia caused by unusual offending vessels and one case of tic convulsif. They were treated by microvascular decompression using Teflon felt. Post-operative courses were uneventful and marked symptomatic improvement had beef achieved.
두통을 주소로 내원한 베체트병 환자에서 상악동 내 발생한 림프종
홍현종 ( Hyun Jong Hong ),이상엽 ( Sang Yeob Lee ),김혜인 ( Hye In Kim ),황진연 ( Jin Yeon Hwang ),조용민 ( Yong Min Jo ),류환철 ( Hwan Cheol Ryu ),이성원 ( Sung Won Lee ),정원태 ( Won Tae Chung ),김대철 ( Dae Cheol Kim ) 대한류마티스학회 2008 대한류마티스학회지 Vol.15 No.1
Behcet`s disease is chronic and systemic inflammatory vasculitis, characterized by immunologically involving in variable size of arteries and veins. Clinically, principal manifestations are recurrent oral ulcer, genital ulcer, skin and eye lesions. Compared to other connective tissue disease, cancer is not accompanied commonly in Behcet`s disease. But, immunological confusion such as T cell depletion or B cell hyperplasia, or long-term of immunosuppressive treatment lead to occurrence of malignancy. Recently, we experienced a case of maxillary mass, induced to abrupt headache in Behcet`s disease, confirmed diffuse large B cell lymphoma by biopsy, and treated by rituximab-CHOP chemotherapy. Thus we report these with literature review.
Ruptured Pseudoaneurysm after Minor Head Injury, is it Traumatic?
김동원,이형중,홍현종,고용 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.35 No.3
Traumatic intracranial aneurysms are rare, and their occurrences can only be assumed in the presence of major head injury, unusual location and rather unique radiological findings. We describe one patient having giant pseudoaneurysm arising at distal middle cerebral artery. A 22-year-old woman presented with sudden mental deterioration. She had suffered minor head injury 2 months ago, and complained headache since then. Brain computed tomography and angiography revealed thick subarachnoid hemorrhage, huge intraparenchymal hematoma and aneurysmal dilatation at the distal middle cerebral artery. Surgical trapping and excision of the ruptured aneurysm were conducted. Histopathological examination confirmed a pseudoaneurysm and she recovered gradually thereafter. Although there had been no definite evidence of recent major head injury, peripheral location of the aneurysm, histologically proven pseudoaneurysm and clinical deterioration following 2 months of minor head injury all made us believe that this aneurysm might be caused by trauma.