뇌량주위동맥에 발생한 외상성 뇌동맥류 - 증례보고 -

서의교,주진양,Seo, Eui Kyo,Joo, Jin Yang 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.12

Traumatic intracranial aneurysms are rare, compromising less than 1% of intracranial aneurysms. The case of 20-year-old man suffered from delayed frontal intracerebral hematoma, subarachnoid hemorrhage and intraventricular hemorrhage from traumatic pericallosal aneurysm 12 days after head injury is presented. Traumatic pericallosal artery aneurysm is always near the falcine edge, is unrelated to arterial branching point. Sudden movement of brain and artery causes vessel wall injury against the stationary edge of the falx. Because of high mortality rate of ruptured traumatic aneurysm, clinical suspicion must be focused on the prompt diagnostic work-up and early treatment.

단일 모동맥에서의 다발성 뇌동맥류

서의교,안정용,주진양,Seo, Eui Kyo,Ahn, Jung Yong,Joo, Jin Yang 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.12

Objective : Multiple cerebral aneurysms reportedly account for 14-33% of all cerebral aneurysms. However, multiple separate aneurysms on single parent artery are uncommon. The majority of these are found on middle cerebral artery(MCA). Multiple aneurysms arising from anterior communicating artery(ACoA) are rare. We report 5 cases of multiple aneurysms developed separately on single artery and describe angiographic and operative findings of these lesions. Materials and Methods : Among 127 patients of cerebral aneurysms operated in our hospital, only 5 had multiple aneurysms on single parent artery. Results : Among 5 cases, 4 were diagnosed preoperatively and the only one was found intraoperatively. Two were found on MCA bifurcation, one on M2 and two on ACoA. All separate aneurysms developed on single parent artery were treated successfully with multiple clipping. Conclusion : Multiple cerebral aneurysms, developed separately on single parent artery, are uncommon. Furthermore, those arising from ACoA are very rare. Despite the advanced technology in radiological examinations, multiple cerebral aneurysms may not be detected on preoperative study only. Close proximity or smaller size of the lesion may be responsible for the preoperative false negative angiographic findings.

본태성 다한증 환자의 수술 후 발생하는 보상성 다한증

서의교,조용은,윤도흠,김영수,Seo, Eui Kyo,Cho, Yong Eun,Yoon, Do Heum,Kim, Young Soo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4

Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.

뇌 교육종 - 증례보고 -

안정용,서의교,주진양,Ahn, Jung Yong,Kyo, Seo Eui,Joo, Jin Yang 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.7

Gliosarcoma is a rare malignant tumor of the central nervous system consist of gliomatous and sarcomatous elements. The authors report a case of gliosarcoma in the right frontal lobe. Sharp demarcation of the tumor from surrounding tissue and its superficial location may lead to complete removal and prolonged survival despite high malignancy.

골다공증성 척추체 압박골절에 대한 경피적 척추성형술시 자기공명영상과 골 주사 검사의 의의

김세혁,이완수,서의교,신용삼,장호열,전평,Kim, Se Hyuk,Lee, Wan Su,Seo, Eui Kyo,Shin, Yong Sam,Zhang, Ho Yeol,Jeon, Pyoung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.7

Objective : Percutaneous vertebroplasty is often complicated by the presence of multiple fractures or non-localizing pain in the patients with osteoporotic vertebral fractures. The purpose of this study is to estimate the value of preoperative radiologic studies in the localization of symptomatic vertebrae and to determine the factors which can influence on the clinical results. Materials and Methods : We retrospectively reviewed the clinical and radiologic data of 57 vertebrae in 30 patients underwent percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Inclusion criteria was severe pain(McGill-Melzack score 3, 4 or 5) associated with the acute vertebral fractures and absence of spinal nerve root or cord compression sign. Acute symptomatic vertebral fracture was determined by the presence of signal change on MR images or increased uptake on whole body bone scan. Results : Pain improvement was obtained immediately in all patients and favorable result was sustained in 26 patients(86.7%) during the mean follow-up duration of 4.7 months(5 complete pain relief, 21 marked pain relief). Those who underwent vertebroplasty for all acute symptomatic vertebrae had significantly better clinical result than those who did not. Further vertebral collapse and eventual bursting fracture occurred in 1 vertebra which showed intradiskal leakage of bone cement and disruption of cortical endplate on postoperative CT scan. Conclusion : Preoperative MR imaging and whole body bone scan are very useful in determining the symptomatic vertebrae, especially in the patients with multiple osteoporotic vertebral fractures. To obtain favorable clinical result, the careful radiologic evaluation as well as clinical assessment is required. Control of PMMA volume seems to be the most critical point for avoiding complications.

천막 수막종으로 오인했던 결핵종의 치료

양나래(Na-Rae Yang),서의교(Eui-Kyo Seo),구혜수(Hye Soo Koo) 대한두개저학회 2010 대한두개저학회지 Vol.5 No.2

We report the case of a 44-year-old woman who presented with a headache and right sixth cranial nerve palsy. The lesion mimicked a tentorial meningioma in the brain and was investigated using computed tomography and magnetic resonance imaging. Gross total resection was achieved using a subtemporal approach. Histologic examination of the mass revealed the typical tuberculoma such as granulomas with caseous necrosis. Postoperative antituberculous medication led to complete resolution of neurological symptoms and radiological examinations. Intracranial tuberculoma is an uncommon disease. Early diagnosis and adequate treatment is important in postoperative prognosis.

실비안 열구에 착상된 이소성 두개인두종

이규성 ( Kyu Sung Lee ),서의교 ( Eui Kyo Seo ),김태승 ( Tai Seung Kim ) 대한뇌종양학회 2002 대한뇌종양학회지 Vol.1 No.1

A rare case of intracranial seeding from a craniopharyngioma is presented. A 25-year-old man underwent radical resection of a suprasellar papillary craniopharyngioma 3 months previously. There had been no clinical evidence of recurrence, however, routine follow-up MRI showed a recurrent tumor. The multilobulated metastatic craniopharyngioma was not anatomically connected to the suprasellar region, but originated from the Sylvian fissure along the former surgical route. Pathologic examination again showed papillary craniopharyngioma that had the same histological features of the previous tumor. This case signifies that direct implantation of the tumor could occur adjacent to the surgical exposure site.

임상 : 상측뇌실 종양의 수술적 치료

양나래 ( Na Rae Yang ),진성철 ( Sung Chul Jin ),서의교 ( Eui Kyo Seo ) 대한뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.2

Objective: Lateral ventricular tumors are rare lesions of the central nervous system. Since most tumors are benign or low grade, good outcomes can be achieved with complete removal. However, optimal surgical management in lateral ventricle tumors remains controversial. We review six cases of patients with these lesions treated with a surgical approach on the basis of the tumor location. Methods: Six patients underwent surgery for lateral ventricle tumors. The transcortical approach was used in five patients, and the transcallosal approach was used in one patient. Transcortical approaches are frontal transcortical, middle temporal gyrus, and posterior parietal transcortical approaches. And we operated one patient with atypical meningioma of frontal horn and body by anterior interhemispheric transcallosal approach. Results: Gross total resection was performed in five patients. There was the only surgical morbidity that the tumor bed operated was bled, and the outcome of the patient remained poor. Two visual field deficits were developed transiently, however they were recovered during follow-up period. Conclusions: Lateral ventricle tumors can be treated best by careful selection of the approach according to the specific location, size, and vascularization of these tumors.

전척추동맥의 동맥류에 대한 수술적 치료

김정재(Jung Jae Kim),조동영(Dong Young Cho),서의교(Eui Kyo Seo) 대한두개저학회 2019 대한두개저학회지 Vol.14 No.2

Aneurysms arising from anterior spinal arteries are very rare. Rupture of an anterior spinal aneurysm is a rare cause of subarachnoid hemorrhage accounting for less than 1% of all cases reported in the literature. The management options include a surgical approach, endovascular embolization, or conservative treatment. Endovascular treatment with embolization using coils or liquid embolic agents is very difficult to reach to the aneurysm and to preserve parent artery. So the surgical approach is usually employed in origin of anterior spinal artery aneurysm. Far lateral approach is useful method to approach to the origin of anterior spinal artery and manage the aneurysm.

영상의학적으로 뇌실내 종양처럼 보이는 뇌실내 동맥류: 증례 보고

김명철(Myeong Cheol Kim),양나래(Na-rae Yang),서의교(Eui Kyo Seo) 대한두개저학회 2017 대한두개저학회지 Vol.12 No.2

Ventricular aneurysms are very rare. Most ventricular aneurysms are developed at the choroidal artery or a major branch of the circle of Willis. However, in the present study, we will introduce a special case of an intraventricular aneurysm that does not have the parent artery. Previously, a healthy 55 year-old man was admitted to our outpatient clinic with the complaints of headache of 3-month duration and gait disturbance of 2-month duration. On Brain computed tomography and magnetic resonance imaging, he had an intraventricular mass with a cyst. Furthermore, he did not have any aneurysm on magnetic resonance angiography. We used the endoscopic approach and the tumor was successfully removed. Pathological examination revealed that it was not a tumor, but an aneurysm. We experienced a special case that was suspected intraventricular tumor radiologically, but it was identified as an aneurysm. We found that ventricular system is a possible location of aneurysms which have no parent artery.