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한정인 ( Jung In Han ),김창현 ( Chang Hyun Kim ),문재곤 ( Jae Gon Moon ),조탁근 ( Tack Geun Cho ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.2
Less than 50 cases of primary fourth ventricular meningioma are reported in literature. Most of them are hypo- to iso-signal intensity on T1-weighted images and iso- to mildly hyper-signal intensity on T2-weighted images compared with gray matter. Contrast enhancement is strong in all tumors, and the enhancement is homogeneous in 69% and heterogeneous in 31%. It could be harder to differentiate meningiomas of the fourth ventricle from ependymomas and choroid plexus papilloma. Most meningiomas in the fourth ventricle adhere to the choroid plexus. We present a new case and summarize features of magnetic resonance images.
서현성 ( Hyun Sung Seo ),김은영 ( Eun Young Kim ),박인서 ( In Suh Park ),박현선 ( Hyun Seon Park ),박형천 ( Hyung Chun Park ),박종운 ( Chong Oon Park ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.2
Acute tumor-like demyelination or demyelinating pseudotumor is a variant presentation of demyelinating diseases, such as multiple sclerosis. A 32 years old male developing left side hemiparesis for 4 days and general tonic clonic seizure lasting 2 minutes was admitted to the hospital. Brain magnetic resonance imaging(MRI) taken at other hospital showed a large and irregular well enhancing intra-axial mass in right fronto-parietal area with massive surrounding edema. Craniotomy was planned under the impression of the malignant glioma. The edema and hemiparesis subside by preoperative use of corticosteroid. Therefore we had to rule out lymphoma. Stereotactic biopsy revealed a demyelinating lesion consistent with demyelinating pseudotumor. The patient recovered from hemiparesis by corticosteroid treatment over several weeks. The demyelinating pseudotumor, which usually presents as a well enhancing and poorly defined intra-axial lesion with edema, is very hard to distinguish from intra-axial tumors such as lymphoma and malignant glioma. Neurosurgeons should be aware of the possibility of demyelinating pseudotumor though it is rare.
좌측 실비우스 종양 수술 후 생긴 양측성 소뇌출혈 -증례보고-
석주완 ( Ju Wan Seok ),김충현 ( Choong Hyun Kim ),홍현종 ( Hyun Jong Hong ),정진환 ( Jin Hwan Cheong ),김재민 ( Jae Min Kim ),오영하 ( Young Ha Oh ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.2
Hemorrhagic complications may be occasionally developed after intracranial surgery. However, remote cerebellar hemorrhage( RCH) following supratentorial surgery is uncommonly reported. A 49-year-old male presented with seizure, which was characterized by a generalized tonic-clonic type for 3 times. There was a well-enhanced round mass in the preoperative brain magnetic resonance(MR) image. We performed tumor resection with left frontotemporal craniotomy. Pathological examination of tumor specimen was confirmed as a malignant meningioma. There was no hypertensive event or coagulopathy in the perioperative period. On the follow-up brain computed tomography(CT) scans taken at 48 hours after surgery, it revealed bilateral streaky intracerebellar hemorrhage. The patient was recovered by the conservative treatment without any neurological deficits. This case report emphasizes an importance of close monitoring of patients to detect rarely occurring complications like RCH. The authors also review pertinent literatures and discuss a pathogenesis of RCH.
김일섭 ( Il Sup Kim ),이상원 ( Sang Won Lee ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2006 대한뇌종양학회지 Vol.5 No.1
The pineal region tumor is one of the difficult ones to exposure and remove. Selecting an operative approach to the pineal region tumor involving the third ventricle requires an understanding of the microsurgical anatomy of the posterior third ventricle. There are variable surgical approaches to the pineal region. The approaches suitable for reaching the pineal region are the infratentorial supracerebellar, occipital transtentorial, posterior transcallosal, posterior transcortical and combined supra/infratentorial-transsinus approach. Considerations important in selecting one of these surgical approaches are reviewed from the anatomical viewpoint.
이정훈 ( Jeong Hoon Lee ),공두식 ( Doo Sik Kong ),박관 ( Kwan Park ),김종현 ( Jong Hyun Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2
We report two rare cases of pituitary adenomas arising from the pituitary stalk. The major complaints of both patients were headaches and visual disturbances. On magnetic resonance imaging, both tumors were suprasellar in location. Gross tumor excision was performed via the pterional approach. The pathologic diagnoses were pituitary adenomas in both patients. The tumors were shown to be non-functioning by immunochemistry analyses. No remnant tumors existed postoperatively on follow-up magnetic resonance imaging. The pituitary stalk was preserved in both cases and pituitary hormonal activity remained intact postoperatively. One patient had normal visual function pre- and post-operatively;the other patient had improvement in the visual field defect and temporal hemianopsia involving the left eye. While there are many case reports involving ectopic pituitary adenomas, pituitary adenomas originating from the pituitary stalk are extremely rare.
김진욱 ( Jin Wook Kim ),하영수 ( Young Soo Ha ),하윤 ( Yoon Ha ),정준호 ( Jun Ho Jung ),박종운 ( Chong Oon Park ),현동근 ( Dong Keun Hyun ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2007 대한뇌종양학회지 Vol.6 No.1
The authors present two cases of ectopic meningioma which are very rare. One was located at the intra-orbital space with orbital bone erosion and the total removal was performed via frontal craniotomy and superior orbitotomy. Histopathologic examination of the tumor was consistent with atypical meningioma. The other was located at the subcutaneous tissue with hyperostosis of the skull at the frontal area. We performed a total removal via frontal craniectomy. Histologically, it showed the transitional cell type meningioma. In both cases, even though ectopic miningioma is locally invasive, the prognosis is good if the total excision of the tumor is performed.
설호준 ( Ho Jun Seol ),박승우 ( Seoung Woo Park ),김광기 ( Kwang Ki Kim ),박성혜 ( Sung Hye Park ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.1
The incidence of primary central nervous system lymphoma(PCNSL) is increasing, however, primary ventricular involvement is very rare. We report a rare case of intraventricular PCNSL in a 76 year-old male who presented with cognitive dysfunction. Brain magnetic resonance imaging showed enhancing nodular lesions in both frontal horns and right temporal horn of lateral ventricle. Diffuse large B-cell lymphoma was confirmed by endoscopic biopsy. No evidence of parenchymal central nervous system or systemic lymphoma was identified throughout the course of disease.
김승민 ( Seong Mim Kim ),김한규 ( Han Kyu Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.1
The posterior cranial fossa, the largest and deepest of the three cranial fossae, contains the most complex intracranial anatomy. That contains cerebellum, fourfh ventricle and 10 pairs of cranial nerves. The relationships of the fourth ventricle to the cerebellar surfaces and the fissures through which the ventricle is approached surgically are among the most complex in the brain. We reviewed and discussed about the microsurgical anatomy and surgical approaches to the fourth ventricle.
피질과 피질하 뇌종양 수술 후 지연 발생한 경막하 수종2례 보고
문형식 ( Hyung Sik Moon ),정태영 ( Tae Young Jung ),최정욱 ( Jeong Wook Choi ),정신 ( Shin Jung ),문경섭 ( Kyung Sub Moon ),김인영 ( In Young Kim ),강삼석 ( Sam Suk Kang ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.2
Subdural hygroma is a common complication of craniotomy. We introduce two cases of delayed-onset subdural hygroma, which developed after cortical or subcortical tumor surgery, and reviewed recent related literature to discuss the possible pathogenesis and clinical course of these hygromas, and to provide appropriate guidelines for the optimal management of this clinical condition. The possible pathogenesis of delayed postoperative subdural hygroma may be associated with CSF retention due to the tearing of the arachnoid membrane during surgery.
안경록 ( Kyoung Rok Ahn ),장인복 ( In Bok Chang ),류경식 ( Kyung Sik Ryu ),조병문 ( Byung Moon Cho ),오세문 ( Sae Moon Oh ),박세혁 ( Se Hyuck Park ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.2
We report a case of meatstatic choriocarcinoma mimicking systemic necrotizing vasculitis on cerebral angiogram. A 35- year-old female presented with right side hemiplegia and drowsy mental status. Computed tomography(CT) scan revealed an intracerebral hemorrhage in the left frontal region. Cerebral angiogram showed multiple microaneurysms arising from the bilateral anterior cerebral artery and middle cerebral arteries. Renal angiogram showed multiple microaneurysms arising from the left distal renal artery. Chest CT scan revealed multiple metastatic lesions in the left lower lung field. The hematoma and microaneurysms were surgically removed. Choriocarcinoma was diagnosed on histologic examination. Despite of postoperative chemotherapy, she died 1 month after operation.