J Korean Neurosurg S
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J Korean Neurosurg S · Sep 2008
Case ReportsUpward migration of distal ventriculoperitoneal shunt catheter into the heart: case report.
Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. ⋯ Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.
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J Korean Neurosurg S · Sep 2008
Two cases of symptomatic perineural cysts (tarlov cysts) in one family: a case report.
Symptomatic sacral perineural cysts are uncommon. Several hypotheses have been proposed to explain the etiologies of perineural cysts, but the accurate etiologies remain unclear. ⋯ We experienced the excellent treatment outcome with the surgical management of symptomatic perineural cysts in the sacral region. We assume that the theory of congenital origin including a familial tendency is the most plausible of the hypotheses that have been proposed.
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J Korean Neurosurg S · Sep 2008
Intracranial Fusiform Aneurysms: It's Pathogenesis, Clinical Characteristics and Managements.
The objective of this study is to investigate clinical characteristics, management methods and possible causes of intracranial fusiform aneurysm. ⋯ There is a subset of cerebral aneurysms with discrete fusiform morphology. Although the dissection or injury of internal elastic lamina of the cerebral vessel is proposed as the underlying cause for most of fusiform aneurysm, more study about pathogenesis of these lesions is required.
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J Korean Neurosurg S · Sep 2008
Endocrine outcome of endoscopic endonasal transsphenoidal surgery in functioning pituitary adenomas.
Microscopic and endoscopic transsphenoidal approach (TSA) are major surgical techniques in the treatment of pituitary adenoma. Endoscopic endonasal transsphenoidal approach (EETSA) has been increasingly used for pituitary adenomas, however, its surgical outcome particularly in functioning pituitary adenoma has been debated. Here, we investigated the endocrine outcome of the patients with growth hormone (GH) and adrenocorticotropic hormone (ACTH) secreting pituitary adenoma treated by EETSA. ⋯ EETSA appears to be an effective and safe method for the treatment of functioning pituitary adenomas.
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J Korean Neurosurg S · Sep 2008
Extravasation during Aneurysm Embolization without Neurologic Consequences. Lessons learned from Complications of Pseudoaneurysm Coiling. Report of 2 Cases.
Although endovascular intervention is the first-line treatment of intracranial aneurysm, intraprocedural rupture or extravasation is still an endangering event. We describe two interesting cases of extravasation during embolotherapy for ruptured peripheral cerebral pseudoaneurysms. Two male patients were admitted after development of sudden headache with presentation of intracerebral and subarachnoid hemorrhage, respectively. ⋯ Intraprocedural extravasation is an endangering event and needs prompt management, however proximal plugging with coil deployment can be sufficient alternative, if one confronts with peripheral pseudoaneurysm. Peculiar angiographic features are deemed attributable to extremely fragile, porous vascular wall of the pseudoaneurysm. Accordingly, it should be noted that extreme caution being needed to handle such a friable vascular lesion.