Publications (40)52.52 Total impact
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Article: Painful Tic Convulsif Caused by an Arteriovenous Malformation.
Clinical neuroradiology. 08/2012; -
Article: Neurolysis for meralgia paresthetica.
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ABSTRACT: Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.Journal of Korean Neurosurgical Society 06/2012; 51(6):363-6. · 0.60 Impact Factor -
Article: E-cadherin as a predictive marker of brain metastasis in non-small-cell lung cancer, and its regulation by pioglitazone in a preclinical model.
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ABSTRACT: It remains unclear whether patients with non-small-cell lung cancer (NSCLC) develop brain metastasis during or after standard therapy. We attempted to identify biological markers that predict brain metastasis, and investigated how to modulate expression of such markers. A case-control study of patients who were newly diagnosed with NSCLC and who had developed brain metastasis during follow-up was conducted between 2004 and 2009. These patients were compared with a control group of patients who had NSCLC but no evidence of brain metastasis. Immunohistochemical analysis of expression of Ki-67, p53, Bcl-2, Bax, vascular endothelial growth factor, epidermal growth factor receptor, caspase-3, and E-cadherin was conducted. The methylation status of the genes for O(6)-methylguanine-DNA-methyltransferase, tissue inhibitor of matrix metalloproteinase (TIMP)-2, TIMP-3, and death-associated protein-kinase was also determined, by use of a methylation-specific polymerase chain reaction. A significantly increased risk of developing brain metastasis was associated with the presence of primary tumors with low E-cadherin expression in patients with NSCLC. We also investigated the effects of pioglitazone, a peroxisome proliferator-activated receptor γ-activating drug, in tumor-bearing mouse models. We found that E-cadherin expression was proportional to pioglitazone exposure time. Interestingly, pioglitazone pretreatment before cancer cell inoculation prevented loss of E-cadherin expression and reduced expression of MMP9 and fibronectin, compared with the control group. E-cadherin expression could be a predictor of brain metastasis in patients with NSCLC. Preventive treatment with pioglitazone may be useful for modulating E-cadherin expression.Journal of Neuro-Oncology 05/2012; 109(2):219-27. · 3.21 Impact Factor -
Article: Occipital nerve stimulation for medically refractory hypnic headache.
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ABSTRACT: Hypnic headache is a rare, primary headache disorder that exclusively occurs regularly during sleep. We present a case of hypnic headache successfully managed with occipital nerve stimulation. A 64-year-old female presented with a four-year history of a right occipital headache that regularly awakened her from sleep. The headache, which was dull and throbbing, would awaken her regularly at 4:00 am, five hours after bedtime at 11:00 pm. No photophobia, nausea or vomiting, lacrimation, or other autonomic symptoms were present. The headache was refractory to various medical treatments, including indomethacin, flunarizine, propranolol. She underwent a trial of occipital nerve stimulation with a lead electrode using a medial approach. During the ten-day trial stimulation, she reported almost complete relief from hypnic headache. Chronic occipital nerve stimulation replicated the trial results. The attacks of hypnic headache recurred in one year with loss of stimulation-induced paresthesia; a subsequent x-ray showed electrode migration. After revision of the electrode to the original location, the effectiveness of the occipital nerve stimulation against hypnic headache was achieved again, and this effect has been consistent through 36 months of follow-up. Occipital nerve stimulation was effective in a patient with chronic, refractory hypnic headache.Neuromodulation 02/2012; 15(4):381-6. · 1.19 Impact Factor -
Article: Transaxillary subpectoral implantation of implantable pulse generator for deep brain stimulation.
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ABSTRACT: Deep brain stimulation (DBS) is an effective modality of treating cardinal motor symptoms of several movement disorders such as Parkinson's disease, essential tremor, and dystonia. Although hardware-related complications of DBS have been reported, the cosmetic satisfaction and discomfort associated with infraclavicular subcutaneous implantation of the pulse generator has not been described. The authors adopted a technique of transaxillary subpectoral implantable pulse generator (IPG) placement and investigated the difference in the discomfort, cosmetic satisfaction, mean operation time for IPG implantation, and severity of postoperative pain between infraclavicular subcutaneous placement and transaxillary subpectoral implantation of IPG. 25 patients who underwent bilateral, infraclavicular subcutaneous IPG placement for DBS and 15 patients who had bilateral, transaxillary subpectoral IPG placement were investigated. The differences in cosmetic satisfaction and discomfort between the two groups were significant. The cosmetic satisfaction was higher and discomfort was less in the subpectoral IPG implantation group (p = 0.002 and p = 0.000). However, more time was needed for IPG implantation, and the postoperative pain was more severe after subpectoral IPG implantation (p = 0.002 and p = 0.000). There was no difference in cosmetic satisfaction according to sex (p = 0.907). There was one transient intercostobrachial nerve injury in the subpectoral IPG implantation group and two infections which needed removal of one side of the DBS hardware in the infraclavicular IPG implantation group. These results demonstrated that subpectoral transaxillary IPG implantation can provide better cosmetic satisfaction in patients undergoing DBS, with less discomfort and morbidity related to erosion and infection.Neuromodulation 02/2012; 15(3):260-6; discussion 266. · 1.19 Impact Factor -
Article: Transzygomatic Approach with Intraoperative Neuromonitoring for Resection of Middle Cranial Fossa Tumors.
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ABSTRACT: The authors reviewed the surgical experience and operative technique in a series of 11 patients with middle fossa tumors who underwent surgery using the transzygomatic approach and intraoperative neuromonitoring (IOM) at a single institution. This approach was applied to trigeminal schwannomas (n = 3), cavernous angiomas (n = 3), sphenoid wing meningiomas (n = 3), a petroclival meningioma (n = 1), and a hemangiopericytoma (n = 1). An osteotomy of the zygoma, a low-positioned frontotemporal craniotomy, removal of the remaining squamous temporal bone, and extradural drilling of the sphenoid wing made a flat trajectory to the skull base. Total resection was achieved in 9 of 11 patients. Significant motor pathway damage can be avoided using a change in motor-evoked potentials as an early warning sign. Four patients experienced cranial nerve palsies postoperatively, even though free-running electromyography of cranial nerves showed normal responses during the surgical procedure. A simple transzygomatic approach provides a wide surgical corridor for accessing the cavernous sinus, petrous apex, and subtemporal regions. Knowledge of the middle fossa structures is essential for anatomic orientation and avoiding injuries to neurovascular structures, although a neuronavigation system and IOM helps orient neurosurgeons.Journal of neurological surgery. Part B, Skull base. 02/2012; 73(1):28-35. -
Article: Percutaneous radiofrequency thermocoagulation under fluoroscopic image-guidance for idiopathic trigeminal neuralgia.
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ABSTRACT: We retrospectively investigated the long-term results of percutaneous radiofrequency thermocoagulation (RFT) using fluoroscopic image-guidance for treatment of trigeminal neuralgia. A total of 38 patients diagnosed and treated with RFT as an idiopathic trigeminal neuralgia were investigated. To minimize the risks related to conventional technique based on cutaneous landmarks, and to eliminate the need to frequent reposition of cannula, we adopted a technique of image-guided fluoroscopic cannulation of the foramen ovale. To minimize sensory complication following thermal lesion, our target response was a generation of a lesion with mild to moderate hypalgesia rather than dense hypalgesia. The immediate pain-relief was achieved in all patients underwent RFT. With mean duration of follow-up of 38.2 months (range,12-72), 11 (28.9%) experienced recurrence of pain. The mean timing of recurrence was 26.1 months (range,12-46). A 42.7% recurrence rate was estimated by Kaplan-Meier analysis for the 38 patients at 46 months; 20.2% within 2 years, 29.1% within 3 years. In the long-term, 27 patients (71%) and 6 patients (15.8%) showed Barrow Neurological Institute (BNI) score I and BNI score II responses. 3 (7.9%) patients was assessed as BNI score III, 2 patients (5.3%) showed BNI score IV response. As a complication, troublesome dysesthesia occurred in 3 of 38 patients (7.9%), however, there was no permanent cranial nerve palsy or morbidity. These results indicates that RFT under fluoroscopic image-guided cannulation of foramen ovale is a safe, effective, and reliable means of treating trigeminal neuralgia.Journal of Korean Neurosurgical Society 11/2011; 50(5):446-52. · 0.60 Impact Factor -
Article: Position Change of the Neurovascular Structures around the Carpal Tunnel with Dynamic Wrist Motion.
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ABSTRACT: The purpose of this study was to determine the anatomic relationships between neurovascular structures and the transverse carpal ligament so as to avoid complications during endoscopic carpal tunnel surgery. Twenty-eight patients (age range, 35-69 years) with carpal tunnel syndrome were entered into the study. We examined through wrist magnetic resonance imaging in three different positions (neutral, radial flexion, and ulnar flexion) and determined several anatomic landmark (distance from the hamate hook to the median nerve, ulnar nerve, and ulnar vessel) based on the lateral margin of the hook of the hamate. The median nerve and ulnar neurovascular structure were studied with the wrist in the neutral, ulnar, and radial flexion positions. The ulnar neurovascular structures usually passed just over or ulnar to the hook of the hamate. However, in 12 hands, a looped ulnar artery coursed 0.6-3.3 mm radial to the hook of the hamate and continued to the superficial palmar arch. The looped ulnar artery migrates on the ulnar side of Guyon's canal (-5.2-1.8 mm radial to the hook of the hamate) with the wrist in radial flexion. During ulnar flexion of the wrist, the ulnar artery shifts more radially beyond the hook of the hamate (-2.5-5.7 mm). It is appropriate to transect the ligament greater than 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the transverse carpal ligament in the ulnar flexed wrist position to protect the ulnar neurovascular structure.Journal of Korean Neurosurgical Society 10/2011; 50(4):377-80. · 0.60 Impact Factor -
Article: Painless dissecting aneurysm of the aorta presenting as simultaneous cerebral and spinal cord infarctions.
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ABSTRACT: Authors report a case of a painless acute dissecting aneurysm of the descending aorta in a patient who presented with unexplained hypotension followed by simultaneous paraplegia and right arm monoparesis. To our knowledge, case like this has not been reported previously. Magnetic resonance imaging of the brain and spine revealed hemodynamic cerebral infarction and extensive cord ischemia, respectively. Computerized tomography angiography confirmed a dissecting aneurysm of the descending aorta. The cause of the brain infarction may not have been embolic, but hemodynamic one. Dissection-induced hypotension may have elicited cerebral perfusion insufficiency. The cause of cord ischemia may be embolic or hemodynamic. The dissected aorta was successfully replaced into an artificial patch graft. The arm monoparesis was improved, but the paraplegia was not improved. In rare cases of brain and/or spinal cord infarction caused by painless acute dissecting aneurysm of the aorta, accurate diagnosis is critical because careless thrombolytic therapy can result in life-threatening bleeding.Journal of Korean Neurosurgical Society 09/2011; 50(3):252-5. · 0.60 Impact Factor -
Article: Chorea-ballism associated with nonketotic hyperglycaemia or diabetic ketoacidosis: characteristics of 25 patients in Korea.
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ABSTRACT: Chorea-ballism is a rare form of movement disorder complicated by severe hyperglycaemia and in association with a contralateral basal ganglia lesion. We analysed the clinical characteristics of 25 Korean patients with chorea-ballism associated with nonketotic hyperglycaemia or diabetic ketoacidosis. Possible mechanisms of disease are also discussed.Diabetes research and clinical practice 05/2011; 93(2):e80-3. · 2.16 Impact Factor -
Article: Posterior C1 stabilization using superior lateral mass as an entry point in a case with vertebral artery anomaly: technical case report.
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ABSTRACT: This is the first report of using the superior lateral mass as an alternative starting point for C1 posterior screw placement, demonstrating the importance of recognizing vertebral artery (VA) anomaly in deciding the surgical strategy for C1 screw placement. A 56-year-old man presented with severe neck pain after a fall. Imaging demonstrated an unstable bursting fracture at C4, C1-2 instability, and a subluxation at C2-3. Computed tomography angiography indicated that the persistent first intersegmental artery was located on the left side. The patient underwent anterior-posterior cervical fixation and fusion. Posterior C1 fixation was done with polyaxial screw rod construct using C1 superior lateral mass on the left side and C1 inferior lateral mass on the right side. The patient had no immediate postoperative deficits. At the 8-month follow-up examination, the patient was neurologically intact with a solid cervical fusion. The third segment of the VA is heterogeneous; therefore, preoperative radiologic studies should be performed to identify any anatomical variations. Using preoperative 3-dimensional computed tomography angiography, we can precisely identify an anomalous VA, thereby significantly reducing the risk of VA injury. To avoid significant morbidities associated with VA injury, a more optimal entry point for C1 fixation can be selected if a persistent first intersegmental artery or fenestrated VA is detected.Neurosurgery 03/2011; 68(1 Suppl Operative):246-9; discussion 249. · 2.79 Impact Factor -
Article: Is computerized tomography angiographic surveillance valuable for prevention of tracheoinnominate artery fistula, a life-threatening complication after tracheostomy?
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ABSTRACT: The aim of this study was to evaluate the utility of volume-rendered helical computerized tomography (CT) angiography focusing tracheostomy tube and innominate artery for prevention of tracheoinnominate artery fistula. The authors retrospectively analyzed 22 patients with tracheostomy who had checked CT angiography. To evaluate the relationship between tracheostomy tube and innominate artery, we divided into three categories. First, proximal tube position based on cervical vertebra, named "tracheostomy tube departure level (TTDL)". Second, distal tube position and course of innominate artery, named "tracheostomy tube-innominate artery configuration (TTIC)". Third, the gap between the tube and innominate artery, named "tracheostomy tube to innominate artery gap (TTIG)". The TTDL/TTIC and TTIG are based on 3-dimensional (3D) reconstruction around tracheostomy and enhanced axial slices of upper chest, respectively. First, mean TTDL was 6.8±0.6. Five cases (23%) were lower than C7 vertebra. Second, TTIC were remote to innominate artery (2 cases; 9.1%), matched with it (14 cases; 63.6%) or crossed it (6 cases; 27.3%). Only 9% of cases were definitely free from innominate artery injury. Third, average TTIG was 4.3±4.6 mm. Surprisingly, in 6 cases (27.3%), innominate artery, trachea wall and tracheostomy tube were tightly attached all together, thus have much higher probability of erosion. If low TTDL, match or crossing type TTIC with reverse-L shaped innominate artery, small trachea and thin TTIG are accompanied all together, we may seriously consider early plugging and tube removal.Journal of Korean Neurosurgical Society 02/2011; 49(2):107-11. · 0.60 Impact Factor -
Article: Surgical treatment of os odontoideum.
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ABSTRACT: Os odontoideum is a rare disease. There have been few reports of os odontoideum in the literature. In this study we retrospectively reviewed eight surgically treated patients. One patient underwent C1-2 transarticular screw fixation, five patients underwent C1-2 polyaxial screw and rod fixation and two patients with dystopic os odontoideum underwent occipito-cervical (O-C) fusion. Of the eight patients, neck pain was alleviated in seven (87.5%). Of the six patients who had neurological signs and symptoms, five (83.3%) exhibited neurological improvement. Radiologically, solid fusion was observed in seven patients (87.5%). Active surgical treatment should be considered even in patients with os odontoideum who exhibit mild symptoms. In most patients with os odontoideum, use of the C1-2 polyaxial screw and rod technique may be the most appropriate treatment. In patients with dystopic os odontoideum, O-C fusion should be considered.Journal of Clinical Neuroscience 01/2011; 18(4):481-4. · 1.25 Impact Factor -
Article: Noncommunicating spinal extradural meningeal cyst in thoracolumbar spine.
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ABSTRACT: Spinal extradural meningeal cyst has been rarely reported, whose etiologies are assumed to be the communication of cerebrospinal fluid (CSF) between intradural subarchnoid space and cyst due to the congenital defect in dura mater. Although the CSF communication due to this defect can be found, in most case, few cases in which there is a lack of the communication have also been reported. We report a case of the huge extradural meningeal cyst occurring in the thoracolumbar spine (from T10 to L2) where there was a lack of the communication between the intradural subarachnoid space and cyst in a 46-year-old man who presented with symptoms that were indicative of progressive paraparesis and leg pain. The patient underwent laminectomy and cyst excision. On intraoperative findings, the dura was intact and there was a lack of the communication with intradural subarachnoid space. Immediately after the surgery, weakness and leg pain disappeared shortly.Journal of Korean Neurosurgical Society 12/2010; 48(6):534-7. · 0.60 Impact Factor -
Article: C7 posterior fixation using intralaminar screws : early clinical and radiographic outcome.
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ABSTRACT: The use of segmental instrumentation technique using pedicle screw has been increasingly popular in recent years owing to its biomechanical stability. Recently, intralaminar screws have been used as a potentially safer alternative to traditional fusion constructs involving fixation of C2 and the cervicothoracic junction including C7. However, to date, there have been few clinical series of C7 laminar screw fixation in the literature. Thus, the purpose of this study is to report our clinical experiences using C7 laminar screw and the early clinical outcome of this rather new fixation technique. Thirteen patients underwent C7 intralaminar fixation to treat lesions from trauma or degenerative disease. Seventeen intralaminar screws were placed at C7. The patients were assessed both clinically and radiographically with postoperative computed tomographic scans. There was no violation of the screw into the spinal canal during the procedure and no neurological worsening or vascular injury from screw placement. The mean clinical and radiographic follow up was about 19 months, at which time there were no cases of screw pull-out, screw fracture or non-union. Complications included two cases of dorsal breech of intralaminar screw and one case of postoperative infection. Intralaminar screws can be potentially safe alternative technique for C7 fixation. Even though this technique cannot be used in the cases of C7 laminar fracture, large margin of safety and the ease of screw placement create a niche for this technique in the armamentarium of spine surgeons.Journal of Korean Neurosurgical Society 08/2010; 48(2):129-33. · 0.60 Impact Factor -
Article: The effect of patient age on the internal carotid artery location around the atlas.
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ABSTRACT: The aim of this study was to analyze the exact location of the internal carotid artery (ICA) relative to the C-1 lateral mass and describe the effect of age on the tortuosity of the ICA. The authors analyzed 641 patients who had undergone CT angiography to evaluate the location of the ICA in relation to the C-1 lateral mass. Each patient was assigned to 1 of 3 age groups (< 41 years, 41-60 years, and > 60 years of age). The degree of lateral positioning of the ICA was classified into 4 groups: Group 1 (lateral to the C-1 lateral mass), Group 2 (lateral half of the lateral mass), Group 3 (medial half of the lateral mass), or Group 4 (medial to the lateral mass). The anteroposterior relationship of the ICA was classified into Group A (posterior to the anterior tubercle) or Group B (anterior to the anterior tubercle). Distances from the ICA to the midline, anterior tubercle, and anterior cortex of the lateral mass were measured. Distances between the lateral margin of the lateral mass and the longus capitis muscle were also evaluated. The prevalence of the ICA located in front of the lateral mass (Groups 2 and 3) was 47.4% overall. The position of the ICA changes with age due to vessel tortuosity. Only 18.3% of patients in the youngest age group (< 41 years of age) had an ICA in front of the lateral mass (Group 2 or 3 area). However, this percentage increased in the older 2 groups (43.5% in the 41-60 year old group, and 57% in the > 60-year-old age group). The mean distance from the midline to the ICA was 22.6 mm, and the mean distance from the ICA to the C-1 anterior tubercle and the ventral cortex of the lateral mass was 4.7 and 4.5 mm, respectively. Moreover, the ICA is more prone to injury during bicortical C-1 screw placement when the longus capitis muscle is hypotrophic and does not cover the entire ventral surface of the lateral mass. Elderly patients have a higher incidence of a medially located ICA that may contribute to the risk of injury to the ICA during bicortical C-1 screw or C1-2 transarticular screw placement. Although the small number of reported cases of ICA injury does not allow for determination of a direct relationship with specific anatomical characteristics, the presence of unfavorable anatomy does warrant serious consideration during evaluation for C-1 screw placement in elderly patients.Journal of neurosurgery. Spine 06/2010; 12(6):613-8. · 1.61 Impact Factor -
Article: A rare case of spontaneous true aneurysm of the occipital artery.
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ABSTRACT: A 51-year-old man presented with a pulsatile scalp mass over the right occipital region, which had increased in size over the previous 1 month. He had no previous history of head trauma. Three-dimensional computed tomography (3D-CT) angiography of the brain revealed a 3.0 x 1.5 cm occipital artery aneurysm arising from the occipital artery. The occipital artery aneurysm was removed following the ligation of the proximal and distal portion of the occipital artery aneurysm. The histological diagnosis was true aneurysm. To the best of our knowledge, this is the first reported case in the literature.Journal of Korean Neurosurgical Society 04/2010; 47(4):310-2. · 0.60 Impact Factor -
Article: Cerebellar hemorrhage after burr hole drainage of supratentorial chronic subdural hematoma.
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ABSTRACT: Cerebellar hemorrhage is an unusual complication of supratentorial neurosurgery. To the best of our knowledge, only three case reports have described the occurrence of cerebellar hemorrhage after burr hole drainage for the treatment of chronic subdural hematoma (SDH). We present the case of a patient with this rare postoperative complication of cerebellar hemorrhage after burr hole drainage of a chronic SDH. Although burr hole drainage for the treatment of chronic SDH is rare complication, it is necessary to be aware of the possibility of cerebellar hemorrhage after supratentorial surgery, even with limited surgery such as burr hole drainage of a chronic SDH.Journal of Korean Neurosurgical Society 12/2009; 46(6):592-5. · 0.60 Impact Factor -
Article: Repeat operations in pediatric patients with recurrent craniopharyngiomas.
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ABSTRACT: Controversy continues over the optimal management of recurrent craniopharyngiomas. Our strategy for approaching repeatedly recurrent craniopharyngiomas in pediatric patients has been to decompress vital structures and relieve the symptoms as early as possible. The purpose of this study was to present our experiences of repeatedly recurrent craniopharyngiomas and the pattern of failure associated with treatment. A retrospective review was conducted on 7 pediatric patients who underwent resection >2 times in a single institution between 1990 and 2004. Resections were performed 3-8 times for each patient. Variables including tumor size, consistency and location, extent of resection, adjuvant therapy and morbidity were evaluated. Thirty-two operations were performed in 7 pediatric patients. Total resection was not achieved by the third surgery and thereafter, and the interval between each surgery became shorter. Appetite disorders, neurocognitive disorders and behavioral disorders occurred following repeat surgeries. Repeat operations are associated with a high failure rate of tumor control, even though they can help relieve neurologic symptoms. It is suggested that the number of repeat operations should be limited.Pediatric Neurosurgery 01/2009; 45(6):451-5. · 0.70 Impact Factor -
Article: Surgical decompression of supratentorial arachnoid cysts in pediatric patients younger than one year.
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ABSTRACT: There has been much debate about the optimal surgical management of arachnoid cysts in infants younger than 1 year of age. The authors present the clinical and neuroimaging findings in pediatric patients with supratentorial arachnoid cysts treated by surgical decompression. A retrospective chart review was conducted to identify all pediatric patients who had been diagnosed with arachnoid cysts since 2003. Five infants with symptomatic supratentorial arachnoid cysts underwent surgery at Kangnam St. Mary's Hospital. The initial surgery in 4 patients involved a craniotomy with the excision of the cyst wall and fenestration into the basal cisterns. Three of the four patients needed additional procedures, such as cyst-peritoneal or subdural-peritoneal shunting due to failure of cyst resolution. A shunting procedure was performed as initial therapy in 1 patient who presented with increased intracranial pressure. Our strategy for approaching arachnoid cysts in pediatric patients has been to diagnose and treat the cysts as early as possible and to avoid the complications of shunts whenever possible. However, open craniotomy with excision and fenestration of the cyst is associated with a relatively high failure rate in pediatric patients younger than 1 year of age with supratentorial arachnoid cysts.Pediatric Neurosurgery 12/2008; 44(6):465-70. · 0.70 Impact Factor
Top co-authors
Top Journals
Institutions
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2003–2012
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Catholic University of Korea
- • Department of Neurosurgery
- • Department of Radiology
- • College of Medicine
Seoul, Seoul, South Korea
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2008–2011
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Saint Vincent Hospital
Worcester, MA, USA
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1998
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St Mary's Hospital NHS
Newport, ENG, United Kingdom
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