| Dong-Been Park | 5 Articles |
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[English]
[English]
Lumbar disc herniations at the L1-L2, L2-L3, and L3-L4 level are rare. The purpose of this study is to observe the variable clinical finding of upper lumbar disc herniations and to provide proper treatment modality. Between 1998 Jan. and 1999 Dec., seventeen patients with upper lumbar disc herniations who were undergone surgery in our institute were retrospectively evaluated. Patients were evaluated based on following factors : age, sex, aggravating factor, symptoms and signs type of disc herniation, type of surgery, and outcome of post-surgery. The incidence of lumbar disc herniation at the level of L1-2, L2-3 and L3-4 is 6.1% with declining frequency as the level ascends. The peak age incidence is 6th decade in both sex. Preoperative symptomes and signs are variabe. In sixteen cases, posterior approach was done. In these cases, twelve cases were performed microscopic partial hemilaminectomy, and four cases with spinal stenosis were performed total laminectomy and posterior screw fixation with bone fusion. In one case, lateral extracavitary approach was done. In results of operation, fourteen cases showed more than good grade(82%). The age incidence of lumbar disc herniations at the level of L1-2, L2-3 and L3-4 older than lumbar disc herniations at the lower level of L4-5 and L5-S1. The signs and symptoms are variable. In our cases, most of the patients were performed posterior approach with microscopic partial hemilaminectomy except the patients combined spinal stenosis. One case was performed a lateral extracavitary approach because the risk of the cord and cauda equina injuries. The prognosis of upper lumbar disc herniations after treatment with only microscopic partial hemilaminectomy and diskectomy is comparable with the prognosis of lumbar disc herniations at the lower level.
[English]
A series of 115 cases with intraventricular hemorrhage due to hypertension diagnosed by computed tomography was analyzed with the early conscious level(Glasgow Coma Scale), the site of hemorrhage, the grading of the severity of intraventricular hemorrhage, and the final outcome. The mean systolic blood pressure was 195.7mmHg & the mean diastolic blood pressure was 119.6mmHg. It is generally considered to be of grave prognostic significance. The overall mortality rate was 70.4%. Poor outcome was associated with increasing age, low admission Glasgow Coma Scale, hemorrhage in all four ventricles and very high blood pressure. The surgical treatrnent including extraventricular drainage was not satisfactory as yet.
[English]
A series of 21 cases with traumatic intraventricular homorrhage diagnosed by computed tomography is described. Most were victims of traffic accident and suffered from severe head injuries. Cerebral contusions and subarachnoid hemorhage were the most common associated findings. Blood was present in one or both lateral ventricles in 13 cases ; the 3rd or 4th ventricles in 2 and all ventricles in 6 cases. The presence of IVH indicated a poor outcome. Poor outcome was associated with increasing age, low admission Glasgow Coma Scale, the presence of space occupying lesions and hemorrahge in all four ventricles. IVH after blunt head trauma is uncommon and reflects the severity of the head injury.
[English]
A series of 96 cases with intraventricular hemorrhage diagnosed by computed tomography (CT scan) is described. The early conscious level, the causes, the site of ventricular hemorrhage and the final outcome are analyzed. Intraventricular hemorrhage is generally considered to be of grave prognostic significance. Hypertension and arterial aneurysm accounted for 73.9% of the cases. The overall mortality rate was 68.8%. All cases were admitted on Day 0 or 1, and more than half were classified neurologically as grade IV or V. CT scan reliably demonstrated the presence and distribution of blood within the ventricular system including the third and fourth ventricles. Surgical treatment was beneficial in only a small number of cases.
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, Do Sang Cho
