소뇌경색 2예 보고
Two Cases of Cerebellar Infarction
이선호, 왕규창, 한대희, 지제근,
소속 상세정보
이선호 ( Lee Sun-Ho )
서울대학교 의과대학 신경외과학교실
왕규창 ( Wang Kyu-Chang )
서울대학교 의과대학 신경외과학교실
한대희 ( Han Dae-Hee )
서울대학교 의과대학 신경외과학교실
지제근 ( Chi Je-Geun )
서울대학교 의과대학 병리학교실
KMID : 0359819830120030471
Abstract
Occlusion of vertebro-basilar artery and its branches can produce massive cerebellar lesion with edematous swelling from ischemia and accompanying hemorrhage. Recognition of this massive cerebellar lesion is essential, because it compresses the brain stem and rapidly leads to coma and death unless immediate surgical decompression of posterior fossa is performed. However, surgery might not be beneficial if the arterial occlusion had simultaneously produced and extensive infarction in the brain stem. The clinical and radiological findings are important in determining the optimum therapy and indication for decompressive surgery. CT scan was the most useful diagnostic test. Prompt and correct diagnosis of this illness is required to ensure adequate therapy. We are presenting two cases of cerebellar infarction, which have quite different clinical pictures and courses. One case has progressive headache for 2 months, which was misdiagnosed as tumorous condition and suboccipital craniectomy was performed but died due to brain swelling. The other one has acute course with compression of brain stem 24hr after onset of sudden headache and suboccipital decompressive surgery was performed and the patient recovered successfully.
키워드
Key Words: Cerebellar infarction; Edematous swelling; Brain stem compression; Computed tomography(CT); Suboccipital decompressive surgery
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