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Chang Hwa Choi 4 Articles
Spontaneous Disappearance of Unruptured Intracranial Aneurysm: A Case Report
Sang Hoon Jeong, Jung Hwan Lee, Tae Hong Lee, Chang Hwa Choi
Kosin Med J. 2021;36(2):148-152.   Published online December 31, 2021
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Spontaneous resolution or thrombosis of giant or ruptured intracranial aneurysms is occasionally reported. However, spontaneous resolution of unruptured aneurysms without any intervention is extremely rare. Recently, we encountered a case of spontaneous resolution of a small unruptured aneurysm of the anterior communicating artery. We describe this rare case and discuss the mechanism of resolution with a review of the related literature.

Idiopathic Intracranial Hypertension following Ventriculoperitoneal Shunt Malfunction in Infant Hydrocephalus
Sangjun Ahn, Jae Meen Lee, Young Mi Kim, Hyeshin Jeon, Chang Hwa Choi
Kosin Med J. 2021;36(1):44-50.   Published online June 30, 2021
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Idiopathic intracranial hypertension (IIH) is a syndrome defined by elevated intracranial pressure without any abnormal findings. In the present study, we report a rare case of IIH in a patient after ventriculoperitoneal shunt (VPS) due to infant hydrocephalus. A 13-year-old girl with a history of VPS due to infant hydrocephalus was admitted to emergency room with the complaint of severe headache and visual disturbance. Brain computed tomography showed normal findings. However, based on the measurement by lumbar puncture, her cerebrospinal fluid (CSF) pressure was observed to be very high. The shunt function test revealed a VPS malfunction. Thus, we conducted VPS revision in this patient. All symptoms improved immediately after the revision. Thus, it is proposed that IIH should be considered for patients with visual disturbance and severe headache after VPS due to infant hydrocephalus without ventriculomegaly.

Unusual Magnetic Resonance Imaging Findings Contrast-induced Encephalopathy following Cerebral Angiography
Won Ho Cho, Jung Hwan Lee, Tae Hong Lee, Chang Hwa Choi, Jun Kyeung Ko
Kosin Med J. 2021;36(1):51-55.   Published online June 30, 2021
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Contrast-induced encephalopathy (CIE) following cerebral angiography has similar clinical presentations to ischemic complications of cerebral angiography. Neurologic deficits in CIE are mostly transient, but those caused by acute cerebral infarction (ACI) as ischemic complications of cerebral angiography may be permanent. Therefore, distinguishing CIE from ACI is important. Diffusion restriction on magnetic resonance imaging (MRI) implies ACI, while hyperintensity on diffusion weighted imaging (DWI) without correlation on the apparent diffusion coefficient (ADC) map implies CIE. We reported a rare case of CIE with diffusion restriction on MRI following cerebral angiography that mimicked MRI findings of ACI. The mechanism of this phenomenon remains unknown and requires further investigation.

Gamma Knife Radiosurgery in Recurrent Trigeminal Neuralgia after Other Procedures
Jae Meen Lee, Beong Ik Hur, Chang Hwa Choi
Kosin Med J. 2019;34(1):30-37.   Published online June 30, 2019
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Trigeminal neuralgia (TN) is undurable paroxysmal pain in the distribution of the fifth cranial nerve. Invasive treatment modalities for TN include microvascular decompression (MVD) and percutaneous procedures, such as, radiofrequency rhizotomy (RFR). Gamma Knife radiosurgery (GKRS) is a considerable option for patients with pain recurrence after an initial procedure. This study was undertaken to analyze the effects of gamma knife radiosurgery in recurrent TN after other procedures.


Eleven recurrent TN patients after other procedures underwent GKRS in our hospital from September 2004 to August 2016. Seven patients had previously undergone MVD alone, two underwent MVD with partial sensory rhizotomy (PSR), and two underwent RFR. Mean patient age was 60.5 years. We retrospectively analyzed patient's characteristics, clinical results, sites, and divisions of pain. Outcomes were evaluated using the Visual Analog Scales (VAS) score.


Right sides were more prevalent than left sides (7:4). The most common distribution of pain was V1 + V2 division (n = 5) following V2 + V3 (n = 3), V2 (n = 2), and V1 + V2 + V3 (n = 1) division. Median GKRS dose was 80 Gy and the mean interval between the prior treatment and GKRS was 74.45 months. The final outcomes of subsequent GKRS were satisfactory in most cases, and at 12 months postoperatively ten patients (90.0%) had a VAS score of ≤ 3.


In this study, the clinical result of GKRS was satisfactory. Invasive procedures, such as, MVD, RFR are initially effective in TN patients, but GKRS provides a safe and satisfactory treatment modality for those who recurred after prior invasive treatments.

KMJ : Kosin Medical Journal