Neurosurgical Case Profile in Korea

Lee, Kyu Chang

Abstract

From January to December in 1983, neurosurgical statistics of 38 training hospitals in Korea was summarized as follows. The total number of neurosurgical admission was 27,185. The total operations were 10,980. Each of 25( out of the 38) training units performed 100 to 400 operations during this one year period. Out of 10,980 operations, 3,938 cases were trauma, approximately 36% against the total. Of the trauma surgery, 88% was done for head injuries and remaining 12% for spine injuries. There were 2,233 cases(20.34% of the total) of spine surgery, which was next to trauma surgery. Surgery for lumbar disc herniation(2,047 cases) occupied 92% of spine surgery. Of 1,302 operations(11.86% of the total) for cerebrovascular diseases. 719 cases(55.23%) were spontaneous intracerebral hematomas and 441 cases(33.87%) were ruptured cerebral aneurysms. Forty-two per cent of aneurysms was found in anterior communicating artery and 25% in internal carotid-posterior communicating artery junction. It is interesting to note that only 1% of posterior circulation aneurysms was detected by the four vessel angiography. Another remarkable finding was the cerebrovascular occlusive lesion was rarely found among Korean patients, and consequently, the surgery for ischemic stroke was performed infrequently Remaining vascular surgery was done for the cerebral vascular malformations such as arteriovenous malformation and Moya Moya disease. Tumor surgery was done for 1,060 cases, which represents 9.65% of all. Of these tumor surgeries, 97.73% was done for primary brain tumors. Glial tumors were 41.2% of all primary brain tumors and 20.8% was meningiomas. The pituitary tumor was 10% of all primary brain tumors, and 56% of pituitary tumors was operated on by transsphenoidal approach. Five per cent of all primary brain tumors was pineal tumors, but most of pineal tumors were treated by shunt surgery and radiation therapy. Consequently, direct operation for pineal tumor was performed only in 13 case. Shunt operation was performed in 650 cases. Functional neurosurgery cases were 207 and 148(71.5%) of them were pain surgery. Twenty-two cases of microvascular decompression were performed for hemifacial spasm. Surgery for infection was 3.57% of the total.