The authors found that GKS was an effective treatment modality for cavernous hemangiomas, especially for those located within the brainstem, basal ganglia, or deep portions of the brain. It can reduce seizure frequency significantly although this takes time. In the group receiving a marginal dose below 15 Gy the patients fared better than when the dose exceeded 15 Gy.

A 38-year-old non-smoker man presented with a ruptured aneurysm one month after clipping of a previous aneurysm. He was first admitted because of sudden onset of severe headache. Brain computed tomography showed subarachnoid hemorrhage. Angiography showed an aneurysm of the left anterior choroidal artery which was surgically clipped. Two weeks later, he was discharged without neurological deficits. One month after the initial hemorrhage, he was readmitted to the emergency room with stuporous mentality. Repeat angiography showed two aneurysms of the A 2 portion of the left anterior cerebral artery which were not demonstrated by the initial angiography. The diagnosis was de novo aneurysms. The larger aneurysm was clipped and the other was coated. De novo aneurysm should be suspected if a patient with a previously clipped aneurysm complains of typical headache or any suggestive symptoms or signs of cranial nerve dysfunction, especially if known risk factors are present.

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We have 32 university hospitals and 18 general hospitals for neurosurgical training in Korea. Recently I have analyzed intracranial aneurysm cases which had an operation in 28 university hospitals and nine general hospitals. I have reported 2863 aneurysm operation cases. The location of the aneurysm consisted of 865 aneurysms (30.2%) in the anterior communicating artery, 724 aneurysms (25.3%) in the internal carotid artery, 687 aneurysms (24.0%) in the middle cerebral artery, 129 aneurysms (4.5%) in the anterior cerebral artery, 152 aneurysms (5.3%) in the posterior circulation, and 306 (10.7%) multiple aneurysms. The overall approximation of the operation rate of aneurysm is approximately 6.6 cases per 100,000 population in 1996 in Korea.