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The Surgical Results of Traumatic Subdural Hygroma Treated with Subduroperitoneal Shunt  

Ju, Chang-Il (Department of Neurosurgery, College of Medicine, Chosun University)
Kim, Seok-Won (Department of Neurosurgery, College of Medicine, Chosun University)
Lee, Seung-Myoung (Department of Neurosurgery, College of Medicine, Chosun University)
Shin, Ho (Department of Neurosurgery, College of Medicine, Chosun University)
Publication Information
Journal of Korean Neurosurgical Society / v.37, no.6, 2005 , pp. 436-442 More about this Journal
Abstract
Objective: The detection rate of traumatic subdural hygroma(TSH) has increased after the development of computed tomography and magnetic resonance imaging. The treatment method and the mechanism of development of the TSH have been investigated, but they are still uncertain. This study is performed to evaluate the effectiveness of subduroperitoneal shunt in traumatic subdural hygroma. Methods: Five hundred thirty six patients were diagnosed as TSH from 1996 to 2002, among them, 55 patients were operated with subduroperitoneal shunt. We analyzed shunt effect on the basis of clinical indetails, including the patient's symptoms at the diagnosis, duration from diagnosis to operation, changes of GCS, hygroma types. We classified the TSH into five types (frontal, frontocoronal, coronal, parietal and cerebellar type) according to the location of the thickest portion of TSH. Results: The patients who have symptoms or signs related to frontal lobe compression (irritability, confusion) or increased intracranial pressure (headache, mental change), had symptomatic recovery rate above 80%. However, the patients who have focal neurological sign (hemiparesis, seizure and rigidity), showed recovery rate below 30%. The improvement rate was very low in the case of the slowly progressing TSH for over 6weeks. We experienced complications such as enlarged ventricle, chronic subdural hematoma, subdural empyema and acute SDH. Conclusion: Subduroperitoneal shunt appears to be effective in traumatic subdural hygroma when the patients who have symptoms or signs related to frontal lobe compression or increased ICP and progressing within 5weeks.
Keywords
Traumatic subdural hygroma; Subduroperitoneal shunt;
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1 Hoff JT, Bates E, Barnes B, Glickmann M, Margolis T : Traumatic subdural hygroma. J Trauma 13 : 870-876, 1973   DOI
2 Izumihara A, Orita T, Tsurutani T, Kajiwara K : Natural course of nonoperative cases of acute subdural hematoma : Sequential computed tomographic study in the acute and subacute stages. No Shinkei Geka 25 : 307-314, 1997   PUBMED
3 Jaccard E, de Tribolet N : Post-traumatic subdural hygroma. Neurochirurgie 29 : 333-338, 1983   PUBMED
4 Koizumi H, Fukamachi A, Wakao T, Tasaki T, Nagaseki Y, Yanai Y : Traumatic subdural hygromas in adult. Neurol Med Chir(Tokyo) 21 : 397-406, 1981   DOI   PUBMED
5 Litofsky NS, Raffel C, McComb JG : Management of symptomatic chronic extra-axial fluid collection in pediatric patients. Neurosurgery 31 : 445-450, 1992   DOI   PUBMED
6 Markwalder TM : Chronic subdural hematomas:a review. J Neurosurg 54 : 637-645,1981   DOI   PUBMED
7 McCluney KW, Yeakley JW, Fenstermacher MJ, Baird SH, Bonmati CM : Subdural hygroma versus atrophy on MR brain scans:'the cortical vein sign', Am J Neuroradiol 13 : 1335-1339, 1992
8 Nishizaki T, Tamaki N, Fujiwara H, Matsumoto S : Posterior fossa subdural effusion due to head trauma. Neurosurgery 23 : 81-84, 1988   DOI   PUBMED
9 Ohno K, Suzuki R, Masaoka H, Matsushima Y, Inaba Y, Monma S : Chronic subdural hematoma preceded by persistent traumatic subdural fluid collection. J Neurol Neurosurg Psychiatry 50 : 1694-1697, 1987   DOI
10 Schachemayr W, Friede RL : The origin of subdural neomembranes. Am J Pathol 92 : 53-68, 1978
11 So SK, Ogawa T, Gerberg E, Sakimura I, Wright W : Tracer accumulation in a subdural hygroma : A case report. J Nucl Med 17 : 119-121, 1976   PUBMED
12 Borzone M, Capuzzo T, Perria C, Rivano C, Tercero E : Traumatic subdural hygromas : a report of 70 surgically treated cases. J Neurosurg Sci 27 : 161-165, 1983   PUBMED
13 Hill NC, Goldstein NP, McKenizie BF, Svien HJ : Cerebrospinal-fluid proteins, glycoproteins, and lipoproteins in obstructive lesion of the central nervous system. Brain 82 : 581-593, 1959   DOI   ScienceOn
14 Park CK, Choi KH, Kim MC, Kang JK, Choi CR : Spontaneous evolution of posttraumatic subdural hygroma into chronic subdural haematoma. Acta Neurochir (Wien) 127 : 41-47, 1994   DOI   ScienceOn
15 Pietil TA, Palleske H, Distelmaier PM : Subdural effusions : Determination of contrast medium influx from CSF to the fluid accumulation by computed tomography as an aid to the indications for management. Acta Neurochir (Wien) 118 : 103-107, 1992   DOI   PUBMED
16 Lee KS, Doh JW, Bae HG : Relations among traumatic subdural lesions. J Korean Med Sci 11 : 55-63, 1996   DOI   PUBMED
17 McConell AA : Traumatic subdural effusion. J Neurol Neurosurgery Psychiatry 4 : 237-256, 1941   DOI
18 Hasegawa M, Yamashima T, Yamashita J, Suzuki M, Shimada S : Traumatic subdural hygroma : Pathology and meningeal enhancement of magnetic resonance imaging. Neurosurgery 31 : 580-585, 1992   DOI   PUBMED
19 St John JN, Dila C : Traumatic subdural hygroma in adults. Neurosurgery 9 : 621-626, 1981   DOI   PUBMED
20 Njiokiktjien CJ, Valk J, Ponssen H : Subdural hygroma : Results of treatment by ventriculo-abdominal shunt. Childs Brain 7 : 285-302, 1980   PUBMED
21 French BN, Cobb CA 3d, Corkil G, Youmans JR : Delayed evolution of posttraumatic subdural hygroma. Surg Neurol 9 :145-148, 1978   PUBMED
22 Haines DE, Harkey HL, Al-Mefty O : The 'subdural space' : a new look at an outdated concept. Neurosurgery 32 :111-120, 1993   DOI   PUBMED
23 Todorow S, Happe M : Traumatic subdural hygromas. Neurochirurgia (Stuttg) 24 : 131-136, 1981   PUBMED
24 Nobuhiko A : Extracerebral fluid collections in infancy : Role of magnetic resonance imaging in differentiation between subdural effusion and subarachnoid space enlargement. J Neurosurg 81 : 20-23, 1994   DOI   PUBMED   ScienceOn
25 Naffziger HC : Subdural fluid accumulations following head injury. JAMA 82 : 1751-1752, 1924   DOI
26 Stone JL, Lang RGR, Sugar O, Mood RA : Traumatic subdural hygroma, Neurosurgery 8 : 542-549, 1981   DOI   PUBMED
27 Wetterling T, Demierre B, Rama B, Spoerri O : The clinical course of surgically treated posttraumatic subdural hygromas. Acta Neurochir (Wien) 83 : 99-104, 1986   DOI   ScienceOn