• Journal of Korean Neurosurgical Society
• /
• v.59 no.5
• /
• pp.498-504
• /
• 2016

Objective : Although subdural hematoma (SDH) is commonly treatable by burr hole surgery in the late subacute or chronic stage, there is no clear consensus regarding appropriate management and exact predictive factors for postoperative recurrence also remain unclear. The aim of this study was to evaluate risk factors associated with recurrence of SDH that requires burr hole surgery in the late subacute or chronic stage. We also identified the appropriate timing of surgery for reducing the recurrence. Methods : We retrospectively reviewed 274 patients with SDH in the late subacute or chronic stage treated with burr hole surgery in our hospital between January 2007 and December 2014. Excluding patients with acute intracranial complications or unknown time of trauma onset left 216 patients included in the study. Results : Of 216 patients with SDH in the late subacute or chronic stage, recurrence was observed in 36 patients (16.7%). The timing of the operation in patients with late subacute stage (15-28 days) resulted in a significant decrease in recurrence (RR, 0.33; 95% CI, 0.17-0.65; p=0.001) compared to chronic stage (>28 days). Otherwise, no significant risk factors were associated with recurrences including comorbidities and surgical details. Conclusion : The results indicated that time from trauma onset to burr hole surgery may be important for decreasing the risk of recurrence. Therefore, unless patients can be treated conservatively without surgery, prompt surgical management is recommended in patients diagnosed as having late subacute or chronic subdural hematoma treatable by burr hole surgery, even when neurological deficits are unclear.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.3
• /
• pp.210-214
• /
• 2009

Objective : Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. Methods : Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n=25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n=32), and group III, small craniotomy with irrigation and closed-system drainage (n=30). Results : Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. Conclusion : Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2005.10a
• /
• pp.873-877
• /
• 2005

The burr of micro drilling and micro cutting on thin metal film is a major obstacle to mass production for micro PCB boards in micro technologies of personal computing and telecom explosion. As the burr affects on the assembling process, it is necessary to study continuously on control or elimination of the burr. In order to get higher valued products, it is also needed to competitive techniques with the high resolution. In this paper, we studied experimentally the burr generation that when it is processed on the copper foil by laser in micro-hole machining. Unlike mechanical machining the burr produced on substrate is a resultants of melt and re-solidification of a melten metal which was heated and treated by laser. And higher laser energy increases the size of burr. Therefor in micro-drilling with laser, it is difficult to reduce the effects of burr for very thin metal sheets. We investigated the stale of the burr and analyzed the laser ablation Cu micro machining with respect to laser intensity and processing time.

• Transactions of Materials Processing
• /
• v.12 no.4
• /
• pp.314-319
• /
• 2003

In the micro hole punching, the size and shape of burr and burnish zone are very important factors to evaluate quality of micro holes which depend on punch-die clearance, strain rate, workpiece material and etc. To get micro holes with small burr and wide burnish zone for industrial demands, not only the parametric study but also a study on fracture behavior in shear band are necessary. In this study, 100 $\mu$m, 25 $\mu$m micro holes in diameter were fabricated on brass (Cu63/Zn37) and SUS 316 foils as aspect ratio 1:1, and the characteristics of micro holes was investigated comparing with those of macro holes over several mm by scanning electron microscopic views and section views. Like macro hole, micro hole is also composed of 4 portions, rollover. burnish zone, fracture zone and burr, and it shows similar fracture behavior in shear band. But by high strain rate (10$^2$∼10$^3$s$^{-1}$ ) condition unlike that of macro hole fabrication and by the increment of relative grain size in the direction of the workpiece thickness, fracture zone is not observed.

• Journal of Trauma and Injury
• /
• v.25 no.4
• /
• pp.209-216
• /
• 2012

Purpose: The objectives of this study are to classify chronic subdural hematomas based on brain computerized tomographic scan (CT scan) findings and to determine the mechanism of evolution and treatment methods. Methods: One hundred thirty-nine patients who were diagnosed with a chronic subdural hematoma and who available for follow up assessment 6 months post-surgery were analyzed retrospectively. The presence of trauma and past medical history were reviewed and evaluation criteria based on brain CT scan findings were examined. Results: Initial brain CT scans revealed a chronic subdural hematoma in 106 patients, a subdural hygroma in 24 patients, and an acute subdural hematoma in 9 patients. In all cases where the initial acute subdural hematoma had progressed to a chronic subdural hematoma, final was a hypo-density chronic subdural hematoma. In case where the initial subdural hygroma had progressed to a chronic subdural hematoma, the most cases of hematoma were hyper-density and mixed-density chronic subdural hematoma. In total, 173 surgeries were performed, and they consisted of 97 one burr-hole drainages, 70 two burr-hole drainages and 6 craniotomies. Conclusion: This study demonstrates that rebleeding and osmotic effects are mechanisms for enlarging of a chronic subdural hematoma. In most cases, one burr-hole drainage is a sufficient for treatment. However, in cases of mixed or acute-on-chronic subdural hematomas, other appropriate treatment strategies are required.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2006.10a
• /
• pp.415-416
• /
• 2006

• Transactions of the Korean Society of Mechanical Engineers A
• /
• v.21 no.3
• /
• pp.430-438
• /
• 1997

Deburring and edge finishing technology as the final process of machining operation is required for manufacturing of advanced precise conponents. But, deburring is considered as a difficult problem on going to the high efficient production and automation in the FMS. Removal of burr couldn't have a standard of its definition because of its various shapes, dimensions and properties and mostly depends on manual treatment. Especially, deburring for cross hole inside is very difficult owing to its shape passing through out perpendicular to a main hole. The electrochemical method is suggested as its solution in practical aspect. Therefore, electrochemical deburring technology needs to be developed for the high efficiency and automation of internal deburring in the cross hole. In this study, the new process in the eliminating burr inside cross hole, electrochemical deburring by the wheel electroplated with Cubic-Boron-Nitrade abrasives, is suggested. Its deburring mechanism is described and machining performances is investigated. Also, CBN electroplated wheel is designed and manufactured and then characteristics of electrochemical deburring are investigated through experiments. Overall electrochemical deburring performance against burr inside cross hole is examined in the various power sources such as peak current and direct current.

• Proceedings of the Korean Society for Technology of Plasticity Conference
• /
• 2002.02a
• /
• pp.260-265
• /
• 2002

In micro hole punching process, it is very difficult to align punch with die hole. Misalignment can cause a falling-on in hole quality and breakage of punch and die. Micro punching using soft die plate without a die hole has a big advantage because it is not necessary to align punch with die hole and to consider die clearance. Soft die plates are made by polymers or hard rubbers which are softer than metals. In this study, several micro punching experiments are conducted. Micro punching test with some materials shows that micro hole punching is feasible with some soft die plates. Through the section shape obtained by mounting and polishing, the punched hole quality is measured and the shapes of burr and dome we studied.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2009.06a
• /
• pp.415-416
• /
• 2009

• Proceedings of the Korean Society for Technology of Plasticity Conference
• /
• 2003.10a
• /
• pp.386-390
• /
• 2003

As a trial of application of hydrostatic pressure in micro fomring, burr-free punching has been conducted by means of hydro-mechanical procedure. Even though it is in beginning stage, result of the hydro-mechanical punching is promising. Hydrostatic pressure helps delay fracture initiation and makes it possible to get clean shearing surface. Without any burr on both side of sheet, smooth holes are archived as intended. To verify the significance of hydro-mechanical punching, conventional punching is performed under similar conditions and relatively larger portion of fracture surface is detected in the punching hole. Despite the quality of sidewall is not good enough, it might be possible to make the hole shaped upright, reduce the roll-over radius and minimize the fracture surface by optimizing process parameters.