• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.810-814
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• 2000

We report two cases of spinal subdural hematoma in the lumbar region after trauma. They developed in a 27-years old man and a 32-year-old woman. They had no other causes such as bleeding tendency, preexisting spinal lesions, lumbar puncture, vascular malformation and anticoagulant therapy. There lesions were diagnosed with MRI(fat suppression) and treated by lumbar puncture.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.93-96
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• 2006

A traumatic spinal subdural hematoma is a rare condition, and only nine cases have been reported until now. We report a rare case of concomitant intracranial hemorrhage and spinal subdural hematoma with a review of the literature. A 45-year-old man was referred to our institute after being stroke by a car. He complained of nausea, headache, back pain, and bilateral sciatica. Brain computed tomography and lumbar spine magnetic resonance images revealed both an intracerbral hemorrhage and a subdural hematoma in the L4 to S1 level. After performing a lumbar spinal puncture and draining the hemorrhagic cerebrospinal fluid (CSF), the intracranial and spinal hematomas were resolved completely without any neruologic deficits.

• Child Health Nursing Research
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• 제12권4호
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• pp.462-469
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• 2006

Purpose: This study was done to verify the effects of preeducation and health contract on anxiety and adaptability of children with leukemia when undergoing a spinal puncture. Methods: Children in experimental group 1 (10) were given preeducation prior to the procedure and children in experimental group 2 (13), a health contract. Children in the control group (16) received the regular hospital preparation. Observation tools were used to evaluate adaptability and anxiety. Heart rate and oxygen saturation was also used as a measure of anxiety. The data were analyzed using the SPSS program. Results: Compared with the control group, experiment groups 1 and 2 showed significant difference in adaptability regarding the number of assistants and test posture. Experiment groups 1 and 2 showed significant difference in voice tone and movement level when compared with the control group. Elevation level in heart rate showed significant differences between the three groups. Conclusions: Preeducation and nursing mediation through health contracts were shown to be effective methods to reduce anxiety and increase adaptability in children with leukemia who were undergoing a spinal tap.

• Journal of Korean Neurosurgical Society
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• 제30권8호
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• pp.1042-1046
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• 2001

경추간판탈출증 환자에서 척수조술을 위해 요추천자를 시행한 후에 갑자기 양하지마비가 발생한 1례를 보고 한다. 척추종괴환자에서 요추천자후 합병증으로 나타나는 운동마비는 요추천자후 1~4일째에 서서히 오는 경우가 일반적이며, 수시간내에 급성으로 하지마비를 나타내는 경우는 매우 드물어 현재까지 6례 정도만 보고되고 있을뿐이며 그 원인질환은 대부분 척수종양이다. 경추간판탈출증 환자에서 척수조술을 위해 요추천자를 시행한 후에 갑자기 양하지마비가 발생한 임상보고례는 현재까지 없다. 이러한 합병증을 막기위해서는 척수장애증상을 보이는 경추간판탈출증 환자에게 척수조술대신에 자기공명촬을 시행함이 현명하리라 본다. 이러한 합병증이 올 수 있는 기전과 예방방법에 대해 고찰하다.

• The Korean Journal of Pain
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• 제1권2호
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• pp.203-206
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• 1988

1) 통증치료 목적으로 실시한 308경막외 천자 중 원치 않는 경막천자를 일으킨 경우가 5회(1.6%)있었다. 2) 경막천자를 일으킨 5예 중 2예에서는 뇌척수액이 흡입되어 천자당시 알 수 있었으나 나머지 3예에서는 국소마취제 주사 후에 나타나는 척추마취 증상으로 경막천자를 추축할 수 있었다. 3) 뇌척수액이 흡입되지 않은 3예 중 1예에서는 추궁절제술 후 주위조직의 유착으로 인한 경막외강의 신축성 소실 또는 잠재공간의 감소를 일으켜 경막외 주사시의 압력에 의해 경막손상을 입었으리라는 추측이 가능하였고 1예에서는 조직편에 의한 주사침의 폐쇄로 실질적인 경막천자후 뇌척수액 흡입이 음성이었던 것으로 추출되었다. 나머지 1예에서는 경막천자를 의심할만한 이유가 없었으나 나타나는 증상에 의해 경막천자를 의심하였다. 이상의 결과로 보아 경막외 차단 중에는 숙련된 술자에 의해서도 원치않는 경막차단이 일어날 수 있고 특히 뇌척수액의 흡입이 음성인 경우에도 경막천자가 가능하므로 술자에게는 고위 및 전척추마취에 대한 충분한 예비지식 및 응급소생술을 포함한 대처방안이 미리 마련되어 있어야 하고 환자에게 시술전 그 가능성을 인지시켜야 하며 외래 환자의 경우 보호자와 동반 하지 않은 경우는 시술을 될 수록 피하는 것이 좋을 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.384-386
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• 2006

Acute subdural hematoma is an exceptionally rare, but life-threatening complication of spinal anesthesia. The authors report here on a case of acute subdural hematoma in a 52-year-old male who underwent an arthroscopic knee joint operation under spinal epidural anesthesia due to tearing of the medial meniscus. He complained of headache after surgery. Computed tomography[CT] revealed acute subdural hematoma in the right fronto-tempo-parietal area. The headache progressed in spite of analgesics and bed rest; two weeks later, the CT showed subacute subdural hematoma with a mass effect. The patient improved after surgical decompression. The pathogenesis of subdural hematoma formation after dural puncture is discussed and we briefly review the relevant literature. Prolonged and severe postdural puncture headache[PDPH] should be viewed with suspicion and investigated promptly to rule out any intracranial complications. Immediate treatment of the PDPH with an epidural blood patch to prevent further CSF leakage should be considered.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.318-321
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• 2009

Tension pneumocephalus may follow a cerebrospinal fluid(CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.

• 대한한방내과학회지
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• 제43권2호
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• pp.115-121
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• 2022

Lumbar puncture is an essential procedure for obtaining fluid from spinal meningeal spaces, and post-lumbar puncture headache is the most frequent adverse event. This case report evaluates the effects of treatment with traditional Korean medicine on a patient suffering post-lumbar puncture headache using the Headache Disability Inventory (HDI) and the visual analog scale (VAS). The patient's HDI score decreased from 46 to 6 after treatment, and the VAS score decreased from 62 to 5. The results suggest that traditional Korean medicine can be helpful in managing post-lumbar puncture headache.

• Annals of Clinical Neurophysiology
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• 제17권1호
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• pp.41-43
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• 2015

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.237-239
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• 2012

Simultaneous intracranial and spinal subdural hematomas are extremely rare. In most cases, they are attributed to major or minor trauma and iatrogenic causes, such as those resulting from spinal puncture. To the best of the authors' knowledge, there has been only two reports of spontaneous concomitant intracranial and spinal subdural hematomas in a patient receiving anticoagulant therapy who had an absence of evident trauma history. We report on a case of spontaneous concomitant intracranial and spinal subdural hematomas that occurred in association with anticoagulant therapy and present a review of the relevant literature.