• The Korean Journal of Pain
• /
• v.20 no.2
• /
• pp.235-239
• /
• 2007

Spontaneous intracranial hypotension (SIH) is believed to be a benign disease. However, numerous studies have reported serious complications related to SIH, including subdural hematoma. In this case report, a 54-year-old male patient visited the emergency room with orthostatic headache. A brain magnetic resonance imaging (MRI) study showed diffuse mild thickening and enhancement of pachymeninges, with a suspicious minimal amount of subdural fluid collected in the left posterior parietal area. His orthostatic headache showed no improvement with conservative treatment; but his pain was almost completely relieved after two trials of cervical epidural blood patch. On the 74th day after the onset of his pain, the patient showed a drowsy mental status and slurred speech when he visited the pain clinic. Brain computerized tomography indicated a left subdural hemorrhage, and he underwent emergency operation to drain the SDH. In conclusion, pain clinicians should pay attention to abrupt changes in mental status as well as continuous headache, for the early diagnosis of SDH in SIH patients.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.2
• /
• pp.166-167
• /
• 2014

Subdural hemorrhage (SDH) can manifest various neurologic symptoms. However, SDH presenting with only hand weakness has rarely been reported. We report two SDH cases with only hand weakness mimicking peripheral neuropathy. Since SDH can present with hand weakness only, we suggest the clinicians to do a careful history taking and recommend a CT scan in the elderly patients.

• Journal of Biomedical Engineering Research
• /
• v.16 no.2
• /
• pp.167-174
• /
• 1995

Development of a noninvasive intensive care system calls for the use of evoked potentials (EPs) as a means of diagnosing traumatic head-injured patients. The experiment entails surgically placing two subarachnoid bolts and a subdural balloon through the skull to simulate a subdural hematoma. Using various levels of intracranial pressure (ICP) and/or different sizes of balloons, auditory evoked potentials (AEPs) were recorded from a rabbit. Six positive peak latencies ($P_1 - P_6$) and five negative peak latencies ($N_l- N_5$) were extracted from an averaged AEP waveform. Multiple regression analyses were performed for determining. a relationship between the ICP and AEP peak latencies. The results indicate that a major correlation of ch, mges on AEP peak latencies is due to mechanical forces of a mass (inflated balloon simulating a hematoma) in the distortion of the brain matter rather than increased ICP itself.

• Journal of Oriental Neuropsychiatry
• /
• v.16 no.2
• /
• pp.189-199
• /
• 2005

We experienced a 71year-old man who had a traumatic subdural hemorrhage as well as delirium, and whose condition was improved through oriental medical treatment. Herbal medicine Hwaeo-jeon is administered three times a day. We did Mini-Mental State Examination-Korean(MMSE-K) and Korean-Dementia Rating Scale(K-DRS). After being treated, the patient showed that symptoms of delirium(diminished or altered state of consciousness, impairment of cognitive abilities or physical function) was improved considerably. This result suggests that Hwaeo-jeon has good effects on delirium with Traumatic Subdural Hemorrhage.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.4
• /
• pp.397-400
• /
• 2015

The simultaneous occurrence of an intracranial and a spinal subdural hematoma (SDH) is rare. We describe a case of cranial SDH with a simultaneous spinal SDH. An 82-year-old woman visited the emergency room because of drowsiness and not being able to walk 6 weeks after falling down. A neurological examination showed a drowsy mentality. Brain computed tomography showed bilateral chronic SDH with an acute component. The patient underwent an emergency burr-hole trephination and hematoma removal. She exhibited good recovery after the operation. On the fourth postoperative day, she complained of low-back pain radiating to both lower limbs, and subjective weakness of the lower limbs. Spine magnetic resonance imaging revealed a thoracolumbosacral SDH. A follow-up spinal magnetic resonance imaging study that was performed 16 days later showed a significant decrease in the size of the spinal SDH. We discuss the pathogenesis of this simultaneous occurrence of spinal and cranial SDH.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.3
• /
• pp.265-267
• /
• 2013

We report a case of bilateral chronic subdural hematoma (CSDH) in a 75-year-old man after exercise using a vibrating belt machine on the head. He suffered from headache and intermittent left side numbness for ten days. He denied any head injuries except eccentric exercise using a vibrating belt on his own head for 20 days. An MRI revealed bilateral CSDH. The hematoma was isodense on the CT scan. We made burr-holes on the both sides under local anesthesia. We identified the neomembrane and dark red subdural fluid on both sides. In the postoperative CT scan, we found an arachnoid cyst on the left temporal pole. Although the arachnoid cyst itself is asymptomatic, trivial injury such as vibrating the head may cause a CSDH.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.5
• /
• pp.483-486
• /
• 2015

Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural injection in the literature, it can cause severe complications such as large hematoma, infarction by spinal vascular injury. Subdural hematoma has been occurred much less common rather than epidural hematoma in the spinal cord. We report a rare catastrophic case of cervical spinal subdural hematoma with quadriparesis after cervical transforaminal epidural block.

• Journal of Korean Neurosurgical Society
• /
• v.40 no.3
• /
• pp.199-201
• /
• 2006

An organizing hematoma with tumor-like presentation in association with a chronic subdural hematoma[CSDH] has not been reported. Most reported cases of an intracranial mass in association with a CSDH have been associated with primary or metastatic neoplasm. A 72-year-old man presenting with an intracranial contrast-enhancing mass in association with a CSDH in magnetic resonance images is reported. Operative exploration revealed the mass to be an organized hematoma adjoining cortical draining veins between the outer and inner membranes of a chronic subdural hematoma. This report adds another important differential diagnosis to various primary and metastatic neoplasms that have been reported in the literature when encountering an intracranial mass in association with a CSDH. Neurosurgeons should be aware of the possibility and, It necessary, should apply more diagnostic modalities than magnetic resonance images before deciding management plans.

• Journal of Korean Neurosurgical Society
• /
• v.40 no.1
• /
• pp.51-53
• /
• 2006

Decompressive craniectomy is usually performed to relieve raised intracranial pressure[ICP] caused by various intracranial lesions. A 67-year-old man presented with acute subdural hematoma and traumatic intracerebral hematoma. The patient underwent a decompressive craniectomy. Four weeks later, the patient presented with acute neurological deterioration. Brain computed tomographic[CT] scans revealed the marked concavity of the brain at the site of the craniectomy and associated with midline shift which was reversed by cranioplasty. We report an unusual case of cerebral herniation from intracranial hypotension after decompressive craniectomy for a traumatic subdural hematoma. The cranioplasty may be helpful to prevent paradoxial cerebral herniation.

• Journal of Korean Neurosurgical Society
• /
• v.50 no.3
• /
• pp.274-276
• /
• 2011

Spontaneous cerebrospinal fluid (CSF) leak is a recognized cause of spontaneous intracranial hypotension (SIH). Subdural hematoma (SDH) is a serious but rare complication of SIH. An autologous epidural blood patch at the CSF-leak site can effectively relieve SIH. We report a case of bilateral SDH with SIH caused by a CSF leak originating at the C1-2 level. A 55-year-old male complained of orthostatic headache without neurological signs. His symptoms did not respond to conservative treatments including bed rest, hydration and analgesics. Magnetic resonance imaging showed a subdural hematoma in the bilateral fronto-parietal region, and computed tomography (CT) myelography showed a CSF leak originating at the C1-2 level. The patient underwent successful treatment with a CT-guided epidural blood patch at the CSF-leak site after trephination for bilateral SDH.