• Journal of Korean Neurosurgical Society
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• v.58 no.3
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• pp.301-303
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• 2015

We report on a case of an 87-year-old woman who showed spontaneous resolution of a large chronic subdural hematoma which required surgical decompression. She had suffered from confused mentality and right side weakness of motor grade II for 10 days. The initial brain CT scan showed a 22 mm thick low density lesion located in the left fronto-temporo-parietal region with midline shift (12 mm) which required emergency decompression. However, because she and her family did not want surgery, she was followed up in the outpatient clinic. Five months later, follow up brain CT showed that the CSDH had disappeared and the patient became neurologically normal. The reasons for spontaneous resolution of CSDH remain unclear. We discuss the possible relation between mechanisms of physio-pathogenesis and spontaneous resolution of a large chronic subdural hematoma (CSH) in an elderly patient.

• Journal of Acupuncture Research
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• v.31 no.3
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• pp.83-90
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• 2014

Objectives : The objective of this study is to report the clinical effects of Korean medical treatment for spinal subdural hematoma associated with anticoagulant drug. Methods : The patients were treated using acupuncture, electroacupuncture, herbal medication, moxibustion and physical treatment. And we checked American Spinal Injury Association scale, Spinal Cord Independence Measure Version III. Results : Motor score on the American Spinal Injury Association scale is increased 50 to 72. Sensory score on the American Spinal Injury Association scale is increased 124 to 170. Spinal Cord Independence Measure Version III is increased 18 to 26. Conclusions : This study suggest that Korean medical treatments are effective to spinal subdural hematoma patient.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.502-507
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• 2020

This study aimed to investigate the effect of Hwanglyeonhaedok-tang on the clearance of vancomycin-resistant Enterococcus (VRE) colonization in a patient with traumatic subarachnoid hemorrhage and subdural hematoma. A 73-year-old man who was diagnosed with traumatic subarachnoid hemorrhage and subdural hematoma with isolation of VRE colonization was administered Hwanglyeonhaedok-tang and followed up with a rectal swab VRE culture every week. After treatment with Hwanglyeonhaedok-tang, VRE colonization was no longer detected. This case report proved that Hwanglyeonhaedok-tang could be an effective treatment for clearance of VRE colonization in a patient with traumatic subarachnoid hemorrhage and subdural hematoma.

• The Journal of Internal Korean Medicine
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• v.42 no.3
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• pp.308-322
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• 2021

Objectives: This study investigates the latest clinical studies on Korean medicine treatment of chronic subdural hematoma (CSDH) in China. Methods: A CNKI search investigated the last 10 years of clinical studies of Korean medicine treatments in Chinese medical journals for CSDH. The search focused on authors, publication years, types of studies, purposes of studies, methods and duration of treatment, evaluation criteria, and results of treatment. Results: In 19 studies, there were 14 randomized controlled trials (RCTs), 4 case series, and 1 case-control study. In all 19 studies, Korean medical treatment and Western treatment were combined. Herbal medicine was used in 19 studies and acupuncture treatment in 2 studies. The most frequently used prescription was Hyeolbuchukeo-tang-gagambang, and the most frequently used acupoint was PC6. In all 19 studies, the effectiveness of Korean medicine treatment performed in parallel with Western treatment was confirmed. Conclusions: In this study, Korean medicine combined with Western treatment for CSDH was effective. More clinical studies and case reports are required to develop a guided treatment for CSDH.

• Journal of Korean Medicine Rehabilitation
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• v.25 no.3
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• pp.119-125
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• 2015

A chronic subdural hematoma (CSDH) is an old collection of blood and blood breakdown products between the surface of the brain and its outermost covering. We present two cases with tibia fracture caused by traffic accident progressed to chronic subdural hematoma. A 72-year-old male patient had shown signs of headache, urinary incontinence and mental storm when he has been in the hospital after 3weeks without CSDH diagnosis. And a 78-year-old male patient with mild head injury suffered from right side headache after traffic accident. We took korean medical treatments associate with tibial fracture. And we knew subdural hematoma through Brain CT. It is good report which shows CSDH can can occur from traffic accident. It requires correct diagnosis and closed observation for traffic accident patients.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.226-228
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• 2013

Elderly patients with acute subdural hematomas have higher mortality and lower functional recovery rates compared with those of other head-injured patients. Early and widely surgical decompression and active intensive care represent the best way to assist these patients. However, abrupt decompression of the hematoma can lead to brain disruption and secondary ischemia in the brain surrounding the craniectomy site. Acute brain swelling and brain extrusion, which take place shortly after decompression, can lead to a catastrophic situation during the operation due to the impossibility of appropriate closure of the dura and scalp. To avoid the deleterious consequences of disruption of brain tissue, we have adopted multiple fenestrations of the dura in a mesh-like fashion and gradual release of subdural clots through the small dural openings that are left open. This is especially important in cases in which there are massive amount of subdural hematomas with small parenchymal lesion and severe midline shifts in elderly patients. Further clinical experiences should be conducted in a more selected series patients to estimate the impact of this technique on morbidity and mortality rates.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.235-239
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• 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 Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.28-35
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• 2023

Objective: The purpose of this study was to evaluate the effectiveness of middle meningeal artery embolization (MMAE) in elderly high-risk patients with symptomatic chronic subdural hematoma (CSDH) in terms of reduction in hematoma volume and recurrence rate. Methods: We retrospectively reviewed data prospectively collected from nine patients who underwent 13 MMAE for CSDH between June 2017 and May 2022. The volume of the subdural hematoma was measured using a computer-aided volumetric analysis program. Hematoma volume changes during the follow-up period were analyzed and clinical outcomes were evaluated. Results: The mean follow-up period was 160 days (range, 46-311 days). All procedures were technically successful and there were no procedure-related complications. Of the 13 MMAE, 84% (11 out of 13 hemispheres) showed mean 88% of reduction on follow-up volumetric study with eight cases of complete resolution. There was one refractory case with MMAE which had been performed multiple burr-hole trephinations, for which treatment was completed by craniotomy and meticulous resection of multiple pseudomembranes. There was no recurrent case during the follow-up period, except for refractory case. Conclusions: MMAE for CSDH in selected high-risk elderly patients and relapsed patients might be effective. Despite the small cohort, our findings showed a high rate of complete resolution with no complications. Further prospective randomized trials are warranted to evaluate its usefulness as a primary treatment option for CSDH.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.592-595
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• 2009

Cerebellar hemorrhage is an unusual complication of supratentorial neurosurgery. To the best of our knowledge, only three case reports have described the occurrence of cerebellar hemorrhage after burr hole drainage for the treatment of chronic subdural hematoma (SDH). We present the case of a patient with this rare postoperative complication of cerebellar hemorrhage after burr hole drainage of a chronic SDH. Although burr hole drainage for the treatment of chronic SDH is rare complication, it is necessary to be aware of the possibility of cerebellar hemorrhage after supratentorial surgery, even with limited surgery such as burr hole drainage of a chronic SDH.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.108-111
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• 2013

Burr hole drainage has been widely used to treat chronic subdural hematomas (SDH), and most of them are easily treated by simple trephination and drainage. However, various complications, such as, hematoma recurrence, infection, seizure, cerebral edema, tension pneumocephalus and failure of the brain to expand due to cerebro-cranial disproportion may develop after chronic SDH drainage. Among them, intracerebral hemorrhage after evacuation of a recurrent chronic SDH is very rare. Here, we report a fatal case of delayed intracerebral hemorrhage caused by coagulopathy following evacuation of a chronic SDH. Possible pathogenic mechanisms of this unfavorable complication are discussed and a review of pertinent literature is included.