• Journal of Korean Neurosurgical Society
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• 제37권6호
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• pp.436-442
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• 2005

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.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.385-387
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• 2011

Leptomeningeal metastasis is a devastating complication of advanced stage cancer. It is frequently accompanied by hydrocephalus and intracranial hypertension that must be treated by ventriculoperitoneal shunts. However, there are actual risks of peritoneal seeding or accumulation of malignant ascites after the cerebrospinal fluid diversion procedure, though it has not been reported. Here, we present the case of a patient with non-small cell lung cancer with leptomeningeal metastasis in whom malignant ascites developed after a subduroperitoneal shunt.

• 한국산학기술학회논문지
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• 제14권4호
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• pp.1765-1773
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• 2013

본 연구에서는 단순천공배액술을 시행하고 호전된 환자들과 이차 수술로 단순천공배액술을 실시하거나 경막하복강단락술을 실시한 환자들의 임상적 경과 분석을 통해 뇌경막하수종 치료에 도움이 되고자 한다. 2006년 7월부터 2012년 6월까지 본원에서 뇌경막하수종으로 입원하여 단순천공배액술을 시행받은 16례 전체 환자를 대상으로 분석하였다. 연구결과 아스피린을 복용하고 있는 환자는 모두 이차 수술을 시행하였다(p<0.001). 경막하복강단락술을 시행한 환자 4명 중 2명이 아스피린을 복용하여 통계적으로 유의하였다(p=0.014). 경막하복강단락술을 시행한 그룹과 시행하지 않은 그룹 간의 비교 결과, 4명의 환자는 일차수술 후 GCS의 변화는 없었으나 추적 전산화단층촬영 상 정중선 편위가 심하였고 경막하수종은 증가하거나 변화가 없었으며 두통, 구토, 발열, 호흡곤란 등의 뇌압상승 증상을 보여 단락술을 결정하게 되었다(p=0.006). 아스피린을 복용했던 환자들의 수술적 치료는 주의를 요하며 개두술 과정에서 뇌척수액의 급격한 소실과 뇌압의 지나친 변화를 예방하는 것이 중요하다고 사료된다.

• Journal of Korean Neurosurgical Society
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• 제37권6호
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• pp.432-435
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• 2005

Objective: This study was performed to evaluate the usefulness of early operation in children with traumatic subdural hygroma. Methods: The subjects were nine patients (Glasgow coma scale (GCS) score was below 10 and age was below 10 years old) who developed subdural hygroma after trauma between January 2000 to December 2002. Subduroperitoneal shunt was performed in one group and not performed in the other group. We analyzed the GCS score on admission and at 1 year after operation. Overall clinical results were evaluated retrospectively. Results: Patients who underwent operation exhibited higher GCS scores at 1 year after trauma compared to those in the patients who were treated by conservative therapy(p<0.05). Conclusion: The early operation could be an effective treatment to children with subdural hygroma who showed delayed improvement of consciousness and to patients with hygroma that didn't decrease or was above moderate amount.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.273-280
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• 2005

Objective : There is no acceptable indication and treatment of choice for infantile and child subdural hygroma and there are only a few reports about that in Korea. So the authors studied the clinical findings of infantile and child patients with subdural hygroma to improve the understanding and to suggest a standard treatment method. Methods : The authors retrospectively evaluated the causes, preoperative symptoms, radiological thicknesses, and postoperative results of 25patients with subdural hygroma who received surgical therapy. Results : There were 16boys and 9girls whose median age was 6months[range $2{\sim}120months$]. The main clinical manifestations were seizures, increased intracranial pressure, macrocrania and alteration of consciousness. Radiological thicknesses of the subdural hygroma varied from 7mm to 42mm and postoperative changes of thickness[y] could be expressed with the factor of month[x]: $y\;=\;-1.32\;{\times}\;+11.8$ in subdural drainage, and $y\;=\;-1.52\;{\times}\;+14.9$ in subduroperitoneal shunts. Of the 25patients, 2 [50%] were successfully treated by aspiration, 13 [59%] by subdural drainage, and 9 [69%] by subduroperitoneal shunt. Conclusion : It is suggested that the diagnosis and treatment of subdural hygroma in infants and children should be carefully addressed because of its high prevalence in children, and especially in infants. It is also suggested that the subdural drainage could be primary initial treatment method because it is simpler than a shunt, and since our data show that there is no statistical difference in postoperative recovery duration between the two operative methods.