• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.274-279
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• 2000

A 35-year-old female patient who had been paraplegic since her upper thoracic cord injury one and a half years before was presented with a syringomyelia involving C7 to T2 cord segments on follow-up magnetic resonance imaging(MRI). Her pain on the chest and bilateral axilla worsened since about 2 years after initial injury, and MRI demonstrated a progressively enlarging cystic syrinx cavity of the cervicothoracic cord. The posttraumatic syringomyelia was managed operatively by lysis of the arachnoid adhesions, myelotomy, and expansile duraplasty. Post-operatively her pain was relieved, and MRI showed decrease in size of the syrinx, and digital infrared thermographic imaging(DITI) showed diminution of the hyperthermic area on the anterior chest. In conclusion, the posttraumatic syringomyelia can be managed successfully without shunt operation. It seems apparent that expansile duraplasty is effective in controlling the posttraumatic syrinx.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1389-1395
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• 2000

A case report of a post-traumatic syringomyelia in a 29-year old male, developed 15 years after an L1 burst fracture, is presented. On preoperative MRI, the syrinx extended cephalad above the fracture site through the whole thoracic and cervical cord. Serial myelo-CT was performed to evaluate the dynamics of CSF. It was managed by lysis of the arachnoid adhesions, syringosubarachnoid shunt, and expansile duraplasty. After surgery, the patient's symptoms improved, and marked decrease of the syrinx was seen on postoperative MRI. The pathophysiology, the role of preoperative diagnostic methods especially serial myelo-CT, and the contmporary management modalities for posttraumatic syringomyelia is reviewed along with the pertinent literature.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.449-453
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• 2017

A 3-year-old castrated male Maltese dog, weighing 4.8 kg was referred with hindlimb ataxia and right forelimb proprioceptive deficits were shown for 20 months. Chiari-like malformation and syringomyelia diagnosed through MRI at a local animal hospital and Knuckling of right forelimb and reluctance to walk were managed with steroid. The medical management was getting ineffective to manage for the symptoms one month before referred. Physical and neurological examinations, radiography, computed tomography, and magnetic resonance imaging were performed and diagnoses of caudal occipital malformation syndrome (COMS) and subsequent syringomyelia (SM) were made. Given that pharmacological treatment was previously ineffective, surgical intervention was recommended. Foramen magnum decompression with duraplasty using $Lyoplant^{(R)}$ was performed. Three days post-surgery, the dog showed improved gait and activity. After 2 months, the dog received no additional prescription medications. At the 12-month follow-up after surgery, the dog showed no clinical problems or recurrences, despite complete cessation of pharmacological treatment. In present report, we applied $Lyoplant^{(R)}$ as a dural graft has been carried out in a dog with COMS. Surgical decompression with $Lyoplant^{(R)}$ was an effective long-term (12-month) treatment for COMS without the need for any pharmacological treatment.

• Journal of Veterinary Clinics
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• v.40 no.1
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• pp.56-61
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• 2023

A 5-month-old female domestic short-haired cat presented with a history of seizure episodes for two months following an animal bite injury to the head. There were no remarkable findings on physical and neurological examination or blood analysis. Computed tomography revealed a fracture of the left parietal bone with an inward displacement of the bone fragment while magnetic resonance imaging revealed an enlarged temporal horn of the left lateral ventricle and a pseudomeningocele compressing the adjacent cerebral parenchyma. Subsequently, cerebrospinal fluid analysis results were normal. The patient was diagnosed with traumatic brain injury (TBI), with subsequent post-traumatic hydrocephalus (PTH) and pseudomeningocele. Despite treatment with phenobarbital and levetiracetam, seizures were not sufficiently controlled. Craniectomy for bone fragment removal and duraplasty were performed after a week. The patient then returned to normal condition with no further seizure activity. On repeated MRI two months after discharge, the hydrocephalus of the lateral ventricle and pseudomeningocele were enlarged; however, the patient maintained a good clinical status without any neurological signs. To the best of our knowledge, PTH and intracranial pseudomeningoceles have not yet been reported in cats. PTH and pseudomeningocele are among the complications of TBI and may not have any significant relevance with the clinical signs in this case. Thus, to broaden our knowledge about PTH and pseudomeningocele in cats, we describe serial changes in the clinical findings of this cat over the treatment period.

• Journal of Korean Neurosurgical Society
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• v.59 no.1
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• pp.52-57
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• 2016

Objective : Many surgeons advocate for watertight dural reconstruction after posterior fossa surgery given the significant risk of cerebrospinal fluid (CSF) leak. Little evidence exists for posterior fossa dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Our objective was to report the results of using collagen matrix in a non-watertight fashion for posterior fossa dural reconstruction. Methods : We conducted a retrospective review of operations performed by the senior author from 2004-2011 identified collagen matrix (DuraGen) use in 84 posterior fossa operations. Wound complications such as CSF leak, infection, pseudomeningocele, and aseptic meningitis were noted. Fisher's exact test was performed to assess risk factor association with specific complications. Results : Incisional CSF leak rate was 8.3% and non-incisional CSF leak rate was 3.6%. Incidence of aseptic meningitis was 7.1% and all cases resolved with steroids alone. Incidence of palpable and symptomatic pseudomeningocele in follow-up was 10.7% and 3.6% respectively. Postoperative infection rate was 4.8%. Previous surgery was associated with pseudomeningocele development (p<0.05). Conclusion : When primary dural closure after posterior fossa surgery is undesirable or not feasible, non-watertight dural reconstruction with collagen matrix resulted in incisional CSF leak in 8.3%. Incidence of pseudomeningocele, aseptic meningitis, and wound infection were within acceptable range. Data from this study may be used to compare alternative methods of dural reconstruction in posterior fossa surgery.