• Title/Summary/Keyword: 경막하

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Whole Lumbar Spinal Subdural Hematoma with Progressive Paraplegia after Lumbar Spinal Epidural Injection (요추 경막외 신경차단술 후 진행하는 하지마비를 동반한 전 요추 경막하 혈종)

  • Choi, Byung-Wan;Park, Kyung-Gu
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.178-182
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    • 2021
  • Spinal hematomas are a rare but serious complication that is typically observed in the epidural space. Spinal subdural hematomas are a dangerous clinical situation because of their potential to cause significant compression of the neural elements and can be mistaken easily for spinal epidural hematomas. This paper reports a case of a severe whole lumbar subdural hematoma after a simple epidural injection that was treated with surgical decompression with excellent clinical results.

Occurrence of Metachronous Intracranial Dural Arteriovenous Fistula after Embolization of Intracranial Dural Arteriovenous Fistula: A Case Report (두개내 경막 동정맥루 색전술 이후 발생한 이시성 두개내 경막 동정맥루: 증례 보고)

  • Heemin Kang;Sung-Tae Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.489-497
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    • 2023
  • Intracranial dural arteriovenous fistula (DAVF) is an abnormal arteriovenous shunt accounting for approximately 10%-15% of all intracranial vascular malformations. Most intracranial DAVFs are solitary, but multiple lesions at different sites can rarely occur. Most intracranial multiple DAVFs are synchronous types, whereas metachronous lesions are relatively uncommon. Herein, we report a rare case of metachronous DAVF occurring after the embolization of a preceding lesion in a 75-year-old female.

Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

Survival-related Factors in Patients with Traumatic Acute Subdural Hematoma (외상성 급성 경막하 혈종 환자의 생존 관련 요인)

  • Ha, Hey-Jin;Woo, Sang-Jun;Lee, Seung-Woo
    • Journal of the Korea Convergence Society
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    • v.12 no.4
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    • pp.285-291
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    • 2021
  • This study is a retrospective study attempted to determine the factors that influence the survival of patients with traumatic acute subdural hematoma. The study subjects were 207 patients with traumatic subdural hematoma who visited the emergency room from January 2017 to February 2019 at C University Hospital in G Metropolitan City. Data analysis was using the SPSS 23.0 program, and χ2-test, t-test, and logistic regression analysis. As a result of the study, the factors affecting the survival of the subjects were under disease, complications, and initial GCS. Therefore, it is necessary to establish a medical system to check the subject's history and to train medical staff to prevent complications. In addition, it is necessary to improve the transfer system so that the GCS of the subject can be measured from the stage before transfer to a medical institution and transferred to a hospital that can be treated quickly.

Idiopathic Spinal Epidural Lipomatosis - Case Report - (특발성 척추 경막상 지방종증 - 증례보고 -)

  • Han, Young-Min;Ahn, Myung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.795-799
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    • 2001
  • Spinal epidural lipomatosis, which causes symptomatic compression of neural elements, is a relatively uncommon disease. Although it has been reported frequently in association with the administration of exogenous steroids, a few cases of epidural lipomatosis with no association to exogenous steroids, have been reported. Idiopathic spinal epidural lipomatosis may be a separate disease from that induced by steroid. Here, the authors present two cases of symptomatic epidural lipomatosis with no history of steroid-dependent diseases and review the relevant literature.

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Inadvertent Dural Puncture during Epidural Block (경막외 차단시의 경막천자)

  • Kang, Keum-Ye;Min, Ki-Chul;Kim, Dong-Chan;Choe, Huhn
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.203-206
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    • 1988
  • Evaluation of inadvertent dural puncture occuring among 308 epidural blocks done for the relief of pain from various conditions was performed. Dural puncture was suspected in 5 out of 308 epidural bloks. (1.6%) Aspiration of CSF was negative in 3 cases in which dural puncture was suspected only after developing spinal anesthesia. Of the 3 negative CSF aspirations, one case had a history of laminectomy. Adhesions of the adjacent tissues might result in the loss of flexibility and a decrease in potential epidural space which might cause dural tearing during injection and subarachoid injection of the local anesthetic followed by high spinal anesthesia. In another case, the needle tip was obstructed by tissue which led to negative aspiration of CSF and failure to feel loss of resistance. The second injection at the same site may cause subarachnoid injection of the local anesthetic through the previously perforated dura mater and in turn, lead to spinal anesthesia. In the last case, there was no reason to suspect dural puncture since the loss of resistance plus air rebound were definite and aspiration of CSF was negative, but dural puncture was suspected after the patient developed spinal anesthesia.

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Progression of Subdural Effusion after Surgical Treatment (뇌경막하수종의 수술적 치료에 따른 임상 경과)

  • Kim, Jaehyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1765-1773
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    • 2013
  • The purpose of this study was to contribute to the medical treatment of subdural effusion through clinical sequence analysis of patients who experienced improvement of subdural drainage and had a second operation for subdural drainage or subduroperitoneal shunt. Sixteen cases of the whole patients who have been underwent subdural effusion and subdural drainage were analyzed during the period from 2006 July to 2012 June. The study gave us a result that all of patients, who was taking aspirin, have been under the second operation(p<0.001) and these group have had a subduraoperitoneal shunt(p=0.014)). According to the comparative analysis for the patients group that divided into two; one had subduroperitoneal shunt and the other had no subduroperitoneal shunt, the outcomes of this study were shown as follows. First, their median line deviation was serious in their brain CT. In addition, their subdural effusion increased or did not change with a headache, vomiting, fever and dyspnea. As a result of those symptoms. subduraoperitoneal shunt was carried out(p=0.006). The surgical method for patients who were taken asprin must be cautiously selected and the prevention of sudden disappearance of cerebrospinal fluid and excessive change of intracranial pressure is very important in operation craniectomy.

Analysis of Dural-sac Cross Sectional Area Changes According to Vertical Impact rate (수직 충격률에 따른 척추 경막 단면적 변화 해석)

  • 김영은
    • Journal of Biomedical Engineering Research
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    • v.24 no.5
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    • pp.421-425
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    • 2003
  • In this study the occlusion of dural-sac. the outer membrane of spinal cord in the lumbar region. was quantitatively analyzed using one motion segment finite element model. Occlusion was quantified by calculating cross sectional area change of dural-sac for different compressive impact duration (loading rate) due to bony fragment at the posterior wall of the cortical shell in vertebral body. Dural-sac was occluded most highly in the range of 8∼12 msec impact duration by the bony fragment intruding into the spinal canal. $\Delta$t = 400 msec case 4 % cross sectional area change was calculated. which is the same as the cross sectional area change under 6 kN of static compressive loading.

Extradural Spinal Lymphoplasmacyte-Rich Meningioma in the Thoracic Spine: A Case Report and Literature Review (흉추에서 발생한 척수 경막 외 림프구 형질세포 과다형 수막종: 증례 보고와 문헌 고찰)

  • Eun Hye Seo;Jang Gyu Cha;Yu Sung Yoon;Ah Rim Moon
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.924-930
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    • 2022
  • Most spinal meningiomas have an intradural or partly extradural location. The meningothelial origin is the most common pathologic type of spinal meningioma. Pure extradural spinal meningiomas are not common, and lymphoplasmacyte-rich meningioma (LPRM) is very rare. We report a case of isolated extradural spinal meningioma in the thoracic spine that was pathologically confirmed as LPRM.

A Case of Bartter's Syndrome with a Seizure Disorder Associated with Subdural Hematoma (경막하 혈종에 의한 경련이 동반된 Bartter 증후군 1례)

  • Lee, Jae-Jun;Moon, Han-Ku;Park, Yong-Hoon
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.388-397
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    • 1994
  • Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus hyperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy. In addition to a case report, brief review of related lituratures was done.

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