• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.277-280
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• 2009

Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We present this case to emphasize that minor head trauma may lead to a posterior cranial fossa hematoma extending to the cerebellopontine angle and cause peripheral facial palsy in patients using aspirin (acetylsalicylic acid). In addition, partial evacuation and waiting for the resorption of the hematoma may help to prevent damage to the 7th and 8th cranial nerves.

• 한국융합학회논문지
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• 제12권4호
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• pp.285-291
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• 2021

본 연구는 외상성 경막하 혈종 환자의 생존 여부에 영향을 미치는 요인을 규명하기 위해 시도된 후향적 조사연구이다. 연구대상자는 G광역시에 소재한 C대학교 병원에 2017년 1월부터 2019년 2월까지 응급실로 내원한 외상성 경막하 혈종 환자 207명이다. 자료분석은 SPSS 23.0 프로그램을 이용하였으며, χ2-test, t-test, 로지스틱 회귀분석을 시행하였다. 연구결과 대상자의 생존 여부에 영향을 미치는 요인은 기저질환, 입원 시 합병증, 내원 시 GCS로 나타났다. 따라서 대상자의 과거력을 확인할 수 있는 의료시스템 구축과 합병증 예방을 위한 의료진의 교육이 이루어져야 할 것이다. 이와 함께 의료기관 이송 전 단계부터 대상자의 GCS를 측정하여 신속히 치료 가능한 병원으로 이송될 수 있도록 이송체계의 개선이 필요하다.

• 대한의용생체공학회:의공학회지
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• 제16권2호
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• pp.167-174
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• 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 Korean Neurosurgical Society
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• 제60권2호
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• pp.239-249
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• 2017

Objective : The purpose of this study is to evaluate the associations between 30-day mortality and various radiological and clinical factors in patients with traumatic acute subdural hematoma (SDH). During the 11-year study period, young patients who underwent surgery for SDH were followed for 30 days. Patients who died due to other medical comorbidities or other organ problems were not included in the study population. Methods : From January 1, 2004 to December 31, 2014, 318 consecutive surgically-treated traumatic acute SDH patients were registered for the study. The Kaplan-Meier method was used to analyze 30-day survival rates. We also estimated the hazard ratios of various variables in order to identify the independent predictors of 30-day mortality. Results : We observed a negative correlation between 30-day mortality and Glasgow coma scale score (per 1-point score increase) (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.52-0.70; p<0.001). In addition, use of antithrombotics (HR, 2.34; 95% CI, 1.27-4.33; p=0.008), history of diabetes mellitus (HR, 2.28; 95% CI, 1.20-4.32; p=0.015), and accompanying traumatic subarachnoid hemorrhage (hazard ratio, 2.13; 95% CI, 1.27-3.58; p=0.005) were positively associated with 30-day mortality. Conclusion : We found significant associations between short-term mortality after surgery for traumatic acute SDH and lower Glasgow Coma Scale scores, use of antithrombotics, history of diabetes mellitus, and accompanying traumatic subarachnoid hemorrhage at admission. We expect these findings to be helpful for selecting patients for surgical treatment of traumatic acute SDH, and for making accurate prognoses.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.584-590
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• 2017

Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.

• Journal of Korean Neurosurgical Society
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• 제49권6호
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• pp.373-376
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• 2011

We report a case of a non traumatic spinal subdural hematoma or subarachnoid hematoma manifesting as lumbago, leg pain and bladder dysfunction that showed angiographically occult vascular malformation (AOVM). Although the spinal angiogram did not reveal any vascular abnormality, the follow-up magnetic resonance image showed AOVM. Complete surgical removal was performed due to the aggravated bladder dysfunction. This case highlights the need to consider bleeding due to spinal AOVM, even when angiography is negative.

• Journal of Korean Neurosurgical Society
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• 제40권6호
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• pp.441-444
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• 2006

Objective : The goal of this study is to evaluate the clinical results in six patients who underwent surgical decompression for the acute subdural hematomas[ASDH] of posterior cranial fossa. Methods : Six patients [five males and one female] who had undergone surgery for ASDH of posterior cranial fossa between 2000 and 2005, were evaluated retrospectively with regard to clinicoradiological findings and surgical outcomes. The mean age was 45.8 years [range $9{\sim}67\;years$]. Results : Preoperative computed tomography showed ASDH on cerebellar hemisphere in four patients and on midline in two. All patients had the associated lesions such as subarachnoid hemorrhage, epidural or subdural hematoma, intraventricular hemorrhage, contusion or pneumocephalus in supratentorial area. Fracture of occipital bone was noted in two patients. Of the four patients who had 13 to 15 of Glasgow coma scale score at the time of admission, three were deteriorated within 24 hours after trauma. Of these three patients, delayed subdural hematoma developed 1 hour after initial normal CT finding in one patient and increased in thickness in another one. Postoperative outcome showed good recovery in three patients and moderate disability in one. Two patients were expired. Conclusion : This study supports that early diagnosis based on strict observation and prompt surgery in the patients with ASDH in posterior fossa will lead to the best results.

• Journal of Korean Neurosurgical Society
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• 제43권5호
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• pp.242-245
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• 2008

A 64-year-old man with TBI was admitted to our institute. In following days, he showed unusual behavior of agitation, restlessness, emotional instability and inattention. Post-traumatic delirium was tentatively diagnosed, and donepezil was given for his cognitive dysfunction. Although there was partial relief of agitation, he sustained back pain despite medication. Lumbar magnetic resonance image revealed SDH along the whole lumbar spine, and surgical drainage was followed. Postoperatively, his agitation disappeared and further medication was discontinued. We report a unique case of post-traumatic delirium in a patient with concomitant TBI and spinal subdural hemorrhage (SDH) that resolved with operative drainage of spinal hemorrhage.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.810-814
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• 2000

We report two cases of spinal subdural hematoma in the lumbar region after trauma. They developed in a 27-years old man and a 32-year-old woman. They had no other causes such as bleeding tendency, preexisting spinal lesions, lumbar puncture, vascular malformation and anticoagulant therapy. There lesions were diagnosed with MRI(fat suppression) and treated by lumbar puncture.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1992년도 춘계학술대회
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• pp.171-174
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• 1992

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 plating 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 peat latencies ($P_1-P_6$) and five negative peak latencies ($N_1-N_5$) 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 changes on AEP peak latencies is due to mechanical forcer of a mass (inflated balloon simulating a hematoma) in the distortion of the brain matter rather than increased ICP.