Korean journal of neurotrauma
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Korean J Neurotrauma · Oct 2016
Twist-Drill or Burr Hole Craniostomy for Draining Chronic Subdural Hematomas: How to Choose It for Chronic Subdural Hematoma Drainage.
Although twist-drill craniostomy (TDC) has a number of procedural advantages and an equivalent outcome compared to burr hole craniostomy (BHC) for the treatment of chronic subdural hematomas (CSDHs), the latter technique remains the preferred method. We analyzed symptomatic CSDHs in whom TDC at the pre-coronal suture entry point (PCSEP) was the primary method for hematoma drainage and BHC on the parietal was the secondary option. ⋯ When the hematoma was thick enough, a majority of the CSDHs were drained using TDC at the PCSEP as the first procedure, which was especially useful for bilateral hematomas and in elderly patients.
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Korean J Neurotrauma · Oct 2015
Case ReportsRemote Cerebellar Hemorrhage after Surgery for Degenerative Lumbar Spine Disease: A Case Report.
Spine surgery has been increased as the population ages, but the occurrence of unusual complication such as remote cerebellar hemorrhage (RCH) is not well understood. We recently experienced a case of RCH in a 60-year-old woman showed neurologic dysfunction after degenerative lumbar spine surgery. There was no definite dural tearing and cerebrospinal fluid (CSF) loss during operation. ⋯ Most other reports have been suggested that RCH after spinal surgery might be related with excessive CSF drainage perioperatively. Minimizing of CSF loss during operation would be helpful to reduce the risk of RCH. If large volume of CSF has been lost accompanied by neurologic deterioration, brain imaging is necessary simultaneously.
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Korean J Neurotrauma · Oct 2015
Analysis of the Risk Factors Affecting the Surgical Site Infection after Cranioplasty Following Decompressive Craniectomy.
The risk factors for surgical site infections (SSIs) after cranioplasty following decompressive craniectomy remain unclear. The goal of this study was to analyze the risk factors related to developing SSIs after cranioplasty and to suggest valuable predictors. ⋯ Based on our data, cranioplasty following decompressive craniectomy is associated with a high incidence of SSI. Being female, having a primary etiology of TBI and having had a bilateral cranioplasty may be risk factors for surgical site infections after cranioplasty.
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Korean J Neurotrauma · Oct 2015
Case ReportsSpinal Cord Stimulation for Refractory Neuropathic Pain of Neuralgic Amyotrophy.
The aim of this paper was to report the effect of temporary and chronic spinal cord stimulation for refractory neuropathic pain in neuralgic amyotrophy (NA). A 35-year-old female presented with two-months history of a severe, relentless neuropathic pain of the left shoulder, forearm, palm, and fingers. The neuropathic pain was refractory to various medical treatments, including nonsteroidal anti-inflammatory drugs, opiates, epidural and stellate ganglion blocks, and typically unrelenting. ⋯ Permanent stimulation was given with paddle lead. The neuropathic pain in her NA persisted and she continued using the spinal cord stimulation with 12 months after development of NA. The temporary spinal cord stimulation was effective in a patient with an extraordinary prolonged, acute painful phase of NA attack, and the subsequent chronic stimulation was also useful in achieving an adequate analgesia during the chronic phase of NA.
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Korean J Neurotrauma · Oct 2015
Case ReportsEffect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report.
We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. ⋯ Three days after midodrine hydrochloride was added, hypotension improved dramatically. We discuss our rare case with pertinent literatures.