- Burr hole drainage using urokinase for treatment of subacute subdural hematoma.
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Min Su Kim, Seong Ho Kim, Oh Lyong Kim
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Yeungnam Univ J Med. 2015;32(1):8-12. Published online June 30, 2015
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DOI: https://doi.org/10.12701/yujm.2015.32.1.8
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 Abstract
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- BACKGROUND
Enlargement of subdural hematomas is relatively rapid in subacute stage of hematoma with clinical deterioration, which eventually necessitates surgery. The purpose of this study is to investigate the feasibility and safety of burr hole drainage using urokinase for management of patients with subacute subdural hematoma (SASDH). METHODS: Nine patients with SASDH were treated by burr hole drainage using urokinase. Under local anesthesia a catheter was inserted into the hematoma through a burr hole. Burr hole drainage was followed by hematoma thrombolysis with instillation of urokinase (10,000 units) every 12 hours. Drainage was discontinued when a significant decrease of hematoma was observed on cranial computed tomography. RESULTS: The patients' median age was 70 years (range, 62-87). The median Glasgow Coma Scale score before surgery was 15 (range, 11-15). Drainage was successfully performed in all patients. All patients had Glasgow Outcome Scale scores of 5 at discharge. There was no surgery-related morbidity or mortality. CONCLUSION: A burr hole drainage using urokinase could be a safe, feasible and effective minimally invasive method with low morbidity in treatment of selected patients with SASDHs.
- Cystoperitoneal Shunting after Fenestration of an Enlarging Arachnoid Cyst.
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Ik Chan Jeon, Min Su Kim, Seong Ho Kim, Sung Ho Jang
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Yeungnam Univ J Med. 2008;25(2):160-164. Published online December 31, 2008
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DOI: https://doi.org/10.12701/yujm.2008.25.2.160
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Abstract
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- A two-month-old girl with a history of an incidental arachnoid cyst in the prenatal period (38 weeks) presented with persistent irritability. A follow-up computed tomographic (CT) scan revealed an enlarged arachnoid cyst with hydrocephalus. We performed craniotomy and fenestration, but the cyst size did not decrease, and hydrocephalus had worsened on a follow-up CT scan performed 13 months after fenestration. The patient was treated with cystoperitoneal shunting. Follow-up magnetic resonance imaging (MRI) performed 5 years later revealed that the arachnoid cyst had decreased in size and that the hydrocephalus had resolved. Enlarging arachnoid cysts are not common, and optimal surgical treatment is uncertain. Based on the features of this case, we believe cystoperitoneal shunting is an advisable surgical intervention for patients with enlarging arachnoid cysts presenting with hydrocephalus.
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Yeungnam University College of Medicine
