2-4 days of closed system drainage following burr hole craniotomy is an effective and reliable choice of treatment in CSDH. Nevertheless, increasing the duration of drainage to 5-7 days provided better results without increasing the risk of complication.
AbstractÖz Ventriculoperitonal shunt dysfunction can be a displeasing result after management of hydrocephalus. Proksimal tip malfunction of the system is rarely seen compared with distal catheter. Here we report a 6-month-old infant who was treated with ventriculoperitonal shunt system after the diagnosis of hydrocephalus at birth and presented with shunt dysfunction 6 months after the operation.Ventriküloperitonal şant bozukluğu, hidrosefali yönetimi sonrasının istenmeyen bir sonucu olabilir. Sistemin proksimal uç bozukluğu, distal katetere kıyasla nadiren görülür. Burada doğumda hidrosefali teşhisi konulduktan sonra ventriküloperitonal şant sistem tedavisi almış fakat operasyodan 6 ay sonra şant disfonksiyonu gelişen 6 aylık bir yenidoğanın durumu sunulmuştur.
Background: A standard surgical technique has not been developed for Chiari Type-1 malformation. Recently, dural-splitting has also been introduced in addition to duraplasty. We aimed to determine both surgical techniques’ advantages/disadvantages clinically and radiologically. Material and Method: We retrospectively evaluated 28 patients’ data with Chiari Type-I malformation and operated at the Neurosurgery Department of Bülent Ecevit University between January 2014 and April 2018. We retrieved demographic characteristics, symptoms, physical/neurological findings, preoperative/postoperative imaging data/measurements, VAS, Chicago Chiari Outcome Scale, Neck Disability Index, Neurological Scoring System, and modified-JOA scores, operation and hospitalization times, and complications from the automation system. Results: Patients’ mean age was 38.5±13.0 years, and female/male ratio was 2.1/1. Syringomyelia was present in half of all cases. Mean tonsil herniation length was 11.64±4 mm, and mean tonsillo-dural distance was 4.18±1.7 mm. There were no significant relationships between tonsil herniation length and syringomyelia, and between tonsillo-dural distance and clinical improvement. Posterior fossa decompression was initially performed in all patients. Then, in 17 patients, duraplasty was performed. In 11 patients, dural-splitting was used. No significant differences were determined between duraplasty and dural-splitting regarding VAS, Chicago Chiari Outcome Scale, Neck Disability Index, Neurological Scoring System, and modified-JOA scores. Significant differences were present, favoring dural-splitting regarding operation time, hospital stay, and complication rates. Conclusion: Posterior fossa decompression/duraplasty is an effective surgical technique to treat Chiari Type-I malformation. Posterior fossa decompression/dural-splitting is an optimal surgical alternative with a lower complication rate, shorter operation time, and hospitalization period.
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