Intraoperative Traction May Induce Acute Onset Dysphagia With Diffuse Idiopathic Skeletal Hyperostosis After Anterior Cervical Discectomy / 대한신경손상학회지

Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic bone-forming disease, and its pathogenesis remains unknown. Moreover, the incidence of DISH increases with age. DISH may be an age-related disorder that occurs more frequently in degenerative spines than in healthy spines. Most patients with DISH of the cervical spine are asymptomatic; however, mechanical compression of the esophagus by the cervical spine can induce dysphagia, hoarseness, and dyspnea. In most cases, dysphagia progresses slowly. Most cases of postoperative dysphagia after anterior cervical spine surgery occurred within 1 month, and most patients recovered spontaneously. Severe dysphagia is relatively uncommon. Here, we report a case of acute-onset dysphagia with DISH that occurred immediately after anterior cervical discectomy. We should consider the possibility of dysphagia occurring immediately after anterior cervical discectomy in patients with DISH, even in those without dysphagia before surgery. Furthermore, surgical treatment for severe postoperative dysphagia associated with DISH may be a good option.

Comparisons of Radiological and Clinical Characteristics between Traumatic and Non-traumatic Subdural Hematoma Patients / 대한신경손상학회지

Objective@#Subdural hematoma (SDH) primarily occurs in elderly patients. While most patients have good prognosis, some do not. Hematoma recurrence is one of the factors influencing prognosis. Moreover, some characteristic radiological factors may increase the recurrence rate. The aim of this study was to investigate whether the presence of trauma influenced radiological characteristics and hematoma recurrence in SDH patients treated with burr hole trephination. @*Methods@#From January 2012 to December 2014, we selected 83 patients diagnosed with unilateral SDH using computed tomography and/or magnetic resonance imaging. We divided the patients into 2 groups based on the presence of trauma. We compared the 2 groups with multiple parameters, such as patient factors, radiological characteristics, and recurrence rate. @*Results@#Patients who had a prolonged international normalized ratio (INR) were significantly more common in the non-traumatic SDH group (22.2%:55.2%, p=0.002). There was no statistical difference in radiological parameters between the 2 groups. The recurrence rate was marginally higher in the non-traumatic SDH group (14.8%:17.2%, p=0.502), but this difference was not statistically significant. @*Conclusion@#There were no statistically significant differences in the radiological findings, including brain atrophy, hematoma density, thickness of hematoma, and degree of midline shifting between the 2 groups. The associated trauma history may not influence recurrence. Anticoagulants medication influence INR prolongation, and commonly shown in nontraumatic group, but not statistically. INR prolongation was statistically more common in non-traumatic SDH patients than in traumatic SDH patients. INR prolongation is only a different characteristic between 2 groups.