Treatment of Hydrocephalus Following the Operation of Ruptured Intracranial Aneurysms

Hydrocephalus, which is one of the major complications following intracranial aneurysm operations, can prevent patients from improvement of consciousness, symptoms and signs that can be expected after operation. Whenever there is no evidence of appreciable improvement after intracranial aneurysm operation, follow-up brain CT scannings will reveal the development of hydrocephalus. And also radioisotope cisternography and clinical findings could be clarified as Glasgow coma scale(GCS) and Hunt & Hess classification, which will help clinicians making a decision on shunt operation. Among 183 patients of subarachnoiod hemorrhage admitted, 92 patients were operated on due to intracranial aneurysms. Nine patients(9.8%) of them were underwent shunt operations because of hydrocephalus following intracranial aneurysm operations. Eight patients showed improvement of clinical findings and 9 patients have been improved according to GCS score.

Clinical Analysis on Various Fractures of the Axis

This retrospective analysis describes the clinical characteristics, treatment, and outcome of 15 patients with C2 fracture. The Age of the patients varied from 28 to 71. There were only two female patients whose mean age was 25.5 while the mean age of 13 male patients was 44.6. Five patients showed odontoid process fracture, three had C2 body fracture and the remainder were traumatic spondylolisthesis of the axis. The fractures were caused by falls in two patients(13.3%) while in 11 patients(73.3%) they were associated with motor-vehicle accidents. The other two patients were injured by falling objects. No patients suffered a neurological injury associated with the fracture. Three patients are still hospitalized, and follow-up was lost for 2 patients. In 10 patients mean follow-up period was 7 months. External immobilization with halovest was done on all patients. Additionally, anterior interbody fusion was done on 1 patient(Case No. 3). All patients showed the union radiologically, and resumed routine activity. Only 4 of them complained minor limited range of motion of the neck.