Clinical Study of Post-traumatic Normal Pressure Hydrocephalus

The discovery of C-T scan have facilitated the detection of post-traumatic hydrocephalus cases. Of those, 6 cases of hydrocephalus of non-parenchymatous in origin, in other words, normal pressure hydrocephalus were presented. They were diagnosed by repeated brain C-T and cisternography with Iodine 131-labeled human serum albumin. The symptomatology, diagnosis procedure and surgical results were discussed. Followings are the results. 1) The RIHSA cisternogram taken after 6 hrs, 12 hrs, 24 hrs and 48 hrs from lumbar injection showed abnormal features in all cases. 2) Surgical results were thought that there is much correlation with the age and improvement of mental impairments were seen, more or less, in all cases and improvement of gait disturbance and incontinence were seen in 5 cases and 4 cases respectively. 3) In those who sustained severe head injury with delayed recovery, the authors think, repeated check of brain C-T and cisternography is necessitated to perform the V-P shunt or V-A shunt to relieve the symptomatology of normal pressure hydrocephalus.

A Case of Carotid Cavernous Fistula Treated by Muscle and Polyurethane Foam Embolization: Case Report

There have been various surgical methods to treat the carotid cavernous fistula such as the carotid ligation, trapping procedure, embolization with muscle, gelfoam and polyurethane foam, balloon technique and direct transcavernous approach. Each method has its own merits and disadvantages. The ideal treatment of the illness would be the selective closure of the fistula with preservation of carotid patency. The authors are reporting a case of C-C fistula in which selective muscle embolism preserving carotid flow was attempted at first, but the closure was incomplete that polyurethane foam embolization was done in addition with success.