Résumé
Objective@#Digital subtraction angiography (DSA) is an imaging technique used to diagnose and confirm abnormal lesions of cerebral blood vessels in various situations. Several complications such as cerebral infarction, contrast-induced allergy, and angio-site hematoma or infection can occur after DSA. We investigated complication rates and risk factors related to DSA. @*Methods@#All patients who underwent DSA at Incheon St. Mary’s Hospital from January to December 2021 were included. Those who underwent emergency DSA due to stroke or who underwent endovascular surgery within 1 week after DSA were excluded. Complications that occurred within 1 week after DSA were included in the study and was classified into three categories (neurologic complications, contrast-induced allergy, and wound complications). @*Results@#The mean age was 57.7±13.2 years old and the female was dominant at 63.9%. The overall complication rate was 5% (n=20/407). Regarding neurologic complications, the presence of malignancy (p15 minutes, p=0.04) were statistically significant factors. Contrast-induced allergy did not show any statistically significant difference in any parameter. The wound complication rate was higher in men (p=0.02), trans-femoral approach (p=0.02), frequent alcohol drinkers (p=0.04), those taking anticoagulants (p=0.03), and longer procedure time (>15 minutes, p<0.01). @*Conclusions@#DSA is an invasive diagnostic modality and can cause several complications. Patients with cancer should be more careful about the occurrence of cerebral infarction, and men taking anticoagulants or drinking frequently should be more careful about the occurrence of angio-site hematomas.
Résumé
OBJECTIVE: The goal of this study was to assess the incidence and risk factors for post-traumatic hydrocephalus (PTH) following decompressive craniectomy (DC). An additional objective was to investigate the relationship between hydrocephalus and subdural hygroma (SDG) after DC. METHODS: We conducted a retrospective study of 94 patients who were admitted to our department between 2007 and 2010 with severe head injury requiring DC. Post-traumatic hydrocephalus was defined as: frontal horn index (FHI) > or =0.4 or modified FHI > or =0.33 accompanying transependymal edema; the presence of either clinical worsening or failure to make neurological improvement over time; and clinical improvement after ventriculoperitoneal shunt. Post-traumatic SDG was defined as the presence of low density at computerized tomography (CT) of more than 5mm thickness. RESULTS: Among the 94 patients, we could follow up more than 3 months and obtain more than 4 serial CT scans in 41 patients. PTH developed in 29.3% (12/41) and SDG developed in 48.8% (20/41) of these patients. The development of PTH was significantly associated with delayed craniplasty after DC and with interhemispheric SDG. No relationship was found between PTH and age, sex, Glasgow Coma Scale (GCS) score, intraventricular hemorrhage, subarachnoid hemorrhage, midline shift, basal cistern effacement, or cortical opening during DC. CONCLUSION: Hydrocephalus occurred in 29.3% of the patients with severe traumatic brain injury who required DC. Delayed cranioplasty and interhemispheric SDG after DC were risk factors for the development of PTH.