The concepts of hydrocephalus can be applied at all conditions in which the intracranial volume of the cerebrospinal fluid is abnormally largd in relation to the volume of the brain. Most patients suffering from hydrocephalus has increased significantly with the advent of more sophisticated diagmostic tools sucy as CT, MRI and with rapid technical advances in shunt equipment. Since intracranial pressure is variable parameter depending on the factors as that some shunt complication are related to too much or to little cerebrospinal fluid drainage. In this report, the author analyzes post shunt complications of 46 patients from Jan, 1990 to Dec, 1994.
The rate of post shunt complications was 30% and the most common things were underdrtainage(16%), infction(10%), and shunt malfunction(6%).
, Si Hoon Park, Hee Jung Oh Coronary artery-to-left ventricular fistula is an unusual anomaly in adult and consists of a communication between one of coronary arteries and cardiac chambers. Most patients with coronary artery to ventricular fistulae are usually asymptomatic, but some can suffer from anginal pain. which can be caused myocardial ischemia due to coronary steal mechanism. In absence of concomitant atherosclerotic coronary artery disease or left ventricular hypertrophy causing an oxygen demand-supply imbalance, coronary steal appears to be a major importance in pathogenesis of myocardial ischemia in cases with generalized arterial systemic fistulae. We experienced 2 incidently found cases of coronary artery-to-left ventricular fistulae. We report these cases with a review of literature.
, Kyu-Man Shin Chronic hydrocephalus is a frequent occurrence after aneurysmal subarachnoid hemorrhage. 14 patients with chronic hydrocephalus and treating with shunting procedure were retrospectively reviewed. Chronic hydrocephalus after aneurysmal subarachnoid hemorrhage was usually recognized when gradual deterioratsm of consciousnes, unexplanied aggrvation of occuring neurologic defists, especially urinary incontinence.
Two-hundred consecutive patients with aneurysmal SAH were admitted to the neuro-surgical department Ewha Womans university Mok-Dong Hospital between fanuary 1994 and fanuary 2001, in all the patients aneurysms clipping was carried out. Among then 14 patient to chronic hydrocephalus following aneurysmal SAH and treating with shunting procedure were reviewed according to consionsnes level(Hunt-Hess classification), amonts of SAH(grading system of Fisher), sites and incidence. The chronic hydrocephalus was diagnosed CT findings in the clinical findings ; deterioration of level of consiousness, aggravation of neurologic deficits and urinary incontinence.
The average age of patients was 51 and predominant in women(man : woman=4 : 10). The incidence of chronic hydrocephalus was 7% and the aneurysmal sites were followings : posterior communicating artery(7), anterior communicating artery(4), and internal carotid artery bifuncation, middle cerebral artery and superior cerebellar artery were 1 respectiviy. According Hunt-Hess Grades were following ; grade I, II, III and IV=1, 6, 3 and 4. The number of patients according to Fisher's grading system were following ; grade 2, 3, and 4=6, 7, and 1. The outcomes by Glasgow assessment were the followings ; Score 5 and 4=9 and 5.
The response to shunting procedure in symptomatic patients of Chronic hydrocephalus following aneurysmal SAH. good in all patients.
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