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The Scientific World Journal
Volume 2015, Article ID 518494, 6 pages
Clinical Study

Simultaneous Cranioplasty and Subdural-Peritoneal Shunting for Contralateral Symptomatic Subdural Hygroma following Decompressive Craniectomy

1Department of Surgery, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
2Department of Neurosurgery, Taipei City Hospital, Zhong Xiao Branch, Taipei, Taiwan
3Department of Biotechnology and Animal Science, College of Bioresources, National Ilan University, Yilan, Taiwan
4Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
5Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan
6Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
7Department of Neurosurgery, Lo-Hsu Foundation, Lotung Poh-Ai Hospital, Luodong, Yilan, Taiwan
8Department of Mathematics, Tunghai University, Taichung, Taiwan
9Sustainability Research Center, Tunghai University, Taichung 40704, Taiwan

Received 9 December 2014; Revised 27 February 2015; Accepted 28 February 2015

Academic Editor: Warwick W. Butt

Copyright © 2015 Muh-Shi Lin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Contralateral subdural hygroma caused by decompressive craniectomy tends to combine with external cerebral herniation, causing neurological deficits. Material and Methods. Nine patients who underwent one-stage, simultaneous cranioplasty and contralateral subdural-peritoneal shunting were included in this study. Clinical outcome was assessed by Glasgow Outcome Scale as well as Glasgow Coma Scale, muscle power scoring system, and complications. Results. Postoperative computed tomography scans demonstrated completely resolved subdural hygroma and reversed midline shifts, indicating excellent outcome. Among these 9 patients, 4 patients (44%) had improved GOS following the proposed surgery. Four out of 4 patients with lethargy became alert and orientated following surgical intervention. Muscle strength improved significantly 5 months after surgery in 7 out of 7 patients with weakness. Two out of 9 patients presented with drowsiness due to hydrocephalus at an average time of 65 days after surgery. Double gradient shunting is useful to eliminate the respective hydrocephalus and contralateral subdural hygroma. Conclusion. The described surgical technique is effective in treating symptomatic contralateral subdural hygroma following decompressive craniectomy and is associated with an excellent structural and functional outcome. However, subdural-peritoneal shunting plus cranioplasty thoroughly resolves the subdural hygroma collection, which might deteriorate the cerebrospinal fluid circulation, leading to hydrocephalus.