The epidemiological aspect of chronic subdural hematoma (CSH) in the elderly who are 65 years old or elder was evaluated on Awaji Island with about 170,000 inhabitants. The overall incidence of CSH was 13.1 per 100,000⁄year, 3.4 in people under 65 years old, and 58.1 in the elderly. The elderly were 17.7% of all inhabitants. If these incidences of CSH are extrapolated to all of Japan in the year 2020, the incidence will be 16.3 per 100,000⁄year. This suggests that CSH may become the most common neurosurgical condition.

This is a report of our experience with ventriculo-peritoneal shunting, the treatment of congenital and secondary hydrocephalus. It includes a detailed listing of all complications and an analysis of the number of complications per patient and per procedure in patients in whom either a three-piece or a one-piece shunt system had been inserted. A total of 161 patients were in the one-piece series and 196 patients in the three-piece series, with the follow-up being a minimum of 6 months. There were 598 procedures in 196 patients in the three-piece series and 302 procedures in 161 patients in the one-piece series, so that the average number of operations per child in the three-piece series was 3.1 and only 1.9 in the one-piece series. There were 106 instances of ventriculitis in the three-piece series and only 22 in the one-piece series, and 47 non-ventriculitis related complications in the three-piece series, but only 17 in the one-piece series. Data are presented descriptively with listing of specific complications and as computer analysis statistical printouts for categories (disconnections, infections, obstructions) comparing the three-piece and one-piece systems.

IAF therapy was effective in dilating spastic arteries, and clinical improvement was observed in approximately half of the fasudil hydrochloride infusions. Our findings suggested that the IAF therapy was safe and effective for patients with symptomatic vasospasm after subarachnoid hemorrhage.

No abstract