Jui-Feng Lin

Mackay Memorial Hospital, T’ai-pei, Taipei, Taiwan

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Publications (3)1.06 Total impact

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    ABSTRACT: Background Chronic subdural hematoma (CSDH) is common clinical entities in neurosurgical practice. Although several studies have focused on reporting surgical treatment of CSDH in mixed patient populations, there are few data concerning the risk factors, complications, and recurrence in the elderly. This study intended to delineate the perioperative risks, surgical outcomes, and recurrence in elderly patients with CSDH. Methods A retrospective review of 342 age ≥65 years patients with surgically treated CSDH at our institution from 2001 to 2011 was conducted. These patients were divided into three groups according to age (Group A: 65–74 years, Group B: 75–84 years, and Group C: 85–97 years). The demographics, perioperative risk, surgical results, complications, and recurrence were analyzed. The surgical procedure included burr-hole craniostomy with a subdural drainage in each patient. The outcomes were evaluated with initial Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) at discharge. Results The mean age was 77.2 ± 11.4 years, (M:F ratio = 2.2:1). The postoperative neurological status was improved in all subgroups. The overall outcome was favorable in 83.3%, with median GCS was 15, and GOS, 1–2 at discharge recovery. The patients with lower initial GCS and higher GOS at discharge had a higher recurrence rate. The complication and mortality rates did not differ significantly within the age groups. Conclusion An observed correlation is apparent between preoperative status and outcome. Burr-hole craniostomy should be the method of choice for surgical treatment of CSDH.
    No preview · Article · Mar 2014 · International Journal of Gerontology
  • Jui-Feng Lin · Cheng-Chia Tsai
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    ABSTRACT: Background Neurogenic intermittent claudication and degenerative low back pain caused by lumbar spinal stenosis (LSS) often occur after the age of 50 years and represent one of the most common degenerative spinal diseases of the elderly. We reviewed medical records and radiographs for patients with LSS who received an interspinous process device (IPD) between October 2009 and December 2010. The aim of the study was to evaluate surgical outcomes for decompressive surgery involving IPD implantation. Methods We reviewed data for 62 patients who were treated with decompressive surgery and IPD (Coflex or DIAM). Neurogenic signs after surgery are important indicators. The patients were examined the day before, 2 weeks after, and 3 months after surgery. Pain was measured according to a visual analog scale (VAS) and neurologic changes were recorded. Results Postoperative assessments at 2 weeks and 3 months after surgery included pain and neurologic scores and a patient satisfaction survey. For some groups we observed a significant improvement (p < 0.05) in back pain according to the VAS. Conclusion Symptom relief on forward flexion is a key indicator for prognosis. Interspinous implants offer significant, long-lasting symptom control and IPDs are safe and effective devices for LSS.
    No preview · Article · Dec 2013 · International Journal of Gerontology
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    ABSTRACT: A 29-year-old woman who was pregnant for 12 weeks presented with headache for one week and drowsiness for two days. Computed tomography of the brain revealed multifocal hematomas with mass effect. Decompressive craniectomy was done to relieve the increased intracranial pressure. Magnetic resonance angiography and cerebral angiography were subsequently performed, both demonstrating thrombosis of the left transverse sinus. Treatment of sinus thrombosis generally includes correction of increased intracranial pressure and administration of anticoagulants, such as heparin. However, in this case heparin was contraindicated for the presence of intracranial bleeding, a clinical dilemma that requires careful considerations to balance treatment risks and benefits.
    Full-text · Article · Oct 2008 · Acta neurologica Taiwanica