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Sang-Bok Lee, Tae-Gyu Lee, Do-Sung Yoo, Pil-Woo Huh and Kyoung-Suok Cho

Extracorporeal shock wave lithotripsy (ESWL) is a well-established, safe, and effective therapeutic alternative to surgical treatment for urolithiasis. Complications of ESWL do occur in a small number of patients, and when they do, they typically involve the kidney. Formation of a spinal epidural hematoma is an extremely rare complication after ESWL for kidney stone removal. The authors present the case of a 61-year-old man in whom a large spinal epidural hematoma developed after ESWL. They discuss the possible pathogenic mechanism of such a complication.

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Dong Gyu Jang, Seok-Gu Kang, Sang Bok Lee, Do-Sung Yoo, Pil-Woo Huh, Kyoung-Souk Cho, Dal-Soo Kim, Chun Kun Park and Joon Ki Kang

✓ Until now, calcified cephalhematoma has been treated by excision of the lesion and the use of an onlay autograft. The authors report their use of a less complicated alternative, simple excision and periosteal reattachment, in a 3-month-old male infant. They excised the calcified cap of cephalhematoma and reattached the periosteum to the exposed bone surface instead of using an onlay autograft technique. A follow-up CT scan demonstrated a smooth skull contour and good cosmetic appearance.

The authors note that this is the first report of the successful use of simple excision and periosteal reattachment for the treatment of a case of calcified cephalhematoma in which there was a depressed area after the calcified cap was removed. They conclude that in cases of calcified cephalhematoma it may be unnecessary to perform a complicated cranioplasty with bone harvested from the top of the calcification.