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Yujia Zhou, Gesheng Wang, Jialin Liu, Yong Du, Lei Wang, Xiaoyong Wang
BACKGROUND The aim of this study was to evaluate the application of medical adhesive glue for tension-reduced duraplasty in decompressive craniotomy. MATERIAL AND METHODS A total of 56 cases were enrolled for this study from Jan 2013 to May 2015. All patients underwent decompressive craniotomy and the dura was repaired in all of them with tension-reduced duraplasty using the COMPONT medical adhesive to glue artificial dura together. The postoperative complications and the healing of dura mater were observed and recorded...
October 14, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Devesh Jalan, Neginder Saini, Mohammad Zaidi, Alexandra Pallottie, Stella Elkabes, Robert F Heary
OBJECTIVE In acute traumatic brain injury, decompressive craniectomy is a common treatment that involves the removal of bone from the cranium to relieve intracranial pressure. The present study investigated whether neurological function following a severe spinal cord injury improves after utilizing either a durotomy to decompress the intradural space and/or a duraplasty to maintain proper flow of cerebrospinal fluid. METHODS Sixty-four adult female rats (n = 64) were randomly assigned to receive either a 3- or 5-level decompressive laminectomy (Groups A and B), laminectomy + durotomy (Groups C and D), or laminectomy + duraplasty with graft (Group E and F) at 24 hours following a severe thoracic contusion injury (200 kilodynes)...
September 16, 2016: Journal of Neurosurgery. Spine
Levent Tanrikulu, Michael Buchfelder, Ramin Naraghi
AIM: There is a feared complication for cerebrospinal fluid (CSF) leakage after microvascular decompression (MVD). In this study we present our experience of fleece-bound tissue sealing in MVD with our aim to minimize the rate of postoperative CSF leakage. MATERIAL AND METHODS: We treated 50 patients (female/male: 26/24) with neurovascular compression (NVC) syndromes (trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia) by MVD from the year 2003 to 2006...
April 20, 2016: Turkish Neurosurgery
Florian Roser, Florian H Ebner, Marina Liebsch, Marcos S Tatagiba, Georgios Naros
OBJECT: Suboccipital decompression and duraplasty is considered the treatment of choice for Chiari-I-malformation. Several studies have shown improvement of neurophysiological parameters during decompressive surgery in pediatric patients. However, there is no evidence of the beneficial role of intraoperative neuromonitoring in adults. METHODS: A total of 39 consecutive patients (25 female, age 41.1±14.5 years [mean±SD]) underwent suboccipital decompression for the treatment of symptomatic Chiari-I-malformation senior neurosurgeon and his team...
November 2016: Clinical Neurology and Neurosurgery
A E Korshunov, Yu V Kushel'
AIM: The study objective was to develop a rational approach for defining the extent of posterior decompression in children with Chiari 1 malformation. MATERIAL AND METHODS: Posterior decompression was performed in 76 children with Chiari 1 malformation, under 18 years of age, in the period between 2001 and 2015. Fifty two (68%) children had syringomyelia. Extradural decompression (EDD) was performed in 14 (18%) cases, extra-arachnoid duraplasty (EAD) in 21 (28%) cases, intra-arachnoid dissection and duraplasty in 21 (28%) cases, and foramen of Magendie stenting and duraplasty in 20 (26%) cases...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Noam Alperin, James Ryan Loftus, Ahmet M Bagci, Sang H Lee, Carlos J Oliu, Ashish H Shah, Barth A Green
OBJECTIVE This study identifies quantitative imaging-based measures in patients with Chiari malformation Type I (CM-I) that are associated with positive outcomes after suboccipital decompression with duraplasty. METHODS Fifteen patients in whom CM-I was newly diagnosed underwent MRI preoperatively and 3 months postoperatively. More than 20 previously described morphological and physiological parameters were derived to assess quantitatively the impact of surgery. Postsurgical clinical outcomes were assessed in 2 ways, based on resolution of the patient's chief complaint and using a modified Chicago Chiari Outcome Scale (CCOS)...
August 5, 2016: Journal of Neurosurgery. Spine
Kunxue Deng, Xun Ye, Yaya Yang, Man Liu, Ali Ayyad, Yuanli Zhao, Yuyu Yuan, Jizong Zhao, Tao Xu
BACKGROUND: Numerous dura substitutes are commercially available, but no absorbable synthetic dura repair product has been used for both onlay and suture applications. OBJECTIVE: The safety and effectiveness of a new absorbable synthetic substitute composed of Poly-L-lactide microfibers as onlay dural graft were evaluated. METHODS: Physical properties and performance of the microfibrous synthetic dural substitute implanted as an onlay or suturable grafts were compared with these commercial products, including CODMAN ETHISORB™ Dura Patch and DuraGen™ Dural Graft Matrix, in a canine duraplasty model...
September 2016: Neurological Research
Dong-Hyun Lee, Kyoung-Tae Kim, Jeong-Ill Park, Ki-Su Park, Dae-Chul Cho, Joo-Kyung Sung
We propose a double layered (intradural and epidural patch) duraplasty that utilizes Lyoplant and Duraseal. We examined a 47-year-old woman after decompression for thoracic ossification of posterior longitudinal ligament was performed in another hospital. On postoperative day 7, she complained of weakness in both legs. Postoperative magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) collection with cord compression. In the operative field, we found 2 large dural defects on the ventral dura mater...
June 2016: Korean Journal of Spine
Jeffrey S Beecher, Yong Liu, Xiaoming Qi, Paolo A Bolognese
BACKGROUND: A number of different surgical techniques have been used through the years to address Chiari I malformation (CMI). METHODS: This article describes how we surgically manage CMI at two high-volume centers. We call the technique the minimally invasive subpial tonsillectomy (MIST). The technique consists of a minimalistic dissection and craniectomy with a short, linear durotomy for the subpial tonsillar resection. The dura is closed without the use of a duraplasty...
September 2016: Acta Neurochirurgica
Roberto Centonze, Emiliano Agostini, Samantha Massaccesi, Stefano Toninelli, Letterio Morabito
BACKGROUND: A large variety of biological and artificial materials are employed in dural repair, each of them with major limitations. Autologous grafts have limited availability and require an additional incision and surgical time. Cadaveric preparations and heterologous materials entail the risk of iatrogenic transmission of prions, whereas synthetic substitutes have been reported to cause inflammatory reactions and graft rejection. An equine-derived pericardium membrane has been developed (Heart(®), Bioteck, Vicenza, Italy) with mechanical and safety-related features that could make it suitable for neurosurgical application...
July 2016: Asian Journal of Neurosurgery
Hao Xu, LinYang Chu, Rui He, Chang Ge, Ting Lei
The treatment of Chiari malformation type 1 (CM-I) with posterior fossa decompression without (PFD) or with duraplasty (PFDD) is controversial. Our aim is to compare the clinical outcome between the two methods for the treatment of CM-I. In this paper, the authors report a systematic review and meta-analysis of operation time, clinical improvement, and complications of PFD compared with PFDD for the treatment of CM-I. Randomized or non-randomized controlled trials of PFD and PFDD were considered for inclusion...
June 1, 2016: Neurosurgical Review
Wael Mohamed Mohamed Moussa, Wael Khedr
Hypertensive intracerebral hemorrhage (ICH) has high morbidity and mortality rates. Decompressive craniectomy (DC) is generally used for the treatment of cases associated with refractory increased intracranial pressure (ICP). In this study, we investigated the beneficial effects of adding DC and expansive duraplasty (ED) to hematoma evacuation in patients who underwent surgery for large hypertensive ICH. A prospective randomized controlled clinical trial where 40 patients diagnosed having large hypertensive ICH was randomly allocated to either group A or B, each comprised 20 patients...
May 27, 2016: Neurosurgical Review
Nobuhiko Arai, Masanao Tabuse, Akiyoshi Nakamura, Hiromichi Miyazaki
BACKGROUND: The incidence of cerebral venous thrombosis (CVT) is low, and in particular, isolated cortical vein thrombosis (ICVT) is very rare. The diagnosis of ICVT is difficult by using conventional computed tomography (CT) and magnetic resonance imaging (MRI). However, with appropriate treatment, ICVT has a good prognosis. CASE PRESENTATION: Herein, we present a rare case of a 40-year-old woman with ICVT and type II protein S (PS) deficiency, who experienced a stroke...
2016: BMC Neurology
Yi Shen, Chunyue Ma, Liang Wang, Jun Li, Yiqun Wu, Jian Sun
PURPOSE: Giant cell tumors (GCTs) in the temporomandibular joint (TMJ) region invading the lateral skull base are relatively uncommon. The management of these lesions is still controversial because of their proximity to vital neurovascular structures. Although sporadically reported, the clinical outcomes of such disease after surgery are still largely unknown. MATERIALS AND METHODS: We retrospectively reviewed the records of 28 patients with resectable GCTs in the TMJ region involving the lateral skull base treated from 1994 to 2013...
May 14, 2016: Journal of Oral and Maxillofacial Surgery
Rodolfo Morales-Avalos, Adolfo Soto-Domínguez, Jaime García-Juárez, Odila Saucedo-Cardenas, José R Bonilla-Galvan, Marcela Cardenas-Serna, Santos Guzmán-López, Rodrigo E Elizondo-Omaña
PURPOSE: The objective of this study was to characterize and compare the morphological characteristics of the dura mater, the pericranium, and the temporal fascia to ascertain the most adequate tissue to use as a dura graft. METHODS: 20 dura mater, 20 pericranium and 20 temporalis fascia samples were analyzed. Each of the samples was stained with hematoxylin and eosin, orcein, Van Gieson, Masson's trichrome and Verhoeff-Van Gieson (600 slides in total) for a general morphological evaluation, as well as a quantitative, morphometric and densitometric analysis of elastic fibers present in each of the tissues...
May 13, 2016: Surgical and Radiologic Anatomy: SRA
Lei Zhang, Zhiqiang Yi, Hongzhou Duan, Liang Li
OBJECTIVE The purpose of this study was to introduce a novel autologous duraplasty procedure for the treatment of Chiari malformation Type I (CM-I). METHODS The authors retrospectively reviewed data from patients who had been diagnosed with CM-I and had undergone suboccipital decompression and autologous duraplasty in situ or synthetic dural graft duraplasty; patients were treated in the authors' department between 2011 and 2014. All procedures were performed by the same surgeon. The 2 duraplasty methods were compared in terms of surgical factors and complications...
April 15, 2016: Journal of Neurosurgery
Luciano Mastronardi, Guglielmo Cacciotti, Franco Caputi, Raffaelino Roperto, Maria Pia Tonelli, Ettore Carpineta, Takanori Fukushima
BACKGROUND: Cerebrospinal fluid (CSF) leakages represent a major complication of skull base surgery. Watertight dural suture is challenging, and different ways to reinforce it have been proposed. Since 6 months, we use locally harvested autologous pericranium graft for dural repair in retrosigmoid approach. METHODS: Retrospectively, we analyzed 27 patients operated on with key-hole retrosigmoid approach from May 2014. In all, autologous pericranium was harvested and inserted as an underlay "hourglass-shaped" plug under the dura plane and stitched to dura...
2016: Surgical Neurology International
Ishwar Singh, Seema Rohilla, Saquib Azad Siddiqui, Prashant Kumar
BACKGROUND: Growing skull fracture (GSF) is a rare complication of pediatric head trauma and causes delayed onset neurological deficits and cranial defect. GSF usually develops following linear fracture with underlying dural tear resulting in herniation of the brain. Early diagnosis and treatment are essential to avoid complications. However, there are no clear-cut guidelines for the early diagnosis of GSF. The present study was conducted to identify the criteria for the early diagnosis of GSF...
June 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Fei Wang, Yan Xue, Si-Shun Zhao, Ting-Jian Yang, Hao-Qing Song, Hong Liu
Dacron heart patch has been used in decompressive craniectomy, performing the function of septa, mainly to prevent extra adhesion of temporal muscle and decompressive meningeal adhesion in the second-stage cranioplasty, so as to make the operation easier. Then, we made the following modification technology: (1) We used artificial suturing-free dura participate directly in the duraplasty. (2) Dacron patch is not in need of trimming the side holes and can directly cover the decompression window. From March 2012 to October 2013, we applied the technology of artificial dura with Dacron heart patch in 23 patients; after operation, we found that the initial depressive craniectomy cost less time, due to the tension-reduced suture which was not needed, and in the second-stage cranioplasty, the temporal was easy to remove and had no adhesion with the Dacron patch, so as to reach temporal muscle anatomy preservation, and with no obvious postoperative complication...
December 2015: Indian Journal of Surgery
Apostolos Karligkiotis, Mario Turri-Zanoni, Eleonora Sica, Carla Facco, Stefania Freguia, Anna Mercuri, Andrea Pistochini, Maurizio Bignami, Paolo Castelnuovo
BACKGROUND: The purpose of this study was to report our experience with the endoscopic management of sinonasal schwannomas, analyzing the advantages, limitations, and outcomes of the technique. METHODS: A retrospective analysis was carried out on 11 patients treated endoscopically between 2000 and 2014 at a single institution. RESULTS: Eight patients underwent an exclusive endoscopic endonasal approach, whereas, in 3 patients, an osteoplastic flap was combined because of massive or lateral frontal sinus involvement...
April 2016: Head & Neck
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