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Dural closure

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https://www.readbyqxmd.com/read/28235505/tension-pneumomediastnum-a-rare-cause-of-acute-intraoperative-circulatory-collapse-in-the-setting-of-unremarkable-tee-findings
#1
Jonathan B Weaver, Avinash B Kumar
DESIGN: Case report. SETTING: Operating room. PATIENT: 25YF, ASA IV E who underwent an emergent decompressive craniectomy for refractory intracranial hypertension secondary to acute intracranial hemorhage. INTERVENTIONS: A 25Y caucasian female presented with acute intracranial hemorrhage with intraventricular extension secondary to Moya Moya disease. Post admisison, she underwent an emergent decompressive craniectomy for medically refractory intracranial hypertension...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28217074/hemodynamic-disturbance-during-watertight-dural-closure-mind-the-direction-of-saline-irrigation
#2
Surya Kumar Dube, Hirok Roy, Gyaninder P Singh, Arvind Chaturvedi
No abstract text is available yet for this article.
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215907/spinal-arteriovenous-fistulas-in-adults-management-of-a-series-of-patients-treated-at-a-neurology-department
#3
G Ortega-Suero, J Porta Etessam, M Moreu Gamazo, G Rodríguez-Boto
OBJECTIVE: Spinal arteriovenous fístulas (SAVF), a rare type of vascular malformation, account for 3% of all spinal cord lesions. Without early treatment, the associated morbidity is high; furthermore, SAVF pose a major diagnostic challenge. Our purpose was to evaluate the clinical characteristics of SAVF and review their progress after treatment to determine whether it may be too late for treatment in some cases. METHODS: We present a retrospective series of 10 patients diagnosed with SAVF and treated at a tertiary hospital during a 3-year period...
February 16, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28210022/csf-related-complications-after-intradural-spinal-tumor-surgery-utility-of-an-autologous-fat-graft
#4
Kenan I Arnautovic, Marko Kovacevic
OBJECT: The incidence of cerebrospinal fluid (CSF)-related complications after intradural spinal tumor (IST) surgery is high and reported in up to 18% of patients. However, no efficient way to prevent those complications has been reported so far. Treating these complications may require prolonged bed rest, re-exploration, external lumbar drain, use of antibiotics, and possible precipitation of other complications. To alleviate the risk of CSF-related complications, we prospectively adopted the intraoperative use of autologous fat grafting after IST surgery...
December 2016: Medical Archives
https://www.readbyqxmd.com/read/28183608/efficacy-and-safety-of-small-intestinal-submucosa-in-dural-defect-repair-in-a-canine-model
#5
Shu-Kun He, Jin-Hai Guo, Zhu-le Wang, Yi Zhang, Yun-Hu Tu, Shi-Zhou Wu, Fu-Guo Huang, Hui-Qi Xie
Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects...
April 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28182825/biosurgical-hemostatic-agents-in-neurosurgical-intracranial-procedures
#6
Roberto Gazzeri, Marcelo Galarza, Giorgio Callovini, Alex Alfieri
Intraoperative hemostasis during neurosurgical procedures is one of the most important aspects of intracranial surgery. Hemostasis is mandatory to keep a clean operative field and to prevent blood loss and postoperative hemorrhage. In neurosurgical practice, biosurgical hemostatic agents have proved to be extremely useful to complete the more classic use of electrocoagulation. During recent years, many biosurgical topical hemostatic agents were created. Although routinely used during neurosurgical procedures, there is still a great deal of confusion concerning optimal use of these products, because of the wide range of products, as absorbable topical agents, antifibrinolytics agents, fibrin sealants and hemostatic matrix, which perform their hemostatic action in different ways...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28121970/resorbable-mesh-cranioplasty-repair-of-bilateral-cerebrospinal-fluid-leaks-following-pediatric-simultaneous-bilateral-auditory-brainstem-implant-surgery
#7
Giacomo Colletti, Marco Mandalà, Vittorio Colletti, Alberto Deganello, Fabiana Allevi, Liliana Colletti
OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI...
January 24, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28110458/experimental-evaluation-of-new-chitin-chitosan-graft-for-duraplasty
#8
M Pogorielov, A Kravtsova, G C Reilly, V Deineka, G Tetteh, O Kalinkevich, O Pogorielova, R Moskalenko, G Tkach
Natural materials such as collagen and alginate have promising applications as dural graft substitutes. These materials are able to restore the dural defect and create optimal conditions for the development of connective tissue at the site of injury. A promising material for biomedical applications is chitosan-a linear polysaccharide obtained by the deacetylation of chitin. It has been found to be nontoxic, biodegradable, biofunctional and biocompatible in addition to having antimicrobial characteristics. In this study we designed new chitin-chitosan substitutes for dura mater closure and evaluated their effectiveness and safety...
February 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28024891/transdural-herniated-lumbar-disc-disease-with-muscle-patch-for-closure-of-durotomy-a-brief-review-of-literature
#9
REVIEW
Harsha A Huliyappa, Rakesh Kumar Singh, Sunil Kumar Singh, Manish Jaiswal, Somil Jaiswal, Chhitij Srivastava, Balkrishna Ojha, Anil Chandra, Satnam Chhabra
PURPOSE: Intradural migration of disc (IDMD) is a rare clinical entity accounting for 0.27-0.33% of all herniated disc diseases. Flimsy or dense adhesion between the ventral dural surface and the opposing posterior longitudinal ligament (PLL) is the principal pathology for intradural migrated disc. The most commonly affected lumbar segments are L4-5 (55%), L3-4 (16%), L5-S1 (10%) and less commonly L2L3 and L1L2. No imaging feature is characteristic and the management protocol of durotomy via an endoscopic method is unclear...
December 15, 2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27857934/spinal-extradural-arachnoid-cyst
#10
Joon Bum Woo, Dong Wuk Son, Kyung Taek Kang, Jun Seok Lee, Geun Seong Song, Soon Ki Sung, Sang Weon Lee
A spinal extradural arachnoid cyst (SEAC) results from a rare small defect of the dura matter that leads to cerebrospinal fluid accumulation and communication defects between the cyst and the subarachnoid space. There is consensus for the treatment of the dural defect, but not for the treatment of the cyst. Some advocate a total resection of the cysts and repair of the communication site to prevent the recurrence of a SEAC, while others recommended more conservative therapy. Here we report the outcomes of selective laminectomy and closure of the dural defect for a 72-year-old and a 33-year-old woman...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27852504/bilateral-rib-based-distraction-to-the-pelvis-for-the-management-of-congenital-gibbus-deformity-in-the-growing-child-with-myelodysplasia
#11
John T Smith
BACKGROUND: Congenital gibbus deformity of the spine associated with myelodysplasia is a challenging problem in the growing child and is commonly associated with skin breakdown and chronic infection. Surgical solutions including kyphectomy, flap closure of the skin, and early spinal fusion are associated with a high rate of complications and, ultimately, a short trunk due to stoppage of spinal growth. The purpose of this article is to describe our early results in using a rib-based distraction to the pelvis without vertebral resection and fusion to manage this deformity...
January 2016: Spine Deformity
https://www.readbyqxmd.com/read/27813449/spinal-cord-herniation-repair-with-microstaples-case-report
#12
Pedro David Delgado-López, Cecilia Gil-Polo, Vicente Martín-Velasco, Javier Martín-Alonso, Ana María Galacho-Harriero, Elena Araus-Galdós
Idiopathic spinal cord herniation (ISCH) is a relatively rare and frequently misdiagnosed condition. It preferentially affects women and causes progressive thoracic myelopathy that presents as a Brown-Séquard syndrome or as spastic paraparesis. Although its etiology and pathogenesis are controversial, ISCH is characterized by the presence of an anterior dural defect that allows the incarceration of a segment of the cord. Typically, a C-shaped ventral displacement and kinking of the cord are visible on sagittal MRI...
November 4, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27801974/does-arsenic-increase-the-risk-of-neural-tube-defects-among-a-highly-exposed-population-a-new-case-control-study-in-bangladesh
#13
Maitreyi Mazumdar
BACKGROUND: Neural tube defects are debilitating birth defects that occur when the developing neural plate fails to close in early gestation. Arsenic induces neural tube defects in animal models, but whether environmental arsenic exposure increases risk of neural tube defects in humans is unknown. METHODS: We describe a new case-control study in Bangladesh, a country currently experiencing an epidemic of arsenic poisoning through contaminated drinking water. We plan to understand how arsenic influences risk of neural tube defects in humans through mechanisms that include disruption of maternal glucose and folate metabolism, as well as epigenetic effects...
November 1, 2016: Birth Defects Research. Part A, Clinical and Molecular Teratology
https://www.readbyqxmd.com/read/27779560/cost-analysis-of-cerebrospinal-fluid-leaks-and-cerebrospinal-fluid-leak-prevention-in-patients-undergoing-cerebellopontine-angle-surgery
#14
Alexander Chern, Jacob B Hunter, Marc L Bennett
OBJECTIVE: To determine if cranioplasty techniques following translabyrinthine approaches to the cerebellopontine angle are cost-effective. STUDY DESIGN: Retrospective case series. PATIENTS: One hundred eighty patients with available financial data who underwent translabyrinthine approaches at a single academic referral center between 2005 and 2015. INTERVENTION: Cranioplasty with a dural substitute, layered fat graft, and a resorbable mesh plate secured with screws Main Outcome Measures: billing data was obtained for each patient's hospital course for translabyrinthine approaches and postoperative cerebrospinal fluid (CSF) leaks...
January 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/27767903/neurosurgical-sequelae-of-domestic-dog-attacks-in-children
#15
Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
January 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27658949/magnetic-resonance-imaging-appearance-and-mechanism-of-action-of-five-hemostatic-agents-used-in-neurosurgery
#16
Cord M Brundage, Rebecca A Packer, Matthew D Jones
OBJECTIVE: To describe the magnetic resonance (MR) image appearance of 5 hemostatic agents placed in the brain, and to review their clinical application. STUDY DESIGN: Descriptive ex vivo and in vivo study. ANIMALS: Canine cadavers (n=4), client-owned dogs (n=4). METHODS: Heads from 4 canine cadavers were used, each with 5 hemostatic agents placed in specific locations in the brain. Hemostatic agents were used in their native form in 2 cadaveric brains, and in 2 others the materials were saturated with fresh whole blood prior to placement to mimic application in a field of active hemorrhage...
November 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27635962/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guideline-on-surgical-techniques-and-technologies-for-the-management-of-patients-with-nonfunctioning-pituitary-adenomas
#17
John S Kuo, Garni Barkhoudarian, Christopher J Farrell, Mary E Bodach, Luis M Tumialan, Nelson M Oyesiku, Zachary Litvack, Gabriel Zada, Chirag G Patil, Manish K Aghi
BACKGROUND: Numerous technological adjuncts are used during transsphenoidal surgery for nonfunctioning pituitary adenomas (NFPAs), including endoscopy, neuronavigation, intraoperative magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) diversion, and dural closure techniques. OBJECTIVE: To generate evidence-based guidelines for the use of NFPA surgical techniques and technologies. METHODS: An extensive literature search spanning January 1, 1966, to October 1, 2014, was performed, and only articles pertaining to technological adjuncts for NFPA resection were included...
October 2016: Neurosurgery
https://www.readbyqxmd.com/read/27591056/hemostasis-vs-epidural-fibrosis-a-comparative-study-on-an-experimental-rat-model-of-laminectomy
#18
COMPARATIVE STUDY
Hakan Erdogan, Bilal Kelten, Matem Tuncdemir, Salime Pelin Erturkuner, Hafize Uzun, Alper Karaoglan
AIM: The aim of this study was to evaluate the histopathological and biochemical impact and effectiveness of two hemostatic agents, Ankaferd blood stopper (ABS) and Microporous Polysaccharide Hemospheres (MPH), on epidural fibrosis in an experimental rat laminectomy model. MATERIAL AND METHODS: Twenty adult Wistar albino rats were divided into MPH-treated (n=6), ABS-treated (n=6) and control (n=8) groups. Laminectomy of the lumbar spine was performed in all animals and treatment groups were exposed to MPH and ABS while closure was applied in control group as per usual...
2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27586178/evaluation-of-metallic-artifacts-caused-by-nonpenetrating-titanium-clips-in-the-postoperative-neuroimaging
#19
Kiyoshi Ito, Tatsuya Seguchi, Takuya Nakamura, Akihiro Chiba, Takatoshi Hasegawa, Alhusain Nagm, Tetsuyoshi Horiuchi, Kazuhiro Hongo
BACKGROUND: Nonpenetrating titanium clips create no suture holes and thereby reduce cerebrospinal fluid leakage after dural closure. However, no data exists regarding metallic artifacts caused by these clips during postoperative neuroimaging. We aimed to evaluate clip-related artifacts on postoperative MR images of 17 patients who underwent spinal surgery. METHODS: A phantom study evaluated the size of metallic artifacts, while a clinical study evaluated the quality of postoperative spinal MR images...
August 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27554306/perifascial-areolar-tissue-graft-for-spinal-dural-repair-with-cerebrospinal-fluid-leakage-case-report-of-novel-graft-material-radiological-assessment-technique-and-rare-postoperative-hydrocephalus
#20
Ken Matsushima, Ryo Hashimoto, Masahide Gondo, Hirokazu Fukuhara, Michihiro Kohno, Hiroyuki Jimbo
BACKGROUND: Incidental durotomy is a relatively common complication in spinal surgeries, and treatment of persistent cerebrospinal fluid (CSF) leakage is still challenging, especially in cases for which "watertight" suturing is inapplicable. The usefulness of a nonvascularized perifascial areolar tissue (PAT) graft recently was emphasized for plastic and skull base surgeries. Its hypervascularity allows for early engraftment and long-term survival, and its flexibility is advantageous in fixing defects of complex shapes in limited surgical spaces...
November 2016: World Neurosurgery
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