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https://www.readbyqxmd.com/read/29114315/intracranial-hypotension-associated-cerebral-swelling-following-cranioplasty-report-of-two-cases
#1
Masashi Nomura, Takahiro Ota, Mitsugu Ishizawa, Shinsuke Yoshida, Takayuki Hara
Cranioplasty is a comparatively simple neurosurgical procedure, and fatal complications are rare. This report describes two cases of critical brain swelling after otherwise uneventful cranioplasty. Both cases had subarachnoid hemorrhage and extremely similar clinical courses. They underwent decompressive craniotomy and clipping in the acute phase and had cranioplasty in the chronic phase, resulting in serious cerebral swelling and death. Deep venous sinus thrombosis was revealed in the autopsy for one case...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28973649/dural-closure-in-confined-spaces-of-the-skull-base-with-nonpenetrating-titanium-clips
#2
Chad A Glenn, Cordell M Baker, Joshua D Burks, Andrew K Conner, Adam D Smitherman, Michael E Sughrue
BACKGROUND: Dural repair in areas with limited operative maneuverability has long been a challenge in skull base surgery. Without adequate dural closure, postoperative complications, including cerebrospinal fluid (CSF) leak and infection, can occur. METHODS: We reviewed 53 consecutive surgical patients in whom a dural repair technique utilizing titanium microclips was performed from 2013 to 2016 at our institution. The repairs primarily involved difficult-to-reach dural defects in which primary suturing was difficult or impractical...
July 25, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28973401/three-dimensional-endoscopic-magnification-for-treatment-of-thoracic-spinal-dural-arteriovenous-fistulas-technical-note
#3
Alexander G Weil, Sami Obaid, Chiraz Chaalala, Daniel Shedid, Elsa Magro, Romuald Seizeur, Michel W Bojanowski
BACKGROUND: Treatment of thoracic spinal dural arteriovenous fistulas (DAVFs) by microsurgery has recently been approached using minimally invasive spine surgery (MISS). The advantages of such an approach are offset by difficult maneuverability within the tubular retractor and by the creation of "tunnel vision" with reduced luminosity to a remote surgical target. OBJECTIVE: To demonstrate how the pitfalls of MISS can be addressed by applying 3-D endoscopy to the minimally invasive approach of spinal DAVFs...
July 25, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28966827/spontaneous-pseudomeningocele-associated-with-lumbar-spondylolisthesis-a-case-report-and-review-of-the-literature
#4
Gonçalo Novais, Bernardo Ratilal, Lia Pappamikail, Pedro Branco, Nuno Reis
BACKGROUND: Pseudomeningocele, an extradural collection of cerebrospinal fluid (CSF), has only been rarely reported to occur spontaneously in conjunction with isthmic spondylolisthesis (with lysis) in the lumbar spine. CASE DESCRIPTION: A 68-year-old male presented with low back pain and neurogenic claudication of several years duration without any history of trauma, epidural spine injections, or spine surgery. Lumbosacral magnetic resonance imaging (MRI) revealed a grade-I L4-L5 isthmic spondylolisthesis with spinal canal narrowing and a posterior paravertebral collection consistent with CSF...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28954944/design-of-a-locator-for-designing-the-shortest-incision-for-a-polygonal-dural-window
#5
Mutsumi Nagai, Naoki Kaneko, Fumihiro Arai, Gen Kusaka, Mami Ishikawa
When a wide polygonal dural window is created, a short dural incision length is preferred by surgeons because suturing a wastefully long incision line during closure is troublesome. A locator to facilitate making the shortest dural incision when creating a polygonal dural window would be helpful. We geometrically analyzed the shortest incision design for a pentagonal dural window and produced a simple locator for intraoperatively implementing this design. The design for a pentagonal dural window with the shortest incision is the same as the design for a minimum Steiner tree (MST) problem with five vertices...
September 27, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28927211/a-pivotal-randomized-clinical-trial-evaluating-the-safety-and-effectiveness-of-a-novel-hydrogel-dural-sealant-as-an-adjunct-to-dural-repair
#6
Michael J Strong, G Alexander West, Henry Woo, Daniel E Couture, John A Wilson, Lorenzo F Munoz, Charles L Rosen, Jeremy D Greenlee, Harry R van Loveren, Mark Iantosca, Clinton J Baird, Mark Smith, Matt McGirt, Jonathan Parish, Anthony L Asher
BACKGROUND: A watertight dural repair is critical to minimizing the risk of postoperative complications secondary to cerebrospinal fluid (CSF) leaks. OBJECTIVE: To evaluate the safety and efficacy of a novel hydrogel, Adherus Dural Sealant, when compared with control, DuraSeal Dural Sealant System, as an adjunct to standard methods of dural repair. METHODS: In this 17-center, prospective, randomized clinical trial designed as a noninferiority, single-blinded study, 124 patients received Adherus Dural Sealant (test sealant) and 126 received DuraSeal (control)...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28918792/-dural-arteriovenous-fistula-is-a-rare-but-treatable-cause-of-transverse-myelitis
#7
Julie Richter Hansen, Lars Poulsgaard, Markus Holtmannspötter, Joan Højgaard, Peer Tfeldt-Hansen
This is a case report of a 60-year-old male admitted on suspicion of relapse of idiopathic transverse myelitis (TM), who after further diagnostic workup underwent successful closure of a dural arteriovenous fistula (DAVF). Magnetic resonance imaging in DAVF usually shows longitudinal TM, which, unlike DAVF, is also seen with the more common inflammatory or infectious causes usually showing inflammation in the cerebrospinal fluid. The natural history of DAVF is progressive. Since curable options exist, timely diagnosis is most important...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918531/penetrating-orbital-trauma-leading-to-trans-orbital-brain-herniation
#8
Siddharth Vankipuram, Chittij Srivastava, B K Ojha, Sushant Sahoo
INTRODUCTION: Development of a posttraumatic herniation of brain parenchyma through the orbit is a rare complication of orbital roof fracture. Mostly, the injury is due to a direct impact to the frontal region resulting in orbital roof fracture with dural defect and herniation of cerebrospinal fluid or brain parenchyma. These patients present with acute or gradually progressive proptosis with impending risk of loss of vision and mandate surgical decompression of optic nerve with watertight closure of the dural defect...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28808799/transorbital-endoscopic-approach-for-exposure-of-the-sylvian-fissure-middle-cerebral-artery-and-crural-cistern-an-anatomical-study
#9
João Paulo Almeida, Armando S Ruiz-Treviño, Sathwik R Shetty, Sacit B Omay, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The availability of minimal access instrumentation and endoscopic visualization has revolutionized the field of minimally invasive skull base surgery. The transorbital endoscopic approach using an eyelid incision has been proposed as a new minimally invasive technique for the treatment of skull base pathology, mostly extradural tumors. Our study aims to evaluate the anatomical aspects and potential role of the transorbital endoscopic approach for exposure of the sylvian fissure, middle cerebral artery and crural cistern...
October 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a%C3%A2-pilot-study-using-combined-laser-doppler-spectrophotometry
#10
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert J Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
BACKGROUND: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurologic outcome. In this pilot study, we examined the value of a novel noninvasive real-time measurement technique for detecting changes in local microcirculation. METHODS: We used the O2C (Oxygen to see) laser-Doppler spectrophotometry system in 14 patients with Hunt & Hess grade 2-5 SAH who underwent microsurgical cerebral aneurysm clipping...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28754642/symptomatic-thoracic-nerve-root-herniation-into-an-extradural-arachnoid-cyst-case-report-and-review-of-the-literature
#11
Nagesh C Shanbhag, Ruurd F Duyff, Rob J M Groen
BACKGROUND: Spinal extradural arachnoid cysts (SEACs) are relatively rare and usually asymptomatic. They preferentially are situated in the thoracic extradural space and almost always dorsal. SEACs may present with back pain and/or cord compression symptoms. Needle aspiration, needle fenestration, or open surgical resection/fenestration have been reported as treatment modalities. CASE DESCRIPTION: We present a 35-year-old woman who complained of radiating pain from the right lower thoracic region of her back toward the right inguinal region, which was aggravated upon defecation and straining...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28718255/dural-tears-in-patients-with-depressed-skull-fractures
#12
Gul Muhammad, Ahsan Aurangzeb, Shahbaz Ali Khan, Iqbal Hussain, Sudhair Alam, Ehtisham Ahmed Khan Afridi, Baynazir Khan, Sajid Nazir Bhatti
BACKGROUND: The presence of skull fracture in patients sustaining traumatic brain injury is an important risk factor for intracranial lesions. Assessment of integrity of dura in depressed skull fracture is of paramount importance because if dura is torn, lacerated brain matter may be present in the wound which needs proper debridement followed by water tight dural closure to prevent meningitis, cerebral abscess, and pseudomeningocoele formation. The objective of this study was to determine the frequency of dural tear in patients with depressed skull fractures...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28690961/a-unique-presentation-of-an-intracranial-abscess-secondary-to-retained-projectile-after-debridement-with-dural-closure
#13
Jason Milton, Victor Awuor
Patients with penetrating head trauma with retained projectiles develop intracranial abscesses as a common complication. The most common presentation is a suddenly worsening headache. The most common pathogen identified is staphylococcus. Outcomes are related to adherence of Matson's tenets. This case study details the presentation of a 19-year-old patient that presented to the neurological surgery clinic without neurologic deficits. Further questioning revealed complaints of intermittent diffuse headaches with bilateral upper extremity shock-like sensation for two weeks...
June 9, 2017: Curēus
https://www.readbyqxmd.com/read/28690870/spinal-dural-arteriovenous-fistula-a-case-series-and-review-of-imaging-findings
#14
Shandy Fox, Luke Hnenny, Uzair Ahmed, Kotoo Meguro, Michael E Kelly
INTRODUCTION: Spinal dural arteriovenous fistulae (sdAVF) are rare lesions. Patients typically present with slowly progressive myelopathy that is often mistaken for degenerative cervical or lumbar stenosis. On spinal magnetic resonance imaging (MRI), multisegmental T2 hyperintensities along with associated flow voids are pathognomonic of sdAVF. However, diagnosis can be difficult. Definitive diagnosis and localization is achieved with complete spinal angiography. Treatment options include open surgical ligation, endovascular embolization or multimodality treatment...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28685259/extremely-large-sinus-pericranii-with-involvement-of-the-torcular-and-associated-with-crouzon-s-syndrome
#15
Felipe H Sanders, Bryan A Edwards, Matthew Fusco, Rod J Oskouian, R Shane Tubbs, James M Johnston
INTRODUCTION: Sinus pericranii is a rare vascular malformation that connects the intracranial dural sinuses to the extracranial venous drainage system and is caused by either trauma or congenital defects. Although the majority of these vascular structures are due to trauma, some are congenital. CASE REPORT: Herein, we report a 5-month-old patient with a very large and fluctuating subcutaneous mass over the occiput and the diagnosis of Crouzon's syndrome. The child presented with a large midline mass that on imaging, connected to the underlying torcular and was diagnosed as a sinus pericranii...
July 6, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28645591/surgical-repair-of-iatrogenic-transverse-sigmoid-sinus-laceration-with-a-dural-flap-during-skull-base-tumor-surgery-a-technical-case-report
#16
Gerald S Oh, Gregory D Arnone, Hussam Abou-Al-Shaar, Ashley L Barks, Andrew Wong, Fady T Charbel
BACKGROUND: Injury to cerebral venous sinuses during craniotomy procedures can cause significant blood loss or venous air embolism, potentially leading to serious morbidity or mortality. When iatrogenic sinus injuries occur, it is essential to promptly obtain hemostasis and repair the sinus defect. CASE DESCRIPTION: We report on a 43-year-old woman that sustained a transverse-sigmoid sinus injury during a retrosigmoid craniotomy for resection of a cerebellopontine angle meningioma...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28637109/closing-the-dura-dural-hitching-versus-surgicel-and-tisseel-overlay-graft-in-craniocervicaldecompression-for-chiari-1-malformation
#17
Michael Tonkins, Naeem Farooqi, Rohan Ahmed, Saurabh Sinha, Debapriya Bhattacharyya
BACKGROUND: This study compares dural hitching to surgicel and tisseel overlay graft following craniocervical decompression and C1 laminectomy with simple durotomy for Chiari I malformation. Outcome measures were syrinx decompression, headache resolution and complication rates. METHODS: A retrospective analysis of case notes was conducted. Patients who had undergone craniocervical decompression (CCD) were grouped by method of dural closure. Outcomes compared were rates of syrinx decompression, headache resolution, and post-operative complications...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#18
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28632550/suture-choice-in-lumbar-dural-closure-contributes-to-variation-in-leak-pressures-experimental-model
#19
George M Ghobrial, Christopher M Maulucci, Matthew J Viereck, Sara Beygi, Ameet Chitale, Srinivas Prasad, Jack Jallo, Joshua Heller, Ashwini D Sharan, James S Harrop
STUDY DESIGN: Open-label laboratory investigational study; non-animal surgical simulation. OBJECTIVE: The authors perform a comparison of dural closure strength in a durotomy simulator across 2 different suture materials. SUMMARY OF BACKGROUND DATA: Incidental durotomy leading to persistent cerebrospinal fluid leak adds considerable morbidity to spinal procedures, often complicating routine elective lumbar spinal procedures. Using an experimental durotomy simulation, the authors compare the strength of closure using Gore-Tex with other suture types and sizes, using various closure techniques...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28629679/how-to-address-cerebrospinal-fluid-leakage-following-ossification-of-the-posterior-longitudinal-ligament-surgery
#20
Jung Hyeon Moon, Sungjoon Lee, Chun Kee Chung, Chi Heon Kim, Won Heo
BACKGROUND: Primary dural repair in ossification of posterior longitudinal ligament (OPLL) surgery via anterior is challenging because of limited space. Based on several years of our experiences, we present our concept for addressing cerebrospinal fluid (CSF) leakage following dural tear during anterior OPLL surgery. METHODS: We reviewed the medical records of 65 patients who underwent anterior OPLL surgery from 2003 to 2014. We included 7 patients whose operation records described dural tear followed by CSF leakage...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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