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Dural closure

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https://www.readbyqxmd.com/read/28808799/transorbital-endoscopic-approach-for-exposure-of-the-sylvian-fissure-middle-cerebral-artery-and-crural-cistern-an-anatomical-study
#1
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...
August 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a-pilot-study-using-combined-laser-doppler-spectrophotometry
#2
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
OBJECTIVE: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurological outcome. In this pilot study, we examined the value of a novel non-invasive real-time measurement technique to detect changes in local microcirculation. METHODS: We used the laser-Doppler spectrophotometry system "Oxygen-to-see(O2C)" in 14 patients with SAH Hunt & Hess grade 2 to 5, who underwent microsurgical clipping of cerebral aneurysms...
August 9, 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
#3
Nagesh C Shanbhag, Ruurd F Duyff, Rob J M Groen
BACKGROUND: Spinal extradural arachnoid cysts (SEAC) 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 towards the right inguinal region which was aggravated upon defecation and straining...
July 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28718255/dural-tears-in-patients-with-depressed-skull-fractures
#4
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
#5
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
#6
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
#7
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
#8
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: The authors report a 43-year-old female that sustained a transverse-sigmoid sinus injury during a retrosigmoid craniotomy for resection of a cerebellopontine angle meningioma...
June 20, 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
#9
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
#10
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
#11
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
#12
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...
June 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28621617/intrathoracic-meningocele-associated-with-neurofibromatosis-type-1-and-a-novel-technique-for-surgical-repair-case-report
#13
Paramita Das, Tarini Goyal, Matthew A Hunt
Neurofibromatosis Type 1 (NF1) is a neurocutaneous disorder that can have associated spinal abnormalities related to both bone and dural dysplasia. Thoracic meningoceles are one spine anomaly associated with NF1, although they are a fairly uncommon pathology. Surgical techniques to treat these meningoceles, usually undertaken only when the patient is symptomatic, are targeted at decreasing the size of the protrusion and improving lung capacity. Surgical interventions discussed in the literature include shunting the pseudomeningocele, primary repair with laminectomy, thoracoscopic plication, and reinforcement of the closure with cement, muscle, or fascia...
June 16, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28584680/multidisciplinary-surgical-treatment-of-presacral-meningocele-and-teratoma-in-an-adult-with-currarino-triad
#14
Daniel Chakhalian, Arunprasad Gunasekaran, Gautam Gandhi, Lucas Bradley, Jason Mizell, Noojan Kazemi
BACKGROUND: Currarino syndrome (CS) is a rare genetic condition that presents with the defining triad of anorectal malformations, sacral bone deformations, and presacral masses, which may include teratoma. Neurosurgeons are involved in the surgical treatment of anterior meningoceles, which are often associated with this condition. The accepted surgical treatment is a staged anterior-posterior resection of the presacral mass and obliteration of the anterior meningocele. CASE DESCRIPTION: This case involved a 36-year-old female who presented with late onset of symptoms attributed to CS (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28528480/full-endoscopic-treatment-of-dural-tears-in-lumbar-spine-surgery
#15
Joachim M Oertel, Benedikt W Burkhardt
PURPOSE: An incidental durotomy is a common complication of spinal surgery. Its treatment remains challenging, especially in endoscopic procedures. The objective of this study is to describe a technique for endoscopic dural closure which is safe and effective. METHODS: From a prospective database all endoscopic spinal procedures with incidental durotomy were identified. Retrospectively, video recordings were analysed with a special reference to the applied technique of dural closure...
May 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28521353/intraoperative-angiography-for-arteriovenous-malformation-resection-in-the-prone-and-lateral-positions-using-upper-extremity-arterial-access
#16
Erez Nossek, David J Chalif, Razvan Buciuc, Eric J Gandras, Erich G Anderer, Sal Insigna, Amir R Dehdashti, Avi Setton
BACKGROUND: Intraoperative angiography is routinely utilized for aneurysms and arteriovenous malformations (AVMs) to verify complete occlusion and resection. Surgery for spinal and posterior fossa neurovascular lesions is usually performed in prone position. Intraoperative angiography in the prone position is challenging and there is no standardized protocol for this procedure. OBJECTIVE: To describe our experience with intraoperative angiography in the prone and lateral positions, using upper extremity arterial access...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28412565/the-use-of-a-novel-perfusion-based-cadaveric-simulation-model-with-cerebrospinal-fluid-reconstitution-comparing-dural-repair-techniques-a-pilot-study
#17
Joshua Bakhsheshian, Ben A Strickland, Neil N Patel, Andre M Jakoi, Michael Minneti, Gabriel Zada, Frank L Acosta, Patrick C Hsieh, Jeffrey C Wang, John C Liu, Martin H Pham
BACKGROUND CONTEXT: Watertight dural repair is crucial for both incidental durotomy and closure after intradural surgery. PURPOSE: The study aimed to describe a perfusion-based cadaveric simulation model with cerebrospinal fluid (CSF) reconstitution and to compare spine dural repair techniques. STUDY DESIGN/SETTING: The study is set in a fresh tissue dissection laboratory. SAMPLE SIZE: The sample includes eight fresh human cadavers...
April 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28367945/a-case-of-superficial-siderosis-ameliorated-after-closure-of-dural-deficit-detected-by-mri-ciss-constructive-interference-in-steady-state-imaging
#18
Ayako Sakoda, Ken-Ichiro Yamashita, Mitsumasa Hayashida, Yukihide Iwamoto, Ryo Yamasaki, Jun-Ichi Kira
A 64-year-old male developed headache, dizziness, and difficulty hearing, two years after an operation for chronic subdural hematoma due to head injury. These symptoms gradually worsened over the following 15 years. As he showed bloody cerebrospinal fluid (CSF) and marginal hypointensity on the surface of the brain and spinal cord on T2/T2*-weighted MRI, he was diagnosed with superficial siderosis (SS), although the source of the bleeding was unclear and anti-hemorrhagic drugs were ineffective. When he was admitted to our hospital, neurological examination disclosed horizontal gaze-evoked nystagmus, severe bilateral hearing loss, scanning speech, and limb and truncal ataxia...
April 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28357687/efficacy-and-safety-of-non-suture-dural-closure-using-a-novel-dural-substitute-consisting-of-polyglycolic-acid-felt-and-fibrin-glue-to-prevent-cerebrospinal-fluid-leakage-a-non-controlled-open-label-multicenter-clinical-trial
#19
MULTICENTER STUDY
Shunsuke Terasaka, Toshiaki Taoka, Satoshi Kuroda, Nobutaka Mikuni, Toru Nishi, Hiroyuki Nakase, Yukihiko Fujii, Yasuhiko Hayashi, Jun-Ichi Murata, Ken-Ichiro Kikuta, Toshihiko Kuroiwa, Sachie Shimokawa, Kiyohiro Houkin
The objective of this study is to evaluate the efficacy and safety of non-suture dural closure using a novel dural substitute (GM111) consisting of polyglycolic acid felt with a fibrin-glue-coated area commensurate in size with the dural defect. This was a non-controlled, open-label, multicenter clinical trial. The efficacy evaluation endpoints were (1) GM111's intra-operative capability to close dural defects and (2) prevention of cerebrospinal fluid (CSF) leakage and subcutaneous CSF retention throughout the postoperative period (evaluated by diagnostic imaging)...
May 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28336418/treatment-of-cerebrospinal-fluid-leak-after-spine-surgery
#20
REVIEW
Zhao Fang, Rong Tian, Yu-Tao Jia, Tian-Tong Xu, Yang Liu
Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid (CSF) leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows: 1) creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2) retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
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