scholarly journals Comparative analysis of dural reconstruction methods in open brain surgery for prevention of postoperative cerebrospinal fluid leakage

2014 ◽  
Vol 95 (1) ◽  
pp. 45-49 ◽  
Author(s):  
D E Alekseev ◽  
E D Alekseev ◽  
D V Svistov
Keyword(s):  
Cerebrospinal Fluid ◽  
Dura Mater ◽  
Plastic Material ◽  
Collagen Matrix ◽  
Cerebrospinal Fluid Leakage ◽  
Fluid Leakage ◽  
Reconstruction Methods ◽  
Plastic Materials ◽  
Adhesive Compositions ◽  
Dural Graft

Aim. A comparative evaluation of dural reconstruction results using different material: patient’s own tissues (periosteal fragments, m. temporalis fascia or fascia lata), dural graft implants, collagen matrix, as well as evaluation of adhesive compositions effect for dural sutures sealing. Methods. Results of different types of dural reconstruction used in 243 patients operated between 2009 and 2012 were analyzed. Additional materials were required to complete dural reconstruction in 91 cases. Three patient groups were formed depending on the type of plastic material: patient’s own tissues, artificial materials and collagen matrix without suture fixation. In first two groups, sutures fixed plastic material, adhesive compositions or collagen materials were used as sealant in some cases. Effect in postoperative cerebrospinal fluid leakage preventing was assessed for different plastic materials, as well as for additional dural sealants. Results. Cerebrospinal fluid leakage frequency was similar (p 0.05) regardless of the type of plactic material (patient’s own tissues, dural graft implants, collagen matrix) use and was assessed as 26.2, 29.0 and 27.8% accordingly. In subgroups where sutures between dura mater and graft were additionally strengthened by adhesive compositions or collagen stripes, cerebrospinal fluid leakage rate (23.3%) was lower (p 0.05) compared to subgroups without sealant (44.4%). Conclusion. The type of plastic material does not matter for effective cerebrospinal fluid leakage prevention. Additional sealing of recovered dura mater reduces the risk of postoperative cerebrospinal fluid leakage.

Mesh-and-Glue Method to Prevent Cerebrospinal Fluid Leakage After Implantation of a Synthetic Dura Mater Substitute: Pressure Resistance and Histologic Studies

2003 ◽  
Vol 13 (4) ◽  
pp. 275-281
Author(s):  
Kazuya Nagata ◽  
Yoji Shiobara ◽  
Hiroyuki Kobayashi ◽  
Toshiharu Shiba ◽  
Akira Yanagisawa ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Dura Mater ◽  
Cerebrospinal Fluid Leakage ◽  
Fluid Leakage ◽  
Glue Method ◽  
Pressure Resistance

scholarly journals Utility of nonpenetrating titanium clips for dural closure during spinal surgery to prevent postoperative cerebrospinal fluid leakage

2015 ◽  
Vol 23 (6) ◽  
pp. 812-819 ◽  
Author(s):  
Kiyoshi Ito ◽  
Tatsuro Aoyama ◽  
Tetsuyoshi Horiuchi ◽  
Kazuhiro Hongo
Keyword(s):  
Cerebrospinal Fluid ◽  
Dura Mater ◽  
Spinal Surgery ◽  
Water Pressure ◽  
Cerebrospinal Fluid Leakage ◽  
Fluid Leakage ◽  
Dural Closure ◽  
Significant Difference ◽  
Csf Leakage ◽  
Titanium Clips

OBJECT The nonpenetrating titanium clip has been successfully used in peripheral arterial bypass surgery. The purpose of this study was to evaluate the leakage pressures and patterns of nonpenetrating titanium clips using a simple model that mimicked spinal surgery. In addition, the authors describe their surgical experience with these clips and the follow-up results in 31 consecutive patients. METHODS The authors compared nonpenetrating titanium clips and expanded polytetrafluoroethylene (ePTFE) sutures in relation to the water pressure that could be tolerated by sutured ePTFE sheets, and the leakage pressure patterns were determined. The changes in leakage pressures at 5 minutes, 30 minutes, and 12 hours were examined when the clips and sutures were used in combination with the mesh-and-glue technique in an in vitro study. Thirty-one patients underwent spinal intradural procedures using nonpenetrating titanium clips to suture the dura maters using the meshand-glue technique, involving fibrin glue and polyglycolic acid-fibrin sheets. RESULTS A significant difference was apparent between the ePTFE suture group and the nonpenetrating titanium clip group, with the latter showing a leakage pressure that could be sustained and was 1508% higher than that of the former (p = 0.001). In relation to leakage patterns, the nonpenetrating titanium clips did not make any suture holes in the ePTFE sheet and fluid leakage occurred between the clips, whereas fluid leakage was associated with the pressure elevation that occurred at the suture holes made by the ePTFE sutures. Of the 31 patients who underwent spinal intradural procedures using nonpenetrating titanium clips, 1 (3.2%) experienced cerebrospinal fluid (CSF) leakage postoperatively. No other complications—for example, allergic reactions, adhesions, or infections—were encountered. CONCLUSIONS The interrupted placement of nonpenetrating titanium clips enables dural closure without creating any holes. These clips facilitate improvements in the initial leakage pressure and reduce postoperative CSF leakage following spinal surgery. The authors conclude that it is very beneficial to suture the spinal dura mater using nonpenetrating titanium clips given the anatomical characteristics of the spinal dura mater and the fact that the clips do not create suture holes.

scholarly journals Use of lyophilized homografts of dura mater and tissue glue in the repair of cerebrospinal fluid leakage.

1985 ◽  
Vol 78 (6) ◽  
pp. 1035-1039
Author(s):  
Kiyotaka Murata ◽  
Toyohiko Sakai ◽  
Yasuhiro Yoshioka ◽  
Fumihiko Ohta
Keyword(s):  
Cerebrospinal Fluid ◽  
Dura Mater ◽  
Cerebrospinal Fluid Leakage ◽  
Tissue Glue ◽  
Fluid Leakage

scholarly journals Bioresorbable Plate Fracture After Cranioplasty Caused by Head Injury, a Pediatric Case 

2021 ◽  
Author(s):  
Kohei Igarashi ◽  
Atsushi Kuge ◽  
Hiroshi Homma ◽  
Tetsu Yamaki ◽  
Rei Kondo ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Injury ◽  
Head Trauma ◽  
Dura Mater ◽  
Rare Case ◽  
Cerebrospinal Fluid Leakage ◽  
Dural Tear ◽  
Bone Fixation ◽  
Fluid Leakage ◽  
Bioresorbable Plate

Abstract Background: Recently, bone fixation materials have been developed as surgical materials. Bioabsorbable materials offers several advantages over other materials and are widely used. We report a rare case of the fracture of bioresorbable plates caused by head injury, and describe some considerations.Case description: A day, six-year-old boy suffered from consciousness disturbance. He was admitted our hospital and diagnosed with left frontal subcortical hemorrhage due to ruptured arteriovenous malformation (AVM). He was received the surgery of removal of the AVM with decompressive craniectomy. He was discharged without any neurologic deficit and underwent the cranioplasty 4 months after the initial surgery. Two months after the last treatment, he was fallen and hit his left frontal head. The next day, he noticed an abnormal bulge in the injured area. We diagnosed the bulging as the cerebrospinal fluid leakage because of the dural tear. The repairment of dural tear was performed. We found that two bioresorbable plates used by cranioplasty were both cracked and the dura mater beneath them was teared. We repaired the damaged dura with an artificial dura mater. After surgery, cerebrospinal fluid leakage did not occur. Conclusion: It has been reported that the durability of bioresorbable plate is no less than that of titanium plate. We experienced a relatively rare case in which bioabsorbable plate used for bone fixation was damaged due to head trauma. After craniotomy or cranioplasty using bioresorbable plates, special attention should be paid to head trauma that involves bone flap sinking force and side bending stress.

The role of fibroblast growth factor-2 in healing the dura mater after inducing cerebrospinal fluid leakage in rats

2009 ◽  
Vol 16 (4) ◽  
pp. 542-544 ◽  
Author(s):  
Hakan Nurata ◽  
Berker Cemil ◽  
Gökhan Kurt ◽  
Neşe Lortlar Uçankuş ◽  
Fikret Dogulu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Dura Mater ◽  
Fibroblast Growth Factor 2 ◽  
Cerebrospinal Fluid Leakage ◽  
Fibroblast Growth ◽  
Fluid Leakage

scholarly journals Clinical experience with a novel bovine collagen dura mater substitute

2011 ◽  
Vol 69 (2a) ◽  
pp. 217-220 ◽  
Author(s):  
Bruno Silva Costa ◽  
George de Albuquerque Cavalcanti-Mendes ◽  
Marcelo Sartori de Abreu ◽  
Atos Alves de Sousa
Keyword(s):  
Cerebrospinal Fluid ◽  
Dura Mater ◽  
Collagen Matrix ◽  
Cerebrospinal Fluid Leakage ◽  
Dural Substitute ◽  
Bovine Collagen ◽  
Brain Abscesses ◽  
Watertight Closure ◽  
Belo Horizonte ◽  
Initial Results

Dural substitutes are used to achieve watertight closure of the dura mater when adequate closure is not possible. The purpose of this study was to evaluate the efficacy and safety of a new collagen matrix dural substitute (Duradry, Technodry, Belo Horizonte MG) in the repair or expansion of cranial and spinal dura mater. METHOD: Thirty patients, operated on between March and September, 2008, were studied. Surgical records were reviewed for sex, age, location of graft, technique, and presence of fistula or infection. The patients were followed up for at least 3 months, and presence of complications, such as cerebrospinal fluid leakage, infection, asseptic meningitis hydrocephalus, pseudomeningocele, was analyzed. RESULTS: Only one patient presented cerebrospinal fluid fistula. No patients presented wound infections, hydrocephalus, pseudomenigocele, meningites, brain abscesses or signs of toxicity related to the dural substitute. CONCLUSION: The new dural substitute used in this study is effective and safe, and the initial results are similar to those of other dural substitutes reported in the literature.

scholarly journals Bioresorbable plate fracture after cranioplasty caused by head injury: a pediatric case

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Kohei Igarashi ◽  
Atsushi Kuge ◽  
Hiroshi Homma ◽  
Tetsu Yamaki ◽  
Rei Kondo ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Injury ◽  
Head Trauma ◽  
Dura Mater ◽  
Rare Case ◽  
Cerebrospinal Fluid Leakage ◽  
Dural Tear ◽  
Bone Fixation ◽  
Fluid Leakage ◽  
Consciousness Disturbance

Abstract Background Recently, bone fixation materials have been developed as surgical materials. Bioabsorbable materials offer several advantages over other materials and are widely used. We report a rare case of the fracture of bioresorbable plates caused by head injury and describe some considerations. Case description A 6-year-old boy suffered from consciousness disturbance. He was admitted to our hospital and diagnosed with left frontal subcortical hemorrhage due to ruptured arteriovenous malformation (AVM). He received the surgery of removal of the AVM with decompressive craniectomy. He was discharged without any neurologic deficit and underwent the cranioplasty 4 months after the initial surgery. Two months after the last treatment, he was fallen and hit his left frontal head. The next day, he noticed an abnormal bulge in the injured area. We diagnosed the bulging as cerebrospinal fluid leakage because of the dural tear. The repairment of dural tear was performed. We found that two bioresorbable plates used by cranioplasty were both cracked, and the dura mater beneath them was torn. We repaired the damaged dura with an artificial dura mater. After surgery, cerebrospinal fluid leakage did not occur. Conclusion It has been reported that the durability of bioresorbable plates is no less than that of titanium plates. We experienced a relatively rare case in which bioabsorbable plate used for bone fixation was damaged due to head trauma. After craniotomy or cranioplasty using bioresorbable plates, special attention should be paid to head trauma that involves bone flap sinking force and side bending stress.

Development of a Semiautomatic Dura Mater Suturing Device for Preventing Cerebrospinal Fluid Leakage in Transsphenoidal Surgery

2020 ◽  
pp. 155335062096900
Author(s):  
Shohei Suzuki ◽  
Etsuko Kobayashi ◽  
Kenichi Hododuka ◽  
Kosaku Amano ◽  
Ken Masamune ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Conventional Method ◽  
Dura Mater ◽  
Transsphenoidal Surgery ◽  
Technical Skills ◽  
Cerebrospinal Fluid Leakage ◽  
Novel Device ◽  
Fluid Leakage ◽  
Dural Suturing

Dural suturing in transsphenoidal surgery requires well-honed technical skills. We have developed a semiautomatic dural suturing device and confirmed its effectiveness by comparing it with the conventional method. This device significantly shortens the suturing time compared with the conventional method. The dural suturing time in transsphenoidal surgery could be decreased significantly by use of this novel device.

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