| "Basal durotomy" to prevent massive intra-operative traumatic brain swelling. | |
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MedLine Citation:
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PMID: 12910402 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Massive intraoperative swelling (IOS) is a potential complication of intracranial surgery for traumatic hematomas. We present a novel design of dural opening to minimize the risks of IOS. METHODS: Over the last eight years, we have used and evaluated a "reversed U-shaped" durotomy incision, which leaves the dura intact in the parasagittal region. Accordingly, the dura should be opened initially over the fronto-basal eminence of the frontal lobe anterior to the middle meningeal artery and sylvian region. The incision is then carried across the middle meningeal into the temporal region. Additional slit incisions may be made, as needed, around the circumference of the craniotomy in order to obtain sufficient access to remove a subdural hematoma. RESULTS: We have employed this technique in 220 trauma craniotomies without any case of uncontrolled IOS. In all patients a complete dural closure was obtained. CONCLUSION: When IOS is suspected, basal durotomy proved to be an excellent technique to prevent it, without compromising the total evacuation of the traumatic intracranial hematoma. |
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Authors:
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O L Alves; R Bullock |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Acta neurochirurgica Volume: 145 ISSN: 0001-6268 ISO Abbreviation: Acta Neurochir (Wien) Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-08-11 Completed Date: 2003-12-17 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0151000 Medline TA: Acta Neurochir (Wien) Country: Austria |
Other Details:
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Languages: eng Pagination: 583-6; discussion 586 Citation Subset: IM |
Affiliation:
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Serviço de Neurocirurgia, Centro Hospitalar Vila Nova de Gaia, Porto, Portugal. oscar.luis.alves@clix.pt |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Basal Ganglia
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surgery* Brain Edema / etiology, prevention & control* Craniotomy / adverse effects, methods* Dura Mater / surgery* Humans Intracranial Hemorrhage, Traumatic / surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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