Natura Abhorret a Vacuo—use of fibrin glue as a filler and sealant in neurosurgical “dead spaces”. Technical note

Cappabianca, Paolo; Esposito, Felice; Magro, Francesco; Cavallo, Luigi Maria; Solari, Domenico; Stella, L; Divitiis, Oreste de

doi:10.1007/s00701-009-0580-2

Cited by 55 publications

(30 citation statements)

References 23 publications

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“…Thereafter, another layer of collagen matrix was placed and the sphenoid sinus was packed with fibrin glue to fill the dead space, thus holding the graft in place. 3,[5][6][7]18) In this manner, even limited incisions to the abdomen or leg to harvest fascia lata or fat tissue can be avoided, as previous reconstructions have generally been performed using abdominal fat or fascia lata. 1,5,6,9,18) Nevertheless, no consensus has yet been established regarding the material or combination of materials and methods that can be considered the optimal remedy for repairing osteodural defects, with each option providing a similar number of pros and cons.…”

Section: Discussionmentioning

confidence: 99%

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Komatsu

Cavallo

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 38-year-old woman presented with a case of post-traumatic ethmoidal cerebrospinal fluid (CSF) leak that was repaired using a purely endoscopic endonasal approach. Six weeks after a mild domestic maxillofacial trauma, she started complaining of clear, watery discharge from the left nostril and headache. Neuroimaging investigations disclosed a linear fracture of the left anterior ethmoidal roof without evidence of large bony breaches or any brain tissue damage. After conservative medical treatment with carbonic anhydrase inhibitors failed, she was referred to our hospital for surgical repair of the osteodural defect. An endoscopic endonasal transethmoidal approach was successfully performed, and an overlay technique was used to reconstruct the defect. The patient was discharged without clinical evidence of CSF rhinorrhea and no leaks were apparent at the 3-month follow-up clinical and radiological examinations. Post-traumatic CSF rhinorrhea occurs in cases of dural tears associated with small bone breaks, most frequently involving the anterior skull base. Recovery is often spontaneous following only bed rest, or with medical treatments such as inhibitors of carbonic anhydrase diuretics, steroids, or eventually stool softeners to help reduce CSF pressure. Surgical repair is required when first-line conservative treatment proves ineffective. The present case shows that the endoscopic endonasal technique for the management of CSF leaks provides a less invasive surgical route to achieve valid dural repair.

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Section: Discussionmentioning

confidence: 99%

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Komatsu

Cavallo

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…2,4,10 If there is active CSF leak this should be initially closed by resuturing. 4 Cappabianca et al described a minimally invasive technique of repeated percutaneous injection of fibrin glue into the PMC collection cavity after aspiration of the CSF; this technique was extrapolated and modified to use in conjunction with an autologous EBP for the successful treatment of a suboccipital PMC by Paternoster et al 7,11 Paternoster and colleagues described the first case of posterior fossa PMC treated by a modified EBP. They described aspiration of the CSF subcutaneous collection and local injection of autologous EBP combined with fibrin glue into the residual suboccipital pouch in 2012.…”

Section: Discussionmentioning

confidence: 99%

Epidural blood patch for treatment of a large suboccipital pseudomeningocele

Richardson

Tommasi

2017

Int Surg J

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Pseudomeningocele complication is a challenging and common neurosurgical problem. Posterior cranial fossa surgery is reported to have higher pseudomeningocele postoperative complication rates compared to supratentorial surgery. Treatment of posterior fossa pseudomeningoceles can be cumbersome and various techniques have been described ranging from conservative measures to re-operation. We describe a case of a 27 year old woman who developed a large symptomatic suboccipital pseudomeningocele following posterior fossa decompression surgery; this was successfully treated by an epidural blood patch. The current body of literature regarding the treatment of posterior fossa pseudomeningocele is limited. Whilst the use of an epidural blood patch for pseudomeningocele treatment is not novel, this is the first case of standard epidural blood patch, performed in the lumbar region, for treatment of a posterior fossa pseudomeningocele. Epidural blood patch is a minimally invasive technique that is underutilized. This paper demonstrates the use of epidural blood patch as an alternative method for treatment of a large suboccipital pseudomeningocele and summarizes the current literature. It is hoped this paper will highlight the epidural blood patch as a potentially effective treatment option that should be considered when managing posterior fossa pseudomeningocele complications prior to escalation to surgical revision.

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“…humans, in and on the cerebral surface and nerves with only few adverse events indicate that its use is safe and well tolerated (4,6,12,15,16,19,22,24,25,27).…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 94%

Minimizing Collateral Brain Injury Using a Protective Layer of Fibrin Glue: Technical Note

et al. 2015

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Natura Abhorret a Vacuo—use of fibrin glue as a filler and sealant in neurosurgical “dead spaces”. Technical note

Cited by 55 publications

References 23 publications

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Epidural blood patch for treatment of a large suboccipital pseudomeningocele

Minimizing Collateral Brain Injury Using a Protective Layer of Fibrin Glue: Technical Note

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