Urgent Reoperation for Major Regional Complications After Removal of Intracranial Tumors: Outcome and Prognostic Factors in 100 Consecutive Cases

Chernov, Mikhail; Ivanov, Pavel

doi:10.2176/nmc.47.243

Cited by 14 publications

(9 citation statements)

References 19 publications

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“…In neurosurgery, in particular, hemorrhage can lead to devastating consequences for the patient [1–3] because of the limited possibility of spontaneous drainage of the blood and the impairment of the surgeon's view.…”

Section: Introductionmentioning

confidence: 99%

The Platelet Function Analyzer (PFA-100) as a Screening Tool in Neurosurgery

et al. 2012

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We investigated whether the inclusion of the PFA-100 in the preoperative screening of neurosurgical patients might reduce perioperative bleeding complications. Patients with intracranial space-occupying lesions who were scheduled for neurosurgery underwent routine preoperative PFA-100 testing. In case of an abnormal PFA test, patients received prophylactic treatment with desmopressin. 93 consecutive patients were compared to 102 consecutive patients with comparable characteristics operated before introduction of the PFA-100 testing. 2 patients (2.2%) in the PFA group and 2 patients (2.0%) in the non-PFA group experienced clinically relevant intracranial bleeding confirmed by computed tomography (OR 1.05, 95% CI 0.39–2.82; P = 1.0). Transfusions were not significantly different between the two groups. 13 (14.0%) patients in the PFA group and 5 (4.9%) patients in the non-PFA group received desmopressin (OR 3.2, 95% CI 1.1–9.2; P = 0.045). Preoperative screening with the PFA-100 did result in a significant increase in the administration of desmopressin, which could not reduce perioperative bleeding complications or transfusions.

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Section: Introductionmentioning

confidence: 99%

The Platelet Function Analyzer (PFA-100) as a Screening Tool in Neurosurgery

et al. 2012

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“…Yet when it happens it can still be fatal and requires urgent management, and it is also one of the major causes of urgent re-operation during the 1 st week after tumor resection. Prompt craniotomy surgery used to be recommended for abundant or continuous hemorrhage, sometimes with decompressive craniotomy for those with severe intracranial hypertension [7,8]. However, the craniotomy may cause further ICP fluctuation, forming an evil circle till out of control.…”

Section: Discussionmentioning

confidence: 99%

Vaccum drainage system application in the management of operation-related non-regional epidural hematoma

Cheng

et al. 2013

Ann Surg Innov Res

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BackgroundEpidural intracranial hematoma is one of the most common complications of surgeries for intracranial tumors. The non-regional epidural hematoma is related to severe fluctuation of the intracranial pressure during the operation. The traditional management of hematoma evacuation through craniotomy is time-consuming and may aggravate intracranial pressure imbalance, which causes further complications. We designed a method using vaccum epidural drainage system, and tried to evaluate advantage and the disadvantage of this new technique.MethodsSeven patients of intracranial tumors were selected. All of the patients received tumor resection and intra-operative non-regional epidural hematoma was confirmed through intra-operative ultrasound or CT scan. The vaccum drainage system was applied. Another ten patients who received craniotomy for intra-operative non-regional epidural hematoma evacuation were selected as comparison. Regular tests, like serial CT scan, were performed afterward to evaluate the effectiveness and to help deciding when to remove the drainage system.ResultsThe vaccum drainage method was effective in epidual hemotoma clearance and prevented recurrent epidural hemorrhage. The drainage systems were removed within 4 days. All of the patients recovered well. No complications related to the drainage system were observed.ConclusionsCompared to the traditional craniotomy, the new method of epidural hemoatoma management using vaccum epidural drainage system proved to be as effective in hematoma clearance, and was less-invasive and easier to perform, with less complication, shorter hospitalization, less economic burden, and better prognosis.

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“…The most feared complications after craniotomy are intracranial hematoma formation on the surgical site and cerebral edema as a result of surgical trauma, leading to an increase in intracranial pressure. (5)(6)(7)(8)(9)(10) The performance of a bedside neurological examination is one of the possible evaluations for early detection of intracranial hypertension.…”

Section: %mentioning

confidence: 99%

“…It is important to highlight that most hematomas appear in less than six hours after surgery, with quick and progressive neurological deterioration. (7,(14)(15)(16) At this moment of the postoperative period, patients can be under the residual effect of anesthesia, which hampers the assessment of consciousness. In the presence of a severe periorbital edema, it is not possible to perform pupil examination.…”

Section: %mentioning

confidence: 99%

Interferência e características do edema periorbital no exame pupilar após craniotomia

2015

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Objective: To assess the interference and the characteristics of periorbital edema in pupil examination with patients who underwent anterior craniotomy. Methods: Prospective cohort study conducted postoperatively in an intensive care unit and neurosurgery ward. Interference and characteristics of periorbital edema in pupil examination were assessed between patients' admission and the seventh day of the postoperative period. Pupil examination was performed by nurses. Results: One hundred patients were examined and the incidence of periorbital edema was 80%. Pupil examination was not performed by a nurse in 24 patients (30%). The characteristics that influenced the performance of pupil examination were purplish coloration and severe periorbital edema. Conclusion: Periorbital edema was found in most postoperative craniotomy patients and pupil examination was not performed in 30% of them. The presence of severe periorbital edema and purplish coloration were the factors that hampered pupil examination. ResumoObjetivo: Avaliar a interferência e características do edema periorbital no exame pupilar, em pacientes submetidos a craniotomia por via anterior. Métodos: Estudo de coorte prospectivo realizado em pacientes no pós-operatório na unidade de terapia intensiva e internação de neurocirurgia. A interferência e características do edema periorbital no exame pupilar foram avaliados da admissão do paciente até sétimo dia de pós-operatório. O exame pupilar foi realizado por enfermeiros. Resultados: Foram avaliados 100 pacientes e a incidência de edema periorbital foi de 80%. O enfermeiro não realizou o exame pupilar em 24 (30%) pacientes. As características que influenciaram na realização do exame pupilar foram coloração arroxeada e intenso edema periorbital. Conclusão: O edema periorbital estava presente na maioria dos pacientes no pós-operatório de craniotomia e o exame pupilar não foi realizado em 30% dos pacientes. A presença de intenso edema periorbital e de coloração arroxeada foram características que prejudicaram o exame pupilar.

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Urgent Reoperation for Major Regional Complications After Removal of Intracranial Tumors: Outcome and Prognostic Factors in 100 Consecutive Cases

Cited by 14 publications

References 19 publications

The Platelet Function Analyzer (PFA-100) as a Screening Tool in Neurosurgery

The Platelet Function Analyzer (PFA-100) as a Screening Tool in Neurosurgery

Vaccum drainage system application in the management of operation-related non-regional epidural hematoma

Interferência e características do edema periorbital no exame pupilar após craniotomia

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