Abstract:
BACKGROUND:In surgical treatment of acute subdural hematoma (ASDH), neurosurgeons frequently encounter bleeding from cortical arteries, which is usually controlled with bipolar coagulation. However, bipolar coagulation is associated with a risk of sacrificing the cortical artery, which may affect the prognosis of neurological symptoms when these cortical arteries supply critical areas. In this article, we describe microsurgical repair of damaged cortical arteries using a 10-0 nylon micro-suture in patients with arterial-origin ASDH. METHODS:After removal of the subdural hematoma, the exact bleeding point of the cortical artery was identified, and the 10-0 nylon suture stitches were placed on the arterial tear under a microscope. After completion of the micro-suture, vascular patency was confirmed by indocyanine green (ICG) videoangiography. RESULTS:From June 2015 through February 2017, microsurgical repair was performed for seven cortical arteries in six patients. All damaged arteries were located near the Sylvian fissure, and all tears were pinhole tears. The average blood flow occlusion time was 8 min (range, 0-15 min). The patency of all seven repaired arteries was successfully confirmed by ICG videoangiography. Postoperative cerebral infarction was not observed except in one patient with cerebral contusion and a history of severe head trauma. CONCLUSIONS:The present report demonstrates that repair of a cortical artery by the 10-0 nylon micro-suture is a simple and safe method with a low risk of sacrificing the artery. This technique may be a good option in the surgical treatment of arterial-origin ASDH, especially when the accompanying cerebral contusion is minimal.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Uneda A,Hirashita K,Yabuno S,Kanda T,Suzuki K,Matsumoto A,Yunoki M,Yoshino Kdoi
10.1007/s00701-018-3634-5subject
Has Abstractpub_date
2018-10-01 00:00:00pages
1931-1937issue
10eissn
0001-6268issn
0942-0940pii
10.1007/s00701-018-3634-5journal_volume
160pub_type
杂志文章abstract:BACKGROUND:Microendoscopic discectomy (MED) is emerging as a minimally invasive alternative to conventional microsurgical discectomy (MSD). EASYGO! is a new system for spinal endoscopy that claims smooth transition from MSD to MED, with a reduced learning curve period. The aims of this study were to describe the compli...
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更新日期:2020-08-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2009-09-01 00:00:00
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更新日期:2017-03-01 00:00:00
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pub_type: 杂志文章
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01842828
更新日期:1990-01-01 00:00:00
abstract::Twenty-three patients with atypical forms of spinal tuberculosis treated between 1975 and 1985, are described. All presented with signs and symptoms of compression of the spinal cord or cauda equina, ranging from paraesthesiae and increasing weakness of extremities to paraplegia and loss of sphincter control. None of ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01400511
更新日期:1987-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-10-01 00:00:00