Abstract:
OBJECTIVE:Postcraniotomy subdural empyemas and epidural abscesses are uncommon, potentially lethal, complications of neurosurgery. Patients with these complications may be difficult to manage, and mortality can occur. METHODS:Between 1997 and 2006, the authors treated eight patients with recalcitrant postcraniotomy subdural empyema and epidural abscess with combinations of myocutaneous free flap transfer. The free flap transfer was intended for patients who could not be cured with conventional surgical debridement and bone flap removal. Patient ages ranged from 15 to 67 years (mean, 41.5 yr). There were six men and two women. Treatment was required for cranial base tumors (n = 3), the result of trauma (n = 2), malignant tumors (n = 2), and cerebral hematoma (n = 1). In six patients (75%), an expanded polytetrafluoroethylene sheet was used as a dural substitute at the original surgery. We used three rectus abdominis myocutaneous flaps and five latissimus dorsi myocutaneous flaps. In six patients (75%), surgery was performed in the chronic stage of infection, and the other two patients were in the acute stage of infection. RESULTS:Among all the patients, two failures occurred because of flap ischemia, but these were resolved after an additional procedure. However, one of these two patients, in whom surgery was performed at the acute stage of infection, died 4 weeks after the surgery. The postoperative course of the other six patients was uneventful. Isolated microorganisms were methicillin-resistant Staphylococcus aureus (four patients), Pseudomonas aeruginosa (three patients), and methicillin-sensitive Staphylococcus aureus (one patient). CONCLUSION:Myocutaneous free flap transfer allows sufficient blood circulation and dead space control and is resistant to infection. Therefore, free flap transfer is useful for eliminating intractable empyema and abscess; however, it is important that the procedure be considered in the chronic stage of infection.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Mikami T,Minamida Y,Sugino T,Koyanagi I,Yotsuyanagi T,Houkin Kdoi
10.1227/01.NEU.0000249253.63546.19subject
Has Abstractpub_date
2007-02-01 00:00:00pages
ONS83-7; discussion ONS87-8issue
2 Suppl 1eissn
0148-396Xissn
1524-4040pii
00006123-200702001-00012journal_volume
60pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract:OBJECTIVE AND IMPORTANCE:Median nerve neuropathy can be clinically devastating to a patient. It can be caused by compression of the median nerve anywhere along its course. We present the case of delayed median nerve neuropathy after the placement of a vascular graft in the arm. CLINICAL PRESENTATION:An arm shunt was p...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200202000-00035
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To evaluate possible applications of microsurgical extirpation to arteriovenous malformations (AVMs) involving the brainstem. METHODS:We retrospectively reviewed clinical records of 25 patients with AVMs involving brainstems who were admitted to our institute from 1984 to 2004. We defined a brainstem AVM as ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000210001.75597.81
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:The most important treatment options for meningiomas are microsurgery, radiotherapy, and gamma knife radiosurgery (GKRS). The efficacy of GKRS in terms of local tumor control and tumor volume (TV) reduction can best be determined by accurate analysis of changes in tumor size in pre- and post-GKRS images. In t...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1227/01.NEU.0000279999.95953.EA
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Nimodipine is commonly used to improve neurological outcomes after subarachnoid hemorrhage. Although nimodipine reportedly has high specificity for the cerebral vasculature, adverse systemic effects such as hypotension have been described. This case report describes a patient with traumatic sub...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200011000-00048
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:Atlantoaxial rotatory fixation (AARF) remains a recondite entity. Our normative study using CT motion analysis shows that there is a high degree of concordance for rotational behavior of C1 and C2 in children 0 to 18 years. C1 always crosses C2 at or near 0 degree. The predictable relationship between C1 and ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000365800.94865.D4
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Because of the wide dissemination of malignant glioma cells by the time that malignant glioma is diagnosed, anti-invasive strategies that are designed to limit their further spread may be of little value unless mechanisms of the invasive cascade can be used to render invasive cells susceptible to cytoreductiv...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200202000-00021
更新日期:2002-02-01 00:00:00
abstract::A rat model of cortical vein occlusion by the photochemical thrombotic technique was used to evaluate whether monitoring the change in the local cerebral blood flow (LCBF) could predict brain damage after cortical vein occlusion. The cortical vein occlusion was attained by using the photochemical thrombotic technique,...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199508000-00013
更新日期:1995-08-01 00:00:00
abstract::The clinical characteristics of vertebrobasilar dissecting aneurysms occurring with subarachnoid hemorrhage (SAH) were reviewed in 42 patients, with particular focus on the time, incidence, and outcome in association with subsequent rupture. Twenty-nine patients underwent 31 surgical procedures, and the remaining 13 p...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199505000-00003
更新日期:1995-05-01 00:00:00
abstract::The result of 42 blood volume determinations made with autologous red blood cells labeled with chromium-51 are reported. The subjects consisted of 11 control patients and 25 patients with recent subarachnoid hemorrhage (SAH). The mean red blood cell volume (RBCV) and the total blood volume (TBV) for female patients af...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198409000-00010
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:There has not been any effective prophylaxis for delayed cerebral ischemia delayed cerebral ischemia (DCI) since the introduction of nimodipine. Platelet inhibition may reduce the risk by preventing the formation of microthrombi. Tirofiban has been used as a single monotherapy bridge given its safety profile...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa170
更新日期:2020-10-15 00:00:00
abstract:OBJECTIVE:Craniopagus parasiticus is an extremely rare condition. The first attempt to separate such twins was performed in the Dominican Republic in 2004. The infant died 7 hours after surgery. The aim of this report is to present a case in which surgical separation was successfully performed on February 18, 2005. In ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000245587.23710.A6
更新日期:2006-11-01 00:00:00
abstract::The accessory middle cerebral artery is a rare vascular anomaly of the brain. We describe a case of a ruptured aneurysm at the junction of the accessory middle cerebral artery and the horizontal portion of the anterior cerebral artery. The lesion was demonstrated by angiography and confirmed at surgery. No perforating...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1097/00006123-199002000-00022
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:To determine whether adult human dorsal root ganglion neurons can be isolated and maintained in long-term tissue culture, where they would extend processes. METHODS:Dorsal root ganglia were removed from adult human organ donors within 2 hours of clamping the aorta. They were then treated with enzymes for one...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199803000-00054
更新日期:1998-03-01 00:00:00
abstract::The anatomic reorganization of the subnucleus that controls the stylohyoid muscle (the stylohyoid subnucleus) within the brain stem facial nucleus was studied after regeneration of the facial nerve in adult rats. Horseradish peroxidase was injected into the right stylohyoid muscle 3 to 21 months after transection and ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Brain metastases represent the most common intracranial tumors and are associated with very poor prognosis. OBJECTIVE:To investigate the feasibility, survival, and cerebral disease control of patients with singular brain metastases treated with stereotactic 125iodine brachytherapy (SBT), to identify prognos...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31820b526a
更新日期:2011-05-01 00:00:00
abstract::Microvascular endothelial cells were isolated from gerbil brain and cultured. These cells retained an endothelial-specific marker, FVIII-related antigen. Alkaline phosphatase activity was also present in early passage. Two weeks after plating, these cells were attached to the culture dishes and had become like cobbles...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-198909000-00009
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:To physiologically repair damaged neural circuitry using neural transplantation, the donor cells must be able to differentiate into the optimal type and number of neurons for the host brain environment. They must also be capable of functional regulation by the host brain. These features are important to optim...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000351281.45986.76
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Lumbar discectomy is the most commonly performed spine procedure. Academic spine centers with potentially differing caseloads and experience may have different outcomes. OBJECTIVE:To determine whether the choice of center in which surgery is performed affects lumbar discectomy outcomes. METHODS:Spine Patie...
journal_title:Neurosurgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1227/NEU.0b013e31826772cb
更新日期:2012-10-01 00:00:00
abstract::Between June 1979 and May 1994, I performed 148 unilateral or bilateral sympathectomies on 247 limbs in 110 patients using a percutaneous radiofrequency technique, usually on an outpatient surgery basis. Patient ages ranged from 10 to 81 years, with 45 male and 65 female patients. Four patients had unsuccessfully unde...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To demonstrate the technique of stereotactic microsurgical endoscopic removal of intraventricular tumors or colloid cysts assisted by intraoperative computed tomography. METHODS:We adapted a tubular "ventriculoport" for stereotactic insertion of an endoscope into the ventricle. This facilitated microsurgical...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000146227.75138.08
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To study the distribution of intracranial arachnoid cysts in a large and nonbiased patient population. METHODS:One hundred twenty-six patients with 132 arachnoid cysts were studied. Patients were consecutively referred to our department during a 10-year period from a well-defined geographical area with a sta...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199910000-00008
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to investigate the anatomic relationship between neurovascular structures and the transverse carpal ligament (TCL) so as to avoid complications during an endoscopic carpal tunnel release procedure. METHODS:Fresh cadaver hands from seven men and 12 women (age range, 48-74 yr) were...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000193883.02372.3E
更新日期:2006-02-01 00:00:00
abstract::Visual field abnormalities were studied in a retrospective analysis of 199 patients with epidural hematomas. One hundred three patients had been alert enough at the time of hospital admission to have had their visual fields examined, but in only 27 patients were visual fields documented in the charts. Six of the 27 pa...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198208000-00007
更新日期:1982-08-01 00:00:00
abstract::Having encountered a number of thick-walled or mobile symptomatic intracranial cysts that have resisted stereotactic puncture with standard blunt-ended ventricular catheters, the authors have designed a cyst puncture catheter that has a number of features helpful in overcoming this problem. The catheter and its use ar...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:Intraoperative rupture (IOR) of an aneurysm is a known risk in the surgical management of intracranial aneurysms. The purpose of this study was to determine the incidence of IOR in a modern surgical series and to assess which factors bear upon it. METHODS:This study retrospectively examined 1269 patients wit...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1227/01.neu.0000154697.75300.c2
更新日期:2005-03-01 00:00:00
abstract::Currently, only presumptive diagnosis of chronic traumatic encephalopathy (CTE) can be made in living patients. We present a modality that may be instrumental to the definitive diagnosis of CTE in living patients based on brain autopsy confirmation of [F-18]FDDNP-PET findings in an American football player with CTE. [...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyx536
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To assess the role that neuronavigation plays in assisting endoscopic transsphenoidal reoperations for recurrent pituitary adenomas. METHODS:During a 45-month period, 19 endoscopic endonasal transsphenoidal reoperations were performed for recurrent pituitary adenomas. In 11 of 19 patients, the procedure was ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200207000-00020
更新日期:2002-07-01 00:00:00
abstract::Tumor necrosis factor-alpha (TNF-alpha), a cytokine produced by astrocytes in vivo and in vitro, was tested for its effects on two malignant astrocytoma cell lines (A-172, U-87). Both lines were immunoreactive for glial fibrillary acidic protein, vimentin, Class I antigens, and interleukin-6. The lines differed in the...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199301000-00013
更新日期:1993-01-01 00:00:00
abstract::The current tendency in acoustic neuroma surgery to attempt the preservation of hearing function and the problem of accidental hearing loss caused by microsurgical neurovascular decompression operations for hemifacial spasm or trigeminal neuralgia prompted us to study the exact surgical vulnerability of the auditory s...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198301000-00012
更新日期:1983-01-01 00:00:00
abstract::Artificial intelligence (AI)-facilitated clinical automation is expected to become increasingly prevalent in the near future. AI techniques may permit rapid and detailed analysis of the large quantities of clinical data generated in modern healthcare settings, at a level that is otherwise impossible by humans. Subsequ...
journal_title:Neurosurgery
pub_type: 杂志文章,评审
doi:10.1093/neuros/nyz471
更新日期:2020-07-01 00:00:00