Free flap transfer for the treatment of intractable postcraniotomy subdural empyemas and epidural abscesses.

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

Neurosurgery

journal_title

Neurosurgery

authors

Mikami T,Minamida Y,Sugino T,Koyanagi I,Yotsuyanagi T,Houkin K

doi

10.1227/01.NEU.0000249253.63546.19

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

ONS83-7; discussion ONS87-8

issue

2 Suppl 1

eissn

0148-396X

issn

1524-4040

pii

00006123-200702001-00012

journal_volume

60

pub_type

杂志文章
  • Postoperative edema after vascular access causing nerve compression secondary to the presence of a perineuronal lipoma: case report.

    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

    authors: Goldstein LJ,Helfend LK,Kordestani RK

    更新日期:2002-02-01 00:00:00

  • Surgical applications to arteriovenous malformations involving the brainstem.

    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

    authors: Nozaki K,Hashimoto N,Kikuta K,Takagi Y,Kikuchi H

    更新日期:2006-04-01 00:00:00

  • Volumetric follow-up of meningiomas: a quantitative method to evaluate treatment outcome of gamma knife radiosurgery.

    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

    authors: Feigl GC,Samii M,Horstmann GA

    更新日期:2007-08-01 00:00:00

  • Nimodipine-induced acute hypoxemia: case report.

    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

    authors: Devlin JW,Coplin WM,Murry KR,Rengachary SS,Wilson RF

    更新日期:2000-11-01 00:00:00

  • Atlantoaxial rotatory fixation.

    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

    authors: Pang D

    更新日期:2010-03-01 00:00:00

  • Thromboxane synthase inhibitors induce apoptosis in migration-arrested glioma cells.

    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

    authors: Yoshizato K,Zapf S,Westphal M,Berens ME,Giese A

    更新日期:2002-02-01 00:00:00

  • Use of local cerebral blood flow monitoring to predict brain damage after disturbance to the venous circulation: cortical vein occlusion model by photochemical dye.

    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

    authors: Nakase H,Kakizaki T,Miyamoto K,Hiramatsu K,Sakaki T

    更新日期:1995-08-01 00:00:00

  • Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms.

    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

    authors: Mizutani T,Aruga T,Kirino T,Miki Y,Saito I,Tsuchida T

    更新日期:1995-05-01 00:00:00

  • Depression of circulating blood volume in patients after subarachnoid hemorrhage: implications for the management of symptomatic vasospasm.

    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

    authors: Solomon RA,Post KD,McMurtry JG 3rd

    更新日期:1984-09-01 00:00:00

  • Tirofiban Protocol Protects Against Delayed Cerebral Ischemia: A Case-Series Study.

    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

    authors: Zanaty M,Osorno-Cruz C,Byer S,Roa JA,Limaye K,Ishii D,Nakagawa D,Torner J,Yongjun L,Ortega-Gutiérrez S,Samaniego EA,Allan L,Hasan D

    更新日期:2020-10-15 00:00:00

  • Successful separation of craniopagus parasiticus.

    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

    authors: Lotfy M,Sakr SA,Ayoub BM

    更新日期:2006-11-01 00:00:00

  • Ruptured aneurysm at the origin of the accessory middle cerebral artery: case report.

    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

    authors: Kuwabara S,Naitoh H

    更新日期:1990-02-01 00:00:00

  • Isolation and long-term survival of adult human sensory neurons in vitro.

    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

    authors: Sosa IJ,Reyes O,Inserni J,Kuffler DP

    更新日期:1998-03-01 00:00:00

  • Quantitative, morphological, and somatotopic nuclear changes after facial nerve regeneration in adult rats: a possible challenge to the "no new neurons" dogma.

    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:

    authors: Fernandez E,Pallini R,Marchese E,Lauretti L,La Marca F

    更新日期:1995-09-01 00:00:00

  • Stereotactic 125iodine brachytherapy for the treatment of singular brain metastases: closing a gap?

    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

    authors: Ruge MI,Suchorska B,Maarouf M,Runge M,Treuer H,Voges J,Sturm V

    更新日期:2011-05-01 00:00:00

  • Effects of cytokines on cultured microvascular endothelial cells derived from gerbil brain.

    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

    authors: Yoshida S,Minakawa T,Takai N,Tanaka R

    更新日期:1989-09-01 00:00:00

  • Environmental cue-dependent dopaminergic neuronal differentiation and functional effect of grafted neuroepithelial stem cells in parkinsonian brain.

    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

    authors: Mine Y,Hayashi T,Yamada M,Okano H,Kawase T

    更新日期:2009-10-01 00:00:00

  • Spine patient outcomes research trial: do outcomes vary across centers for surgery for lumbar disc herniation?

    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

    authors: Desai A,Bekelis K,Ball PA,Lurie J,Mirza SK,Tosteson TD,Zhao W,Weinstein JN

    更新日期:2012-10-01 00:00:00

  • Percutaneous radiofrequency upper thoracic sympathectomy.

    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:

    authors: Wilkinson HA

    更新日期:1996-04-01 00:00:00

  • Microsurgical removal of intraventricular lesions using endoscopic visualization and stereotactic guidance.

    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

    authors: Harris AE,Hadjipanayis CG,Lunsford LD,Lunsford AK,Kassam AB

    更新日期:2005-01-01 00:00:00

  • Peculiarities of intracranial arachnoid cysts: location, sidedness, and sex distribution in 126 consecutive patients.

    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

    authors: Wester K

    更新日期:1999-10-01 00:00:00

  • Anatomy of neurovascular structures around the carpal tunnel during dynamic wrist motion for endoscopic carpal tunnel release.

    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

    authors: Hong JT,Lee SW,Han SH,Son BC,Sung JH,Park CK,Park CK,Kang JK,Kim MC

    更新日期:2006-02-01 00:00:00

  • Hemianopia: a presenting feature of acute epidural hematomas.

    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

    authors: Matwijecky C,Steinbok P

    更新日期:1982-08-01 00:00:00

  • A special cyst puncture catheter for use in thick-walled or mobile intracranial cysts.

    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:

    authors: Ross DA,Muraszko K,Dauser R

    更新日期:1994-01-01 00:00:00

  • Analysis of intraoperative rupture in the surgical treatment of 1694 saccular aneurysms.

    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

    authors: Leipzig TJ,Morgan J,Horner TG,Payner T,Redelman K,Johnson CS

    更新日期:2005-03-01 00:00:00

  • Postmortem Autopsy-Confirmation of Antemortem [F-18]FDDNP-PET Scans in a Football Player With Chronic Traumatic Encephalopathy.

    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

    authors: Omalu B,Small GW,Bailes J,Ercoli LM,Merrill DA,Wong KP,Huang SC,Satyamurthy N,Hammers JL,Lee J,Fitzsimmons RP,Barrio JR

    更新日期:2018-02-01 00:00:00

  • Image-guided endoscopic transnasal removal of recurrent pituitary adenomas.

    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

    authors: Lasio G,Ferroli P,Felisati G,Broggi G

    更新日期:2002-07-01 00:00:00

  • Differential effects of tumor necrosis factor-alpha on proliferation, cell surface antigen expression, and cytokine interactions in malignant gliomas.

    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

    authors: Chen TC,Hinton DR,Apuzzo ML,Hofman FM

    更新日期:1993-01-01 00:00:00

  • Changes of the auditory system after cerebellopontine angle manipulations.

    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

    authors: Sekiya T,Iwabuchi T,Andoh A,Kamata S

    更新日期:1983-01-01 00:00:00

  • Promises and Perils of Artificial Intelligence in Neurosurgery.

    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

    authors: Panesar SS,Kliot M,Parrish R,Fernandez-Miranda J,Cagle Y,Britz GW

    更新日期:2020-07-01 00:00:00