ABSTRACT
This report describes five cases of cerebrospinal fluid(CSF) rhinorrhea which were caused by head injury in four cases and developed after surgical removal of brain tumor in one case. Intrathecally-enhanced brain computerized tomography(CT) with metrizamide, in addition to isotope cisternography, was helpful in localization of the CSF leakage site. All five cases which could not be managed conservatively were successfully repaired by surgical means using biological fibrin glue.
Subject(s)
Brain , Brain Neoplasms , Cerebrospinal Fluid Rhinorrhea , Cerebrospinal Fluid , Craniocerebral Trauma , Fibrin Tissue Adhesive , MetrizamideABSTRACT
Anastomosis of rat common carotid artery was performed by applying four crossed-fixing sutures and by mantling with human fibrinogen-thrombin glue. There was a 97% patency rate 24 hours after surgery, and the anastomosed vessels were still patent on the 7th and 30th postoperative days. Aneurysm formation was absent but stenotic change was seen to 1 case of 8 angiographic studies. Histopathological studies of microvascular anastomosis showed that this surgical technique of anastomosis has certain advantages, namely that it reduces the number of sutures needed, is less traumatic to the vascular wall, ensures elastic vascular junction, and the glue used possess high biological inertness that provides a better physiological connection of vessels than conventional suturing. The duration of the clipping and the operation is significantly reduced. A tensile strength test 24 hours following operation and 1 week later showed that this anastomosis was significantly better than that achieved with the usual manual suture method. The author therefore concludes that this new surgical technique of microvascular anastomosis may be valuable in microvascular neurosurgery.