Arachnoid Membrane Suturing for Prevention of Subdural Fluid Collection in Extracranial-intracranial Bypass Surgery
Journal of Cerebrovascular and Endovascular Neurosurgery
;
: 71-77, 2014.
Article
in English
| WPRIM
| ID: wpr-162352
ABSTRACT
OBJECTIVE:
Water-tight closure of the dura in extracranial-intracranial (EC-IC) bypass is impossible because the superficial temporal artery (STA) must run through the dural defect. Consequently, subdural hygroma and subcutaneous cerebrospinal fluid (CSF) collection frequently occur postoperatively. To reduce these complications, we prospectively performed suturing of the arachnoid membrane after STA-middle cerebral artery (STA-MCA) and evaluated the clinical usefulness. MATERIALS ANDMETHODS:
Between Mar. 2005 and Oct. 2010, extracranial-intracranial arterial bypass (EIAB) with/without encephalo-myo-synangiosis was performed in 88 cases (male female = 53 35). As a control group, 51 patients (57 sides) underwent conventional bypass surgery without closure of the arachnoid membrane. Postoperative computed tomography (CT) scan was performed twice in three days and seven days later, respectively, for evaluation of the presence of subdural fluid collection and other mass lesions.RESULTS:
The surgical result was excellent, with no newly developing ischemic event until recent follow-up. The additional time needed for arachnoid suture was five to ten minutes, when three to eight sutures were required. Post-operative subdural fluid collection was not seen on follow-up computed tomography scans in all patients.CONCLUSION:
Arachnoid suturing is simple, safe, and effective for prevention of subdural fluid collection in EC-IC bypass surgery, especially the vulnerable ischemic hemisphere.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Arachnoid
/
Subdural Effusion
/
Sutures
/
Temporal Arteries
/
Cerebral Arteries
/
Cerebral Revascularization
/
Cerebrospinal Fluid
/
Prospective Studies
/
Follow-Up Studies
/
Membranes
Type of study:
Observational study
/
Prognostic study
Limits:
Female
/
Humans
Language:
English
Journal:
Journal of Cerebrovascular and Endovascular Neurosurgery
Year:
2014
Type:
Article
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