Search results for "Dura mater"
showing 10 items of 31 documents
Risk factors for incidental durotomy during posterior open spine surgery for degenerative diseases in adults: A multicenter observational study.
2017
Incidental durotomy (ID) is a common intraoperative complication of spine surgery. It can lead to persistent cerebrospinal fluid leakage, which may cause serious complications, including severe headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. As a result, it contributes to higher healthcare costs and poor patient outcomes. The purpose of this study was to clarify the independent risk factors that can cause ID during posterior open spine surgery for degenerative diseases in adults. We conducted a prospective multicenter study of adult patients who underwent posterior open spine surgery for degenerative diseases at 10 participating hospitals from July…
Temporobasal, Transsphenoidal Meningoencephalocele Becoming Symptomatic with Spontaneous Cerebrospinal Fluid Rhinorrhea: Diagnostic Work-up and Micro…
2012
Background We report the rare case of an adult transsphenoidal meningoencephalocele and outline the microneurosurgical strategy. Clinical history, the findings of computerized tomography (CT) scans and magnetic resonance imaging (MRI), the microsurgical procedure, and histopathology are reported. Case Report A 54-year-old female patient complained about cerebrospinal fluid (CSF) rhinorrhea; a transnasal biopsy of a mass in the maxillar sinus prior to diagnostic work-up was performed elsewhere. Persisting CSF leakage prompted CT and MRI, which showed brain tissue extending from the left middle cranial fossa into the left sphenoid sinus through several bony defects. The diagnosis of a trans…
Microsurgical fenestration of perineural cysts to the thecal sac at the level of the distal dural sleeve
2011
Background Surgery for symptomatic sacral perineural cysts remains an issue of discussion. Assuming micro-communications between the cyst and thecal sac resulting in a valve mechanism and trapping of CSF as a pathomechanism, microsurgical fenestration from the cyst to the thecal sac was performed to achieve free CSF communication. Methods In 13 consecutive patients (10 female, 3 male), MRI revealed sacral perineural cysts and excluded other pathologies. Micro-communication between the thecal sac and the cysts was shown by delayed contrast filling of the cysts on postmyelographic CT. Surgical fenestration achieved free CSF communication between the thecal sac and cysts in all patients. The p…
Functional characterization of the dural sinuses as a neuroimmune interface
2021
Summary Despite the established dogma of central nervous system (CNS) immune privilege, neuroimmune interactions play an active role in diverse neurological disorders. However, the precise mechanisms underlying CNS immune surveillance remain elusive; particularly, the anatomical sites where peripheral adaptive immunity can sample CNS-derived antigens and the cellular and molecular mediators orchestrating this surveillance. Here, we demonstrate that CNS-derived antigens in the cerebrospinal fluid (CSF) accumulate around the dural sinuses, are captured by local antigen-presenting cells, and are presented to patrolling T cells. This surveillance is enabled by endothelial and mural cells formin…
Endoscopic dissection of dura and craniotomy with minimal trephines: a preliminary series.
1998
The first nine clinical cases using endoscopic dissection of dura and craniotomy with minimal trephines were performed from June to August 1997 after trial dissection of 19 fresh cadavers conducted at the University of Brno's Pathology Institute in the Czech Republic. These procedures involved the refinement of craniofacial and intracranial surgical techniques using the endoscope and prototype instruments. These dissections demonstrated that intracranial structures can be explored using an endoscope without encumbrance, and that major craniofacial surgeries may also be performed with minor incisions and minimal craniotomies. Furthermore, we seek to illustrate that use of the endoscope in cr…
Assistance of intraoperative microvascular Doppler in the surgical obliteration of spinal dural arteriovenous fistula: cases description and technica…
2003
BACKGROUND: Intraoperative microvascular Doppler may be valuable in assisting in the surgical obliteration of dural arteriovenous fistula of the spinal cord. It enables identification, through flow spectrum analysis, of the anatomic components and haemodynamic features of this type of vascular malformation. METHODS: In two cases, intraoperative microvascular Doppler was used to assist in the surgical obliteration of dural arteriovenous fistula of the spinal cord. The fistulas were identified prior to the dura opening, and for this only minimally invasive surgery was required. Direct recordings of the arterialised draining vein and the nidus of the fistula demonstrated a pathological spectru…
Ultrastructure of Spinal Dura Mater
2014
Pia mater is the innermost of the three meningeal membranes, closely surrounding the brain, the spinal cord, and the portion of spinal nerve roots extending towards their exit across the dura mater. A cellular layer and a subpial compartment shape the structure of the pia mater. The cellular layer is made up of flat, overlapping pial cells with amorphous, fundamental substance interposed among them. The surface of the cellular plane appears smooth and bright under scanning electron microscopy (SEM). Transmission electron microscopy shows that the cellular component is about three to five pial cells thick at the medullary level and two to three cells thick at the level of the nerve roots. Th…
The termination of the vein of ?Labb�? and its microsurgical significance
1992
Information about the termination of the inferior anastomotic vein of Labbé is of crucial importance in the subtemporal neurosurgical approach and its modifications. An intradural course has been observed in all cases. The vein of Labbé reaches in 3/4th the anterior third of the transverse sinus, in 73% of all cases tracing a so-called tentorial sinus. By dissecting the vein of Labbé out of its dural bed and shifting its fixation point, microsurgical access is facilitated considerably.
Experimental study on the free transplantation of mucosa and lyophilised dura to the oral cavity
1978
Summary The covering of epithelial defects in the oral cavity presents special problems in preprosthetic surgery, since special requisites for function and quality of mucosal grafts must be satisfied. In animal experiments mucosal defects in the oral cavity of 30 rabbits were repaired with free transplants of autologous mucosa and heterologous lyophilised dura. A comparative clinical and histological assessment of the healing processes showed that there was no essential difference between both methods. Considering the necessary second intervention, the infliction of a second wound, as well as the limited source of mucosa, our results show that the use of lyophilised dura in preprosthetic su…
Dural splitting reconstruction in retethering after lipomeningocele repair: Technical note
2021
Background: Tethered spinal cord syndrome (TCS) can occur after the surgical repair of lipomeningoceles (LMCs). In these cases, the tethering results from postoperative adhesions between the spinal cord and the overlying repaired dura. A watertight dural closure using the residual dura and/or the surrounding tissues does not always provide enough space for the spinal cord and risks retethering. Here, we report a 16-year-old patient with secondary TCS following lipomeningocele repair who successfully underwent release of the tethered filum terminale utilizing a novel dural splitting reconstructive technique to attain a water-tight closure without the need for a duroplasty. Methods: A 16-yea…