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Cortical gluing and Ringer lactate solution inflation to avoid cortical mantle collapse and subdural fluid collections in pediatric neurosurgery: safety and feasibility

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Abstract

Introduction

Subdural fluid collections following intraventricular and/or paraventricular procedures in pediatric neurosurgery are common and can be hard to treat. We describe our technique to close cortical defects by the aid of a fibrin adhesive and subsequent Ringer inflation with the aim to avoid cortical mantle collapse and to prevent the development of subdural fluid collections.

Materials and methods

We report the preliminary results of a prospective study on a consecutive series of 29 children who underwent 37 transcortical or transcallosal surgical procedures since 2008 in our department.

Results

In 17 procedures, we performed a transcortical approach on lesions, and in other 19 operations, we operated by a transcallosal. In 5/17 transcortical approaches (29 %) and in 3/20 transcallosal approaches (15 %), we observed a 5-mm-thick subdural fluid collection of the 5 patients with subdural fluid collections in the transcortical group, 3 patients (17 %) underwent surgery for symptomatic or progressive subdural fluid collections. Of the 3 patients in the transcallosal group, a subduro-peritoneal shunt was necessary only for 1 patient (5 %). At the very end of the treatment (including chemotherapy and radiotherapy), it was possible to remove the subduro-peritoneal shunt in all these patients because of disappearance of the subdural fluid collections.

Conclusion

In pediatric patients after transcortical or transcallosal procedures, the use of a fibrin adhesive to seal surgical opening and subsequent inflation of the residual cavity with Ringer lactate solution to avoid cortical mantle collapse seems safe and appears to prevent the development of subdural fluid collections.

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References

  1. Boyd MC, Steinbok P (1987) Choroid plexus tumors: problems in diagnosis and management. J Neurosurg 66:800–805

    Article  CAS  PubMed  Google Scholar 

  2. Delalande O, Bulteau C, Dellatolas G et al (2007) Vertical parasagittal hemispherotomy: surgical procedures and clinical long-term outcomes in a population of 83 children. Neurosurgery 60(2 Suppl 1):ONS19–ONS32, discussion ONS32

    PubMed  Google Scholar 

  3. Koos WT, Perneczky A, Horaczek A (1985) Problems of neurosurgical technique for the treatment of supratentorial midline tumors in children. Acta Neurochir Suppl 35:31–41

    CAS  PubMed  Google Scholar 

  4. Morita A, Kelly PJ (1993) Resection of intraventricular tumors via a computer-assisted volumetric stereotactic approach. Neurosurgery 32:920–927

    Article  CAS  PubMed  Google Scholar 

  5. Pencalet P, Sainte-Rose C, Lellouch-Tubiana A et al (1998) Papillomas and carcinomas of the choroid plexus in children. J Neurosurg 88:521–528

    Article  CAS  PubMed  Google Scholar 

  6. Tanaka Y, Mizuro M, Kobayashi S et al (1987) Subdural fluid collection following craniotomy. Surg Neurol 27:353–356

    Article  CAS  PubMed  Google Scholar 

  7. Tanaka Y, Sugita K, Kobayashi S et al (1989) Subdural fluid collections following transcortical approach to intra- or paraventricular ntumours. Acta Neurochir 99:20–25

    Article  CAS  PubMed  Google Scholar 

  8. Tomita T, McLone DG, Flannery AM (1988) Choroid plexus papillomas of neonates, infants, and children. Pediatr Neurosci 14:23–30

    Article  CAS  PubMed  Google Scholar 

  9. Al-Yamani M, Del Maestro RF (2000) Prevention of subdural fluid collections following transcortical intraventricular and/or paraventricular procedures by using fibrin adhesive. J Neurosurg 92:406–412

    Article  Google Scholar 

  10. Cedzich C, Kaden B, Schramm J (1992) Pre- and post-operative hydrocephalus in supratentorial intraventricular tumours. Acta Neurochir 114:33–35

    Article  CAS  PubMed  Google Scholar 

  11. Hirsch JF, Sainte-Rose C (1991) A new surgical approach to subcortical lesions: balloon inflation and cortical gluing. Technical note. J Neurosurg 74(6):1014–1017

    Article  CAS  PubMed  Google Scholar 

  12. Milhorat TH (1971) Closure of cerebral incisions following intraventricular operations. Technical note. J Neurosurg 35:108–111

    Article  CAS  PubMed  Google Scholar 

  13. Davidoff LM, Feiring EH (1953) Subdural hematoma occurring insurgically treated hydrocephalic children. With a note on a method of handling persistent accumulations. J Neurosurg 10:557–563

    Article  CAS  PubMed  Google Scholar 

  14. Hoppe-Hirsh E, Sainte Rose C, Renier D et al (1987) Pericerebral collections after shunting. Childs Nerv Syst 3:97–102

    Article  Google Scholar 

  15. Koizumi H, Fukamachi A, Nukui H (1987) Postoperative subdural fluid collections in neurosurgery. Surg Neurol 27:147–153

    Article  CAS  PubMed  Google Scholar 

  16. Bertelli JA, Mira JC (1993) Nerve repair using freezing and fibrin glue: immediate histologic improvement of axonal coaptation. Microsurgery 14:135–140

    Article  CAS  PubMed  Google Scholar 

  17. Fujimura M, Sugawara T, Seki H et al. Perivascular coating with fibrin glue of cerebral arteries in patients with aneurysmal subarachnoid hemorrhage: incidence of chronic hydrocephalus. Tohoku J Exp Med 179(4):267–72

  18. Lee KC, Park SK, Lee KS (1991) Neurosurgical application of fibrin adhesive. Yonsei Med J 32:53–57, 267–272, 1996

    Article  CAS  PubMed  Google Scholar 

  19. Pomeranz S, Constantini S, Umansky F (1991) The use of fibrin sealant in cerebrospinal fluid leakage. Neurochirurgia 34:166–169

    CAS  PubMed  Google Scholar 

  20. Shaffrey CI, Spotnitz WD, Shaffrey ME et al (1990) Neurosurgical applications of fibrin glue: augmentation of dural closure in 134 patients. Neurosurgery 26:207–210

    Article  CAS  PubMed  Google Scholar 

  21. Bänninger H, Hardegger T, Tobler A et al (1993) Fibrin glue in surgery: frequent development of inhibitors of bovine thrombin and human factor V. Br J Haematol 85:528–532

    Article  PubMed  Google Scholar 

  22. Ghulam Muhammad AK, Yoshimine T, Maruno M et al (1997) Topical application of fibrin adhesive in the rat brain: effect of different cellular elements of the wound. Neurol Res 19:84–88

    CAS  PubMed  Google Scholar 

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Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Correspondence to Giuseppe Mirone.

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Mirone, G., Ruggiero, C., Spennato, P. et al. Cortical gluing and Ringer lactate solution inflation to avoid cortical mantle collapse and subdural fluid collections in pediatric neurosurgery: safety and feasibility. Childs Nerv Syst 31, 945–951 (2015). https://doi.org/10.1007/s00381-015-2660-3

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  • DOI: https://doi.org/10.1007/s00381-015-2660-3

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