{"title":"Surgical technique for a cystic-type metastatic brain tumor: transformation to a solid-type tumor using hydrofiber dressing","authors":"Takeshi Okuda MD , Yoshifumi Teramoto MD , Haruki Yugami MD , Kazuo Kataoka MD , Amami Kato MD","doi":"10.1016/j.surneu.2009.07.045","DOIUrl":"10.1016/j.surneu.2009.07.045","url":null,"abstract":"<div><h3>Background</h3><p>Many metastatic brain tumors have a distinct border with normal brain tissue, which facilitates tumor removal. However, residual tumor tissue may be present after surgery when metastatic brain tumors are of cystic type. We have developed a method using hydrofiber dressing to transform cystic-type into solid-type tumors.</p></div><div><h3>Methods</h3><p>Hydrofiber dressing is a sodium carboxymethylcellulose hydrocolloid polymer with high fluid-absorptive capacity. This material was originally used as a dressing for exudative wounds. Hydrofiber dressing was used for 8 patients with cystic-type metastatic brain tumor. Tumor removal was performed after hydrofiber dressing was inserted into the cyst cavity to transform the tumor into a solid-type tumor.</p></div><div><h3>Results</h3><p>Transformation of cystic-type metastatic brain tumors into smaller solid-type tumors using hydrofiber dressing facilitated en bloc resection of tumor. The dressing also absorbed residual cyst fluid and was thus also effective in preventing intraoperative dissemination of tumor cells. This approach enabled ideal en bloc resection in all patients. There were no adverse events.</p></div><div><h3>Conclusions</h3><p>These findings suggest hydrofiber dressing may be useful in surgery for cystic-type metastatic brain tumors.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 703-706"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.07.045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28441283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A rabbit model for efficacy evaluation of endovascular coil materials","authors":"Masaki Ebara MD , Ichiro Yuki MD , Yuichi Murayama MD , Takayuki Saguchi MD , Yih-Lin Nien MD , Harry V. Vinters MD , Fernando Vinuela MD , Toshiaki Abe MD","doi":"10.1016/j.surneu.2009.04.017","DOIUrl":"10.1016/j.surneu.2009.04.017","url":null,"abstract":"<div><h3>Background</h3><p>To investigate biomaterials seeking for their possible use for aneurysm treatment, in vivo screening tests using a number of potential materials are required. However, there is no established animal model that is suitable for such purpose. Some models require special preparation of tested materials for transcatheter delivery and others are inappropriate in view of their cost-effectiveness. The purpose of this study is to establish an animal model that overcomes these limitations and help us select potential materials before the preclinical evaluation.</p></div><div><h3>Methods</h3><p>Bilateral CCAs in a rabbit were surgically ligated, and a 2-cm segment of either a bare platinum coil or a polymeric coil (a platinum coil coated with PLGA 10/90) was implanted into each blind-ended arterial segment (n = 26). They were harvested at day 1, 7, 10, 14, or 30, respectively. Angiographic and histologic evaluations as well as quantitative analysis on the development of the organized thrombus were performed.</p></div><div><h3>Results</h3><p>One day after the implantation, both platinum and PLGA coils were surrounded by immature thrombus that was induced by blood flow stagnation in the arterial segment. At day 7, minimal thrombus organization was observed around both types of materials. At postimplantation days 10 and 14, fibrocellular responses, the early findings of the thrombus organization process, were observed in both material groups. Such histologic findings were more prominent in the PLGA coil group as compared to the platinum coil group (day 10, <em>P</em> = .051; day 14, <em>P</em> = .011). Well-organized thrombus was observed in both material groups at day 30 without showing statistical difference (<em>P</em> = .12).</p></div><div><h3>Conclusion</h3><p>Given the cost-effectiveness, the simple material preparation process, and its feasible histologic evaluation methods, this new animal model can be useful in screening other potential biomaterials for the development of new coil devices.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 620-627"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.04.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28654349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical NeurologyPub Date : 2009-12-01Epub Date: 2009-03-29DOI: 10.1016/j.surneu.2008.12.008
Jon Olabe MD, Javier Olabe MD, PhD
{"title":"Microsurgical training on an in vitro chicken wing infusion model","authors":"Jon Olabe MD, Javier Olabe MD, PhD","doi":"10.1016/j.surneu.2008.12.008","DOIUrl":"10.1016/j.surneu.2008.12.008","url":null,"abstract":"<div><h3>Background</h3><p>Microneurovascular anastomosis and aneurysm clipping require extensive training before mastering the technique and are a surgical challenge. We developed the “infused chicken wing method” to provide a simple but realistic training method minimizing animal use and need for special facilities for animal care and anesthesia.</p></div><div><h3>Methods</h3><p>Fresh chicken wings were used in this model. The main brachial artery was cannulated, and water was infused at 140 mm Hg followed by anatomical neurovascular dissection. Multiple microsurgical training exercises were performed under microscope vision including terminoterminal, lateroterminal, laterolateral vascular anastomosis, and nerve anastomosis. Different complexity aneurysms were created using venous patches, clipping, rupture, and vascular reconstruction techniques were performed.</p></div><div><h3>Results</h3><p>This novel training model is inexpensive, easily obtainable, and no live animals are required. The diameter and characteristics of arteries and veins used are similar to those of the human brain. Great microsurgical technique progress may be obtained.</p></div><div><h3>Conclusions</h3><p>The infused chicken wing artery model presents a realistic microvascular training method. It is inexpensive and easy to set up. Such simplicity provides the adequate environment for developing microsurgical technique.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 695-699"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2008.12.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28079789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical NeurologyPub Date : 2009-12-01Epub Date: 2009-07-14DOI: 10.1016/j.surneu.2009.05.015
Jamie J. Van Gompel MD , Yasin A. Khan BSc , Eric L. Bloomfield MD , John F. Pallanch MD , John L.D. Atkinson MD
{"title":"Rhabdomyolysis after transnasal repair of anterior basal encephalocele","authors":"Jamie J. Van Gompel MD , Yasin A. Khan BSc , Eric L. Bloomfield MD , John F. Pallanch MD , John L.D. Atkinson MD","doi":"10.1016/j.surneu.2009.05.015","DOIUrl":"10.1016/j.surneu.2009.05.015","url":null,"abstract":"<div><h3>Background</h3><p>Postoperative Rhabdomyolysis (RM) is rare after neurosurgical procedures. Furthermore, it has not been observed after transnasal approaches. The authors report a case of idiopathic RM occurring after transnasal resection of a sincipital encephalocele.</p></div><div><h3>Case Description</h3><p>A 32-year-old woman underwent a transnasal resection of a sincipital encephalocele after 6 years of intermittent clear nasal drainage. Postoperatively, she experienced severe back pain, peripheral neuropathy, associated with a markedly elevated creatinine kinase, and severe RM. The patient was treated with hydration and forced urine alkalization and treated symptomatically for her pain and neuropathy. She ultimately made a full recovery without complication.</p></div><div><h3>Conclusion</h3><p>Rhabdomyolysis is a rare but known complication of neurosurgical procedures. We report the first known case report of RM after a transnasal procedure. Furthermore, a review of documented postneurosurgical cases of RM is presented and reveals that the causes and risk factors for this complication after neurosurgery are similar to those in other surgical subspecialties.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 757-760"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.05.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28309240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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