Neurosurgery
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The use of dural sealants has become common in neurosurgery. Ten patients in whom a bovine albumin-glutaraldehyde combination (BioGlue; Cryolife, Inc., Kennesaw, GA) was implanted have had wound complications. The clinical experience of these patients is presented along with recommendations regarding the use of BioGlue. ⋯ We have found a strong association between the use of BioGlue and postoperative wound complications in our pediatric neurosurgical practice and, thus, discourage its future use. BioGlue triggers an intense acute pyogenic and chronic granulomatous inflammatory response, which is an ideal environment for bacterial growth. The bacteria may arise from the BioGlue or other foreign bodies or, more likely, from the skin if the inflammation breaches the skin surface.
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Case Reports
Symptomatic mass effect of a hypertrophied pericranial flap after repair of a dural defect: case report.
To detail a potential complication of the use of vascularized pericranial flaps in the repair of dural defects, namely, flap hypertrophy secondary to venous engorgement. ⋯ In this case, hypertrophy of the vascularized pericranial flap is hypothesized to have occurred because of venous congestion, possibly secondary to restriction of venous outflow by the overlying bone flap.
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To assess the value of multiplanar reconstruction software in trajectory planning for depth electrode insertion in medically refractory epilepsy. ⋯ The use of reconstructed planes in preoperative trajectory planning allows for the insertion of additional electrode contacts within the target structure.
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Accurate placement of ventricular catheters decreases the incidence of proximal catheter failure. The use of a frameless, interactive neuronavigational system can optimize catheter placement. ⋯ Frameless neuronavigation in the placement of ventricular catheters assures accurate catheter placement, thereby decreasing the incidence of proximal catheter failure. The absence of rigid head fixation allows additional cohorts to benefit from the apparatus. The use of the electromagnetic system provides a safe, simple, and easy adjunct to optimal catheter placement.