Prevention of postoperative subdural fluid collections following transcortical transventricular approach.
BACKGROUND
Subdural fluid collections appear in about 39% of patients after the removal of intra- and paraventricular tumors. This extracerebral fluid collection requires surgical intervention when progressive fluid accumulation takes place. The authors retrospectively and prospectively studied the efficacy of gelfoam and fibrin adhesive in closing cortical and ependymal defects after intraventricular and/or paraventricular lesion resection to prevent the development of SFCs.


METHODS
From 1999 to 2004, we used gelfoam and fibrin adhesive on the cortical and ependymal defects of 28 patients who underwent the resection of intraventricular and/or paraventricular lesions via the transcortical approach associated with the communicated ventricle. We investigated the percentage of symptomatic and asymptomatic SFC.


RESULTS
The patients median age was 59.5 years (range, 30-76 years), and the male/female ratio was 16:12. A frontal approach was performed in 18 patients, an occipital approach in 2, a parietal approach in 4, and a temporal approach in 4. The incidence of SFCs was 7% (2 patients). Of the 2 patients with SFCs, 1 required temporary drainage. The other patient was asymptomatic, and the SFCs were spontaneously absorbed 2 months later.


CONCLUSIONS
The use of gelfoam and fibrin adhesive to seal cortical and ependymal defects after a transcortical procedure might be a viable method of preventing the development of SFC.
Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School, Gwangju, 519-809, South Korea.
Tae-Young
TY
Jung
Shin
S
Jung
Shu-Guang
SG
Jin
Yong-Hao
YH
Jin
In-Young
IY
Kim
Sam-Suk
SS
Kang
Soo-Han
SH
Kim
D000328:Adult; D000368:Aged; D002540:Cerebral Cortex / Q000601:surgery; D002551:Cerebral Ventricle Neoplasms / Q000601:surgery*; D015331:Cohort Studies; D004805:Ependyma / Q000601:surgery; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013353:Subdural Effusion / Q000209:etiology / Q000517:prevention & control*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014014:Tissue Adhesives