Simple solution for preventing cerebrospinal fluid loss and brain shift during multitrack deep brain stimulation surgery in the semisupine position: polyethylene glycol hydrogel dural sealant capping: rapid communication.
This study evaluated preliminary findings on the efficacy of polyethylene glycol (PEG) hydrogel dural sealant capping for the prevention of cerebrospinal fluid (CSF) leakage and pneumocephalus during deep brain stimulation (DBS) surgery in the semisupine position. Group A consisted of 5 patients who underwent bilateral subthalamic nucleus (STN)-DBS surgery without PEG hydrogel dural sealant capping. Group B consisted of 5 patients who underwent bilateral STN-DBS surgery with PEG hydrogel dural sealant capping. The immediate postoperative intracranial air volume was measured in all patients and compared between the 2 groups using the Welch test. Adverse effects were also examined in both groups. The intracranial air volume in Group A was 32.3 ± 12.3 ml (range 19.1-42.5 ml), whereas that in Group B was 1.3 ± 1.5 ml (range 0.0-3.5 ml), showing a significant difference (p < 0.005). No hemorrhage or venous air embolisms were observed in either group. The effect of brain shift was discriminated by STN recordings in Group B. These preliminary findings indicate that PEG hydrogel dural sealant capping may reduce adverse effects related to CSF leakage and brain shift during DBS surgery.
Department of Neurosurgery, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan. takumi@nms.ac.jp
Ichiro
I
Takumi
Masahiro
M
Mishina
Kohei
K
Hironaka
Kenichi
K
Oyama
Akira
A
Yamada
Koji
K
Adachi
Makoto
M
Hamamoto
Shin
S
Kitamura
Daizo
D
Yoshida
Akira
A
Teramoto
D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000517:prevention & control*; D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000379:methods*; D004292:Dominance, Cerebral / Q000502:physiology; D004569:Electroencephalography; D006801:Humans; D020100:Hydrogels; D008279:Magnetic Resonance Imaging; D038361:Neuronavigation; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D011007:Pneumocephalus / Q000517:prevention & control*; D011092:Polyethylene Glycols; D012815:Signal Processing, Computer-Assisted; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000503:physiopathology; D016683:Supine Position / Q000502:physiology*; D014014:Tissue Adhesives; D014057:Tomography, X-Ray Computed
D020100:Hydrogels; D014014:Tissue Adhesives; D011092:Polyethylene Glycols