title: Use of a contoured bioresorbable plate with a hemostatic plug to control life-threatening bleeding from the superior sagittal sinus during hemispherotomy: technical note.
abstract: Profuse bleeding originating from an injured cerebral sinus can be a harrowing experience for any surgeon, particularly during an operation on a young child. Common surgical remedies include sinus ligation, primary repair, placement of a hemostatic plug, and patch or venous grafting that may require temporary stenting. In this paper the authors describe the use of a contoured bioresorbable plate to hold a hemostatic plug in place along a tear in the inferomedial portion of a relatively inaccessible part of the posterior segment of the superior sagittal sinus in an 11-kg infant undergoing hemispherotomy for epilepsy. This variation on previously described hemostatic techniques proved to be easy, effective, and ultimately lifesaving. Surgeons may find this technique useful in similar dire circumstances when previously described techniques are ineffective or impractical.
authors.affiliation: Divisions of 1 Pediatric Neurosurgery and.|Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa; and.
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Tuite
authors.affiliation: Divisions of 1 Pediatric Neurosurgery and.|Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa; and.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Carey
authors.affiliation: Division of Anesthesiology, Department of Surgery, All Children's Hospital/Johns Hopkins Medicine, St. Petersburg, Florida.
authors.forename: William W
authors.initials: WW
authors.lastname: Nelson
authors.affiliation: Divisions of 1 Pediatric Neurosurgery and.|Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa; and.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Raffa
authors.affiliation: Neurology, Neuroscience Institute, All Children's Hospital/Johns Hopkins Medicine, St. Petersburg.|Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa; and.
authors.forename: S Parrish
authors.initials: SP
authors.lastname: Winesett
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D020878:Device Removal; D000069279:Drug Resistant Epilepsy / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D016972:Enterobacter cloacae; D004756:Enterobacteriaceae Infections / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D038421:Hemispherectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000517:prevention & control*; D008297:Male; D054063:Superior Sagittal Sinus / Q000000981:diagnostic imaging / Q000293:injuries*; D013525:Surgical Instruments / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery
keywords: SSS = superior sagittal sinus; cerebral sinus; hemispherotomy; hemorrhage; injury; repair; superior sagittal sinus; technique