Objectives: To determine the effectiveness and safety of Hemopatch as a primary dural sealant in preventing CSF leakage following cranial surgery. Cerebrospinal fluid (CSF) leaks occur in cranial operations and are associated with significant patient burden and expense. The use of Hemopatch as a dural sealant in cranial neurosurgical procedures is described and analyzed in this study.
Methods: Data were retrospectively collected from all patients who underwent a craniotomy for various neurosurgical indications where Hemopatch was used as the primary dural sealant between June 2017 and June 2022. Infection and CSF leak were the main indicators evaluated after surgery.
Results: A total of 119 consecutive patients met our inclusion criteria. The median was age 41.5 years, and 52.5% were female. The mean follow-up period was 2.3 years (7 months to 6 years). There were 110 (92.44%) supratentorial and 9 (7.56%) infratentorial craniotomies. Postoperative CSF leak was reported in 2 patients (1.68%), one in each cohort. Postoperative infection occurred in one patient (0.84%).
Conclusion: The results suggest that using Hemopatch as a dural sealant in cranial surgery is effective and safe. After supra-/infratentorial craniotomies, the rate of postoperative adverse events in our sample was within the range of known surgical revision rates. Future randomized clinical studies are required to confirm our encouraging findings.
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http://dx.doi.org/10.17712/nsj.2024.2.20230109 | DOI Listing |
Brain Sci
December 2024
Department of Neurosurgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy.
: Postoperative cerebrospinal fluid (CSF) fistulas remain a significant concern in spinal neurosurgery, particularly following dural closure. The incidence of dural tears during spinal surgery is estimated between 1.6% and 10%.
View Article and Find Full Text PDFNeurospine
December 2024
Department of Orthopedics, Chulabhorn Hospital, Bangkok, Thailand.
This surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, and power drill usage. Although many dural tears are managed with sealant or gel foam, no standard exists for when surgical repair is necessary.
View Article and Find Full Text PDFClin Neurol Neurosurg
December 2024
CHU de Lille, 2 Avenue Oscar Lambret, Hauts-de-France, France. Electronic address:
Introduction: Spontaneous intracranial hypotension (SIH) is a secondary cause of headache. Its pathophysiology is complex, and relies mainly on the notion of a localized leak, and thus a loss of cerebrospinal fluid (CSF) in the spinal region. SIH is little known to the medical profession, for which CT myelography is a technique on the rise, allowing to identify and treat the leak using a blood-patch or a fibrin sealant.
View Article and Find Full Text PDFJ Korean Neurosurg Soc
December 2024
Department of Neurosurgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Eur Spine J
January 2025
Department of Neurosurgery, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA, 15212, USA.
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