Many metastatic brain tumors have a distinct border with normal brain tissue, which facilitates tumor removal. However, residual tumor tissue may be present after surgery when metastatic brain tumors are of cystic type. We have developed a method using hydrofiber dressing to transform cystic-type into solid-type tumors.
Methods
Hydrofiber dressing is a sodium carboxymethylcellulose hydrocolloid polymer with high fluid-absorptive capacity. This material was originally used as a dressing for exudative wounds. Hydrofiber dressing was used for 8 patients with cystic-type metastatic brain tumor. Tumor removal was performed after hydrofiber dressing was inserted into the cyst cavity to transform the tumor into a solid-type tumor.
Results
Transformation of cystic-type metastatic brain tumors into smaller solid-type tumors using hydrofiber dressing facilitated en bloc resection of tumor. The dressing also absorbed residual cyst fluid and was thus also effective in preventing intraoperative dissemination of tumor cells. This approach enabled ideal en bloc resection in all patients. There were no adverse events.
Conclusions
These findings suggest hydrofiber dressing may be useful in surgery for cystic-type metastatic brain tumors.
{"title":"Surgical technique for a cystic-type metastatic brain tumor: transformation to a solid-type tumor using hydrofiber dressing","authors":"Takeshi Okuda MD , Yoshifumi Teramoto MD , Haruki Yugami MD , Kazuo Kataoka MD , Amami Kato MD","doi":"10.1016/j.surneu.2009.07.045","DOIUrl":"10.1016/j.surneu.2009.07.045","url":null,"abstract":"<div><h3>Background</h3><p>Many metastatic brain tumors have a distinct border with normal brain tissue, which facilitates tumor removal. However, residual tumor tissue may be present after surgery when metastatic brain tumors are of cystic type. We have developed a method using hydrofiber dressing to transform cystic-type into solid-type tumors.</p></div><div><h3>Methods</h3><p>Hydrofiber dressing is a sodium carboxymethylcellulose hydrocolloid polymer with high fluid-absorptive capacity. This material was originally used as a dressing for exudative wounds. Hydrofiber dressing was used for 8 patients with cystic-type metastatic brain tumor. Tumor removal was performed after hydrofiber dressing was inserted into the cyst cavity to transform the tumor into a solid-type tumor.</p></div><div><h3>Results</h3><p>Transformation of cystic-type metastatic brain tumors into smaller solid-type tumors using hydrofiber dressing facilitated en bloc resection of tumor. The dressing also absorbed residual cyst fluid and was thus also effective in preventing intraoperative dissemination of tumor cells. This approach enabled ideal en bloc resection in all patients. There were no adverse events.</p></div><div><h3>Conclusions</h3><p>These findings suggest hydrofiber dressing may be useful in surgery for cystic-type metastatic brain tumors.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 703-706"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.07.045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28441283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.wneu.2009.09.012
James I. Ausman MD, PhD (Editor)
{"title":"A note of appreciation to the editorial board","authors":"James I. Ausman MD, PhD (Editor)","doi":"10.1016/j.wneu.2009.09.012","DOIUrl":"10.1016/j.wneu.2009.09.012","url":null,"abstract":"","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Page 560"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.09.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55278018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate biomaterials seeking for their possible use for aneurysm treatment, in vivo screening tests using a number of potential materials are required. However, there is no established animal model that is suitable for such purpose. Some models require special preparation of tested materials for transcatheter delivery and others are inappropriate in view of their cost-effectiveness. The purpose of this study is to establish an animal model that overcomes these limitations and help us select potential materials before the preclinical evaluation.
Methods
Bilateral CCAs in a rabbit were surgically ligated, and a 2-cm segment of either a bare platinum coil or a polymeric coil (a platinum coil coated with PLGA 10/90) was implanted into each blind-ended arterial segment (n = 26). They were harvested at day 1, 7, 10, 14, or 30, respectively. Angiographic and histologic evaluations as well as quantitative analysis on the development of the organized thrombus were performed.
Results
One day after the implantation, both platinum and PLGA coils were surrounded by immature thrombus that was induced by blood flow stagnation in the arterial segment. At day 7, minimal thrombus organization was observed around both types of materials. At postimplantation days 10 and 14, fibrocellular responses, the early findings of the thrombus organization process, were observed in both material groups. Such histologic findings were more prominent in the PLGA coil group as compared to the platinum coil group (day 10, P = .051; day 14, P = .011). Well-organized thrombus was observed in both material groups at day 30 without showing statistical difference (P = .12).
Conclusion
Given the cost-effectiveness, the simple material preparation process, and its feasible histologic evaluation methods, this new animal model can be useful in screening other potential biomaterials for the development of new coil devices.
{"title":"A rabbit model for efficacy evaluation of endovascular coil materials","authors":"Masaki Ebara MD , Ichiro Yuki MD , Yuichi Murayama MD , Takayuki Saguchi MD , Yih-Lin Nien MD , Harry V. Vinters MD , Fernando Vinuela MD , Toshiaki Abe MD","doi":"10.1016/j.surneu.2009.04.017","DOIUrl":"10.1016/j.surneu.2009.04.017","url":null,"abstract":"<div><h3>Background</h3><p>To investigate biomaterials seeking for their possible use for aneurysm treatment, in vivo screening tests using a number of potential materials are required. However, there is no established animal model that is suitable for such purpose. Some models require special preparation of tested materials for transcatheter delivery and others are inappropriate in view of their cost-effectiveness. The purpose of this study is to establish an animal model that overcomes these limitations and help us select potential materials before the preclinical evaluation.</p></div><div><h3>Methods</h3><p>Bilateral CCAs in a rabbit were surgically ligated, and a 2-cm segment of either a bare platinum coil or a polymeric coil (a platinum coil coated with PLGA 10/90) was implanted into each blind-ended arterial segment (n = 26). They were harvested at day 1, 7, 10, 14, or 30, respectively. Angiographic and histologic evaluations as well as quantitative analysis on the development of the organized thrombus were performed.</p></div><div><h3>Results</h3><p>One day after the implantation, both platinum and PLGA coils were surrounded by immature thrombus that was induced by blood flow stagnation in the arterial segment. At day 7, minimal thrombus organization was observed around both types of materials. At postimplantation days 10 and 14, fibrocellular responses, the early findings of the thrombus organization process, were observed in both material groups. Such histologic findings were more prominent in the PLGA coil group as compared to the platinum coil group (day 10, <em>P</em> = .051; day 14, <em>P</em> = .011). Well-organized thrombus was observed in both material groups at day 30 without showing statistical difference (<em>P</em> = .12).</p></div><div><h3>Conclusion</h3><p>Given the cost-effectiveness, the simple material preparation process, and its feasible histologic evaluation methods, this new animal model can be useful in screening other potential biomaterials for the development of new coil devices.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 620-627"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.04.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28654349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-01DOI: 10.1016/j.surneu.2006.10.076
Hajime Touho MD
Background
Encephalomyosynangiosis is one of the indirect method in which ischemic brain surface is covered by temporal muscle for the treatment of moyamoya disease.
Case Descriptions
A 14-year-old girl who had been treated with bilateral STA-MCA anastomosis and EMS in 1999 was admitted on January 5, 2005. She showed transient incomplete palsy on the left side of the face and the ipsilateral upper extremity. On the day of admission, MRIs/MRA and 3-dimensional regional CBF measurement using stable xenon and CT scanning were conducted after performance of plain CT scanning. The MRI and CT studies showed that ossified and hypertrophied temporal muscle used for EMS to the right MCA territory compressed the brain just under the muscle. MRA demonstrated well-developed collaterals to the territories of the bilateral MCAs via the previously performed anastomosis. The CBF studies disclosed a low CBF value just under ossified and hypertrophied muscle used for EMS on the right side. She showed same transient ischemic attacks repetitively after January 5, 2005.
Conclusions
The repetitive attacks with the transient motor palsy on her left side was thought to be caused by direct compression of the brain by the ossified and hypertrophied muscle used for EMS and decrease in CBF just under it, and its removal was thought to be the treatment of choices. However, the patient and her parents refused the surgical procedure, and she is treated conservatively at present.
{"title":"Cerebral ischemia due to compression of the brain by ossified and hypertrophied muscle used for encephalomyosynangiosis in childhood moyamoya disease","authors":"Hajime Touho MD","doi":"10.1016/j.surneu.2006.10.076","DOIUrl":"10.1016/j.surneu.2006.10.076","url":null,"abstract":"<div><h3>Background</h3><p>Encephalomyosynangiosis is one of the indirect method in which ischemic brain surface is covered by temporal muscle for the treatment of moyamoya disease.</p></div><div><h3>Case Descriptions</h3><p>A 14-year-old girl who had been treated with bilateral STA-MCA anastomosis and EMS in 1999 was admitted on January 5, 2005. She showed transient incomplete palsy on the left side of the face and the ipsilateral upper extremity. On the day of admission, MRIs/MRA and 3-dimensional regional CBF measurement using stable xenon and CT scanning were conducted after performance of plain CT scanning. The MRI and CT studies showed that ossified and hypertrophied temporal muscle used for EMS to the right MCA territory compressed the brain just under the muscle. MRA demonstrated well-developed collaterals to the territories of the bilateral MCAs via the previously performed anastomosis. The CBF studies disclosed a low CBF value just under ossified and hypertrophied muscle used for EMS on the right side. She showed same transient ischemic attacks repetitively after January 5, 2005.</p></div><div><h3>Conclusions</h3><p>The repetitive attacks with the transient motor palsy on her left side was thought to be caused by direct compression of the brain by the ossified and hypertrophied muscle used for EMS and decrease in CBF just under it, and its removal was thought to be the treatment of choices. However, the patient and her parents refused the surgical procedure, and she is treated conservatively at present.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 725-727"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2006.10.076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27074000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For cervical spine ABC, staged surgery and the combination of both anterior and posterior approaches are usually necessary for lesions involving all 3 (anterior, middle, and posterior) columns of the spine (holovertebral).
Case Description
A 20-year-old young man presented with quadriplegia and acute urine retention lasting for 3 days in November 2006. The diagnosis of an ABC involving the C2 vertebral body, pedicles, laminae, and spinous process was made by MRI. One-stage surgery with intralesional injection of fibrin glue via the posterior approach only was able to deliver complete resection and spinal stabilization. His neurologic function recovered well, and he was able to walk independently 10 days postoperation. At the 1-year follow-up, image studies of the cervical spine demonstrated good bone fusion without recurrence of ABC. The C2 vertebral body also showed resolution of ABC and good trabeculation.
Conclusions
Intralesional injection of fibrin glue during the operation for holovertebral ABC can be beneficial to (1) avoid using an anterior approach for complete resection and reconstruction, which was usually required in previous reports, and (2) effectively decrease the blood loss during surgery.
{"title":"One-stage posterior resection is feasible for a holovertebral aneurysmal bone cyst of the axis: a case report and literature review","authors":"Li-Yu Fay MD , Jau-Ching Wu MD , Wen-Cheng Huang MD , Yang-Hsin Shih MD , Henrich Cheng MD, PhD","doi":"10.1016/j.wneu.2009.09.007","DOIUrl":"10.1016/j.wneu.2009.09.007","url":null,"abstract":"<div><h3>Background</h3><p>For cervical spine ABC, staged surgery and the combination of both anterior and posterior approaches are usually necessary for lesions involving all 3 (anterior, middle, and posterior) columns of the spine (holovertebral).</p></div><div><h3>Case Description</h3><p>A 20-year-old young man presented with quadriplegia and acute urine retention lasting for 3 days in November 2006. The diagnosis of an ABC involving the C2 vertebral body, pedicles, laminae, and spinous process was made by MRI. One-stage surgery with intralesional injection of fibrin glue via the posterior approach only was able to deliver complete resection and spinal stabilization. His neurologic function recovered well, and he was able to walk independently 10 days postoperation. At the 1-year follow-up, image studies of the cervical spine demonstrated good bone fusion without recurrence of ABC. The C2 vertebral body also showed resolution of ABC and good trabeculation.</p></div><div><h3>Conclusions</h3><p>Intralesional injection of fibrin glue during the operation for holovertebral ABC can be beneficial to (1) avoid using an anterior approach for complete resection and reconstruction, which was usually required in previous reports, and (2) effectively decrease the blood loss during surgery.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Pages S80-S85"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.wneu.2009.09.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28534051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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