Accepted Manuscript Minimizing Collateral Brain Injury Using a Protective Layer of Fibrin Glue: Technical Note Jaafar Basma, M.D., Francesco Latini, M.D., Mats Ryttlefors, M.D, Ph.D., Tarek Abuelem, M.D., Ali Fadl Krisht, M.D. PII:
S1878-8750(15)00819-0
DOI:
10.1016/j.wneu.2015.06.071
Reference:
WNEU 3023
To appear in:
World Neurosurgery
Received Date: 13 April 2015 Revised Date:
26 June 2015
Accepted Date: 27 June 2015
Please cite this article as: Basma J, Latini F, Ryttlefors M, Abuelem T, Krisht AF, Minimizing Collateral Brain Injury Using a Protective Layer of Fibrin Glue: Technical Note, World Neurosurgery (2015), doi: 10.1016/j.wneu.2015.06.071. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Minimizing Collateral Brain Injury Using a Protective Layer of Fibrin Glue:
RI PT
Technical Note
SC
Jaafar Basma M.D.1, Francesco Latini M.D.1,2,3, Mats Ryttlefors M.D,Ph.D.1,2 ,Tarek Abuelem M.D.1 and Ali Fadl Krisht M.D.1
Author affiliations:
Arkansas Neuroscience Institute, St Vincent’s Infirmary Medical Center, Little Rock, Arkansas, USA
2
Department of Neuroscience, Neurosurgery, Uppsala University Hospital, Uppsala, Sweden
3
Department of Neuroscience and Rehabilitation, Division of Neurosurgery, S.Anna University Hospital, Ferrara, Italy
Corresponding author: Francesco Latini MD
TE D
M AN U
1
Department of Neuroscience
AC C
Uppsala University
EP
Section for Neurosurgery
S-751 85 UPPSALA Sweden
Phone: +46 764244653 Fax: +46 18 55 86 17
E-mail: [email protected]
ACCEPTED MANUSCRIPT
Abstract
RI PT
Background: Neurosurgical procedures expose the brain surface to a constant risk of collateral injury. We describe a technique where the brain surface is covered with a protective layer of fibrin glue and discuss its advantages. Methods: A thin layer of fibrin glue was applied on the brain surface after its exposure in 34 patients who underwent different craniotomies for tumoral and vascular lesions. Data of 35 more patients who underwent standard microsurgical technique were collected as control group. Cortical and pial injuries were evaluated using an intra-operative visual scale. Eventual abnormal signals at the early post-op T2Flair MRI sequences were evaluated in oncological patients.
M AN U
SC
Results: Total pial injury was noted in 63% of cases where fibrin glue was not used. In cases where fibrin glue was applied, a significantly lower percentage of 26% (p
S1878-8750(15)00819-0
DOI:
10.1016/j.wneu.2015.06.071
Reference:
WNEU 3023
To appear in:
World Neurosurgery
Received Date: 13 April 2015 Revised Date:
26 June 2015
Accepted Date: 27 June 2015
Please cite this article as: Basma J, Latini F, Ryttlefors M, Abuelem T, Krisht AF, Minimizing Collateral Brain Injury Using a Protective Layer of Fibrin Glue: Technical Note, World Neurosurgery (2015), doi: 10.1016/j.wneu.2015.06.071. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Minimizing Collateral Brain Injury Using a Protective Layer of Fibrin Glue:
RI PT
Technical Note
SC
Jaafar Basma M.D.1, Francesco Latini M.D.1,2,3, Mats Ryttlefors M.D,Ph.D.1,2 ,Tarek Abuelem M.D.1 and Ali Fadl Krisht M.D.1
Author affiliations:
Arkansas Neuroscience Institute, St Vincent’s Infirmary Medical Center, Little Rock, Arkansas, USA
2
Department of Neuroscience, Neurosurgery, Uppsala University Hospital, Uppsala, Sweden
3
Department of Neuroscience and Rehabilitation, Division of Neurosurgery, S.Anna University Hospital, Ferrara, Italy
Corresponding author: Francesco Latini MD
TE D
M AN U
1
Department of Neuroscience
AC C
Uppsala University
EP
Section for Neurosurgery
S-751 85 UPPSALA Sweden
Phone: +46 764244653 Fax: +46 18 55 86 17
E-mail: [email protected]
ACCEPTED MANUSCRIPT
Abstract
RI PT
Background: Neurosurgical procedures expose the brain surface to a constant risk of collateral injury. We describe a technique where the brain surface is covered with a protective layer of fibrin glue and discuss its advantages. Methods: A thin layer of fibrin glue was applied on the brain surface after its exposure in 34 patients who underwent different craniotomies for tumoral and vascular lesions. Data of 35 more patients who underwent standard microsurgical technique were collected as control group. Cortical and pial injuries were evaluated using an intra-operative visual scale. Eventual abnormal signals at the early post-op T2Flair MRI sequences were evaluated in oncological patients.
M AN U
SC
Results: Total pial injury was noted in 63% of cases where fibrin glue was not used. In cases where fibrin glue was applied, a significantly lower percentage of 26% (p
