How I do it: single-staged emergency neurosurgical management of frontal penetrating craniocerebral injury with depressed skull fracture.
Acta Neurochir (Wien)
; 166(1): 47, 2024 Jan 30.
Article
em En
| MEDLINE
| ID: mdl-38286923
ABSTRACT
CONTEXT Penetrating craniocerebral injury associated with depressed skull fracture is an infrequent yet timely neurosurgical emergency. Such injury frequently occurs in the frontal region during traffic accident or stone throw in the civilian setting. As military neurosurgeons, we present our experience in the surgical debridement and reconstruction of this peculiar type of traumatic brain injury. METHODS:
The patient lies supine, the head in neutral position heal by a Mayfield head clamp. The first step is the debridement of the frontal wound. Then, the depressed skull fracture is operated on using a tailored coronal approach through Merkel dissection plane, in order to keep a free pericranial flap. The bone flap is cut around the depressed skull fracture. Neuronavigation allows to locate the frontal sinus depending on whether it has been breached and thus requires cranialization. Brain and dura mater debridement and plasty are performed. Cranioplasty is performed using either native bone fragments fixed with bone plates or tailored titanium plate if they are too damaged.CONCLUSION:
Performing wounded skin closure first and then a tailored coronal approach with free pericranial flap and a craniotomy encompassing the depressed skull fracture allows to treat frontal penetrating craniocerebral injury in an easy-to-reproduce manner.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fraturas Cranianas
/
Ferimentos Penetrantes
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Fratura do Crânio com Afundamento
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Retalhos de Tecido Biológico
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Traumatismos Craniocerebrais
Limite:
Humans
Idioma:
En
Revista:
Acta Neurochir (Wien)
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França