Minimal craniotomy and matrix hemostatic sealant for the treatment of spontaneous supratentorial intracerebral hemorrhage

Technical note

Restricted access

The authors describe a minimally invasive technical note for the surgical treatment of primary intracerebral hematoma. Thirty-one patients with supratentorial intracerebral hematomas and no underlying vascular anomalies or bleeding disorders underwent treatment with a single linear skin incision followed by a 3-cm craniotomy. After evacuation of the hematoma, a matrix hemostatic sealant (FloSeal) was injected into the surgical cavity, and immediate hemostasis was achieved in all cases. A second operation was necessary in only 1 case. In this preliminary experience, a small craniotomy combined with FloSeal helped to control operative bleeding, reducing brain exposure and damage to the surrounding tissue while reducing the length of the surgery.

Abbreviation used in this paper: ICH = intracerebral hematoma.
Article Information

Contributor Notes

Address correspondence to: Roberto Gazzeri, M.D., Via O. Tommasini 13, 00162 Roma, Italy. email: r.gazzeri@tiscali.it.

© AANS, except where prohibited by US copyright law.

Headings
References
  • 1

    Brott TBroderick JKothari RBarsan WTomsick TSauerbeck L: Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke 28:151997

    • Search Google Scholar
    • Export Citation
  • 2

    Ellegala DBMaartens NFLaws ER Jr: Use of FloSeal hemostatic sealant in transsphenoidal pituitary surgery: technical note. Neurosurgery 51:5135162002

    • Search Google Scholar
    • Export Citation
  • 3

    Mendelow ADGregson BAFernandez HMMurray GDTeasdale GMHope DT: Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet 365:3873972005

    • Search Google Scholar
    • Export Citation
  • 4

    Montes JMWong JHFayad PBAwad IA: Stereotactic computed tomographic-guided aspiration and thrombolysis of intracerebral hematoma: protocol and preliminary experience. Stroke 31:8348402000

    • Search Google Scholar
    • Export Citation
  • 5

    Payner TVega FTaw JPolidoro DPSoria MLReich CJ: Floseal matrix hemostatic sealant. Safety, biocompatibility and biodegradation brain implantation study in rats. Fusion Medical Technologies, IncStudy Number P01-050. Report Date 04-2003

    • Export Citation
  • 6

    Renkens KL JrPayner TLeipzig TJFeuer HMorone MAKoers JM: A multicenter, prospective, randomized trial evaluating a new hemostatic agent in spinal surgery. Spine 26:164516502001

    • Search Google Scholar
    • Export Citation
  • 7

    Thiex RTsirka SE: Brain edema after intracerebral hemorrhage: mechanisms, treatment options, management strategies, and operative indications. Neurosurg Focus 22:5E62007

    • Search Google Scholar
    • Export Citation
  • 8

    Wagner KRXi GHua YZuccarello Mde Courten-Myers GMBroderick JP: Ultra-early clot aspiration after lysis with tissue plasminogen activator in a porcine model of intracerebral hemorrhage: edema reduction and blood-brain barrier protection. J Neurosurg 90:4914981999

    • Search Google Scholar
    • Export Citation
  • 9

    Xi GKeep RFHoff JT: Mechanisms of brain injury after intracerebral hemorrhage. Lancet Neurol 5:53632006

TrendMD
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 265 263 81
Full Text Views 149 74 0
PDF Downloads 126 61 0
EPUB Downloads 0 0 0
PubMed
Google Scholar