Tight Dural Closure with Pedicled Graft in Wounds of the Brain

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Although the importance of not opening the dura unnecessarily has been fully recognized both in regard to cerebral dura2,10 and spinal dura for some time, inadequate attention has been devoted to its repair in cases of penetrating wounds of the brain. The necessity for careful repair of the laceration of the dura in the region of the cribriform plate or one of the paranasal sinuses has long been known by neurologic surgeons.6 On the other hand, deliberate meticulous repair of a laceration of the dura under the vault of the skull has not

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Figures

  • View in gallery

    (left). Cerebral fungus immediately after its appearance.

    (right). Preparation of pedicled periosteal graft. The galea and skin have been reflected off the periosteum.

  • View in gallery

    (left). The suturing of the base of the pedicled graft to the proximal edge of the dural defect.

    (right). Completion of repair of the dural defect with pedicled graft of periosteum.

References

1.

AscroftP. B. Treatment of head wounds due to missiles. Analysis of 500 cases. Lancet19432: 211218.Ascroft P. B. Treatment of head wounds due to missiles. Analysis of 500 cases. Lancet 1943 2: 211–218.

2.

CairnsH. Gunshot wounds of the head in the acute stage. Brit. med. J.19441: 3337.Cairns H. Gunshot wounds of the head in the acute stage. Brit. med. J. 1944 1: 33–37.

3.

DottN.AlexanderG. L. and AscroftP. B. Injuries of the brain and skull. In: Surgery of modern warfare. H. Bailey Ed. Edinburgh: E. & S. Livingstone19443rd ed. pt. 5: 717759.Dott N. Alexander G. L. and Ascroft P. B. Injuries of the brain and skull. In: Surgery of modern warfare. H. Bailey Ed. Edinburgh: E. & S. Livingstone 1944 3rd ed. pt. 5: 717–759.

4.

EckerA. D. Urea and sulphonamide treatment of Bact. coli meningitis. Lancet19451: 176177.Ecker A. D. Urea and sulphonamide treatment of Bact. coli meningitis. Lancet 1945 1: 176–177.

5.

EdenK. Mobile neursurgery in warfare. Experiences in the Eighth Army's campaign in Cyrenaica, Tripolitania and Tunisia. Lancet19432: 689692.Eden K. Mobile neursurgery in warfare. Experiences in the Eighth Army's campaign in Cyrenaica Tripolitania and Tunisia. Lancet 1943 2: 689–692.

6.

GermanW. J. Cerebrospinal rhinorrhea-surgical repair. J. Neurosurg.19441: 6066.German W. J. Cerebrospinal rhinorrhea—surgical repair. J. Neurosurg. 1944 1: 60–66.

7.

O'ConnellJ. E. A. Traumatic cerebral fungus. Brit. J. Surg.194330: 201212.O'Connell J. E. A. Traumatic cerebral fungus. Brit. J. Surg. 1943 30: 201–212.

8.

Spurling R. G. Personal communication.Spurling R. G. Personal communication.

9.

TurnerO. A. The care and treatment of wartime injuries to the head. A review of some recent literature. Milit. Surg.194392: 473490.Turner O. A. The care and treatment of wartime injuries to the head. A review of some recent literature. Milit. Surg. 1943 92: 473–490.

10.

WalkerA. E. Treatment of penetrating wounds of the head. With a critical review of recent literature. War Med.19422: 454464.Walker A. E. Treatment of penetrating wounds of the head. With a critical review of recent literature. War Med. 1942 2: 454–464.

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