Cranioplasty and Duraplasty with Transcranial Color-Coded Duplex Sonography after Aneurysmal Subarachnoid Hemorrhage

详细信息    查看全文

• 作者：Hirokazu Sadahiro ; MD ; ^{sadahiro@kenwakai.gr.jp" class="auth_mail" title="E-mail the corresponding author} ; Akinori Inamura ; MD ; Kazutaka Sugimoto ; MD ; Akiko Yamane ; MD ; Hideyuki Ishihara ; MD ; Satoshi Shirao ; MD ; Hiroshi Yoneda ; MD ; Michiyasu Suzuki ; MD
• 关键词：TCCS ; vasospasm ; SAH ; titanium mesh plate ; Huygens principle ; acoustic impedance
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：24
• 期：11
• 页码：2640-2645
• 全文大小：1507 K

文摘

Transcranial color-coded duplex sonography (TCCS) is a noninvasive technique for monitoring of cerebral vasospasm after neurosurgery for aneurismal subarachnoid hemorrhage. In this surgery, surgical materials are used. The goal of the study was to identify materials that can be used with ultrasound and to propose methods for cranioplasty and duraplasty using materials that permit TCCS.

Methods

The chosen neurosurgical materials were titanium mesh plate (TMP), Gore-tex, SEAMDURA, gelatinous sponge, and oxidized cellulose. B-mode imaging was recorded with the materials placed between urethane resin 10 mm in diameter and the urethane phantom model. TCCS was performed to detect middle cerebral artery flow through TMP and Gore-tex.

Results

TMP and SEAMDURA permitted penetration of ultrasound in B-mode and Doppler imaging, but the other materials did not do so.

Conclusions

A postcraniotomy window (PCW) on a line extending from the horizontal portion of M1 using only TMP permitted flow imaging with TCCS. In external decompression, TCCS was effective only without use of Gore-tex around the postcraniotomy window. This method allows the middle cerebral artery flow to be detected easily.