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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Supratentorial Craniotomies with or without Dural Closure-A Comparison.
Ali Alwadei1, Abdulaziz Oqalaa Almubarak2, Mohammed Bafaquh1
1National Neuroscience Institute, King Fahed Medical City, Riyadh, Saudi Arabia.
World Neurosurgery
|February 20, 2019
Summary
Suturing the dura after supratentorial craniotomy did not significantly reduce cerebrospinal fluid leaks or infections. However, watertight dural closure was associated with a higher incidence of post-craniotomy headaches.
Area of Science:
- Neurosurgery
- Surgical Techniques
- Patient Outcomes
Background:
- Dural closure is a standard neurosurgical procedure.
- The necessity of watertight dural closure in supratentorial craniotomies is debated.
- This study investigates the risks and benefits of dural suturing.
Purpose of the Study:
- To compare watertight dural closure versus no dural closure.
- To assess the incidence of cerebrospinal fluid (CSF) leak, infection, and postcraniotomy headaches.
- To evaluate surgical site swelling after craniotomy.
Main Methods:
- Retrospective study of 216 patients undergoing supratentorial craniotomy.
- Comparison between a group with watertight dural closure and a group without.
- Data collected on CSF leak, infection, swelling, and headaches.
Main Results:
- No significant difference in CSF leak, infection, or swelling between groups.
- The watertight dural closure group had a statistically significant higher incidence of postcraniotomy headaches (P=0.001).
Conclusions:
- Watertight dural closure does not appear to significantly reduce CSF leaks, infections, or swelling.
- Increased incidence of postcraniotomy headaches is associated with watertight dural closure.
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