The reconstructive role of TachoSil in neurosurgery

Hemorrhages, cerebrospinal fluid (CSF) fistula and infections are the most challenging post-operative complications in Neurosurgery [1–5]. Fibrin sealant agents have been developed with the aim to provide efficient hemostasis and safe dural closure [3,6–14]. In this study we report our initial experience using TachoSil® (haemostatic surgical patch; Nycomed, Linz, Austria) in achieving hemostasis and CSF leakage repair during cranio-cerebral procedures [15–18]. We describe and show the unique features of this fibrin sealant, pioneered with stunning success in many surgical procedures known to be at high risk of peri- and postoperative bleeding (i.e. nephrectomies, pulmonary lobectomies, ballistic injuries, arthroplasties, coronary bypass graftings), but still not widely exploited at its best in the field of Neurosurgery

The reconstructive role of TachoSil in neurosurgery

Hemorrhages, cerebrospinal fluid (CSF) fistula and infections are the most challenging post-operative complications in Neurosurgery [1–5]. Fibrin sealant agents have been developed with the aim to provide efficient hemostasis and safe dural closure [3,6–14]. In this study we report our initial experience using TachoSil® (haemostatic surgical patch; Nycomed, Linz, Austria) in achieving hemostasis and CSF leakage repair during cranio-cerebral procedures [15–18]. We describe and show the unique features of this fibrin sealant, pioneered with stunning success in many surgical procedures known to be at high risk of peri- and postoperative bleeding (i.e. nephrectomies, pulmonary lobectomies, ballistic injuries, arthroplasties, coronary bypass graftings), but still not widely exploited at its best in the field of Neurosurgery

The Superficial Anastomosing Veins of the Human Brain Cortex: A Microneurosurgical Anatomical Study

In this microneurosurgical and anatomical study, we characterized the superficial anastomosing veins of the human brain cortex in human specimens. We used 21 brain preparations fixed in formalin (5%) that showed no pathological changes and came from the autopsy sections. The superficial veins were dissected out of the arachnoid with the aid of a surgical microscope. We dissected nine female and 12 male brain specimens, with an average age of 71 ± 11 years (range 51-88 years). We classified the superficial veins in five types: (I) the vein of Trolard as the dominat vein; (II) the vein of Labbé as the dominant vein; (III) a dominant sylvian vein group, and the veins of Trolard and Labbé nonexistent or only rudimentary present without contact to the Sylvian vein group; (IV) very weak sylvian veins with the veins of Trolard and Labbé codominant; and V) direct connection of Trolard and Labbé bypassing the Sylvian vein group. The vein of Trolard was dominant (Type I) in 21.4% and the vein of Labbé (Type II) in 16.7%. A dominant sylvian vein group (Type III) was found in 42.9%. Type IV and Type V were found in 14.3 and 4.7% respectively. No systematic description or numerical distribution of the superior anastomotic vein (V. Trolard) and inferior anastomotic vein (V. Labbé) has been found in the existing literature. This study aimed to fill this gap in current literature and provide data to neurosurgeons for the practical planning of surgical approaches

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes