Intraventricular bone dust migration after neuroendoscopy: report of 2 cases

Ahmadieh, Tarek Y. El; Wolfe, Cody; Koueik, Joyce; Weprin, Bradley E.; Iskandar, Bermans J.; Price, Angela V.

doi:10.3171/2018.5.peds18152

Cited by 3 publications

(8 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This mechanism was described by Tamburrini et al [11] as the "snow globe effect." Furthermore, the post-ETV lumbar puncture could have theoretically created a pressure gradient causing bone fragments to migrate and settle at the floor of the third ventricle via a suction effect [7,12]. Acute deterioration was seen hours after the lumbar puncture was performed in one of our patients; however, the other patient did not become symptomatic until 8 months after the lumbar puncture.…”

Section: Discussionmentioning

confidence: 77%

“…It was hypothesized that the debris flowed into the supratentorial ventricles where they accumulated, and then the gravitational changes after mobilization of the patient in the postoperative period forced this debris to accumulate in the most dependent portion of the system, the floor of the third ventricle [11]. This mechanism was described by Tamburrini et al [11] as the “snow globe effect.” Furthermore, the post-ETV lumbar puncture could have theoretically created a pressure gradient causing bone fragments to migrate and settle at the floor of the third ventricle via a suction effect [7, 12]. Acute deterioration was seen hours after the lumbar puncture was performed in one of our patients; however, the other patient did not become symptomatic until 8 months after the lumbar puncture.…”

Section: Discussionmentioning

confidence: 99%

“…With these findings, the method of using bone dust for the closure of a burr hole during ETV should be discouraged. A modification of this technique may include placing a physical barrier such as a layer of pericranium or dural substitute in the epidural space [12].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intraventricular Bone Dust Migration after Endoscopic Third Ventriculostomy: Illustrative Report of 2 Cases

Chan¹,

Hong²,

Legaspi³

et al. 2022

Pediatr Neurosurg

View full text Add to dashboard Cite

Introduction Autologous bone dust replacement is a commonly used technique to seal a defect created from a burrhole. However, post-operative migration of these bone fragments may occur as an uncommon complication of endoscopic third ventriculostomy (ETV). Case Presentation We report 2 cases of intraventricular bone dust migration resulting in acute hydrocephalus from physical obstruction of the stoma and infection. Discussion/Conclusion From our 2 cases as well as other reported cases, the bone dust may have acted as a foreign body and served as a nidus of infection, in addition to causing physical obstruction. Lumbar puncture performed after ETV may have resulted in a suction effect of the bone dust from the burrhole into the ventricular system. Both our cases necessitated urgent surgical intervention to extract the bone fragments and restore CSF flow. Because of its potential complications, we recommend against using autologous bone dust for closure of a burrhole defect after ETV.

show abstract

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intraventricular Bone Dust Migration after Endoscopic Third Ventriculostomy: Illustrative Report of 2 Cases

Chan¹,

Hong²,

Legaspi³

et al. 2022

Pediatr Neurosurg

View full text Add to dashboard Cite

show abstract

“…In their case, they performed a lumbar puncture to exclude meningitis, causing the bone dust to be pulled along the endoscope's track into the ventricular system secondary to the negative pressure gradient created by the lumbar puncture. El Ahmadieh et al also reported a similar complication after an endoscopic third ventriculostomy (ETV) case with dust migration following a lumbar puncture [8]. They also presented a patient who had migration of the bone dust/fragments covering the burr hole after head trauma.…”

Section: Discussionmentioning

confidence: 94%

Bone Fragment Granuloma Mimicking a Brain Tumor Following Placement of an Intracranial Pressure Monitoring System

Jesús¹,

Thomas²

2021

Cureus

View full text Add to dashboard Cite

The placement of intracranial pressure (ICP) monitoring system requires drilling an orifice in the skull. Bone fragments can accidentally be inserted into the brain parenchyma while introducing the ICP monitoring system during the procedure. An intracranial granuloma can be subsequently formed if a non-specific reaction is induced and maintained by the inserted bone fragment in the brain parenchyma. These intracranial granulomas may eventually be confused with brain masses on follow-up imaging studies. We present the case of a 65-year-old male who underwent cranial surgery secondary to a severe traumatic brain injury (TBI). An intracranial bolt was initially placed contralaterally to measure the ICP. Eleven years later, a granuloma from a retained bone fragment secondary to the intracranial bolt placement was suspected. The clinical course, radiological investigations, and differential diagnosis are presented.

show abstract

“…Furthermore, various adjuncts to the autologous bone dust have been described: e.g., it can be augmented with fibrin glue 5 or previously compressed into a solid plug 3,6,7 . However, this method has been related to post-operative complications, particularly for stand-alone burr-holes performed in endoscopic neurosurgery, caused by the migration of the material used to obstruct the burr hole into the endoscopy tract 8 .…”

mentioning

confidence: 99%

Safety and Performance of a New Burr Hole Covering Device: Results of the Multicenter COVER Registry

Asencio-Cortés

Villalba

Vilalta

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Background: Burr-hole covering in brain surgical procedures can avoid complications and unaesthetic results. Study Aim: The aim of this registry was to assess the safety and performance of a new polymeric burr hole covering device (Cranial COVER, NEOS Surgery). Patients and Methods: A multicentere, prospective, clinical registry was used for the study. All patients that fulfilled inclusion criteria were included in the study and followed up for 6 months. Baseline clinical parameters, surgical variables (technical success of the implantation, surgeon satisfaction), post-operative variables (aesthetic and functional results, neuroimage artifacts) and adverse events were evaluated. Results: Forty-three Cranial COVER devices were implanted in 30 patients. Most of them were implanted in frontal locations (53.5%). After implantation, 97.7% of the devices completely covered the burr hole, and 100% perfectly adapted to the skull surface. All surgeons ranked their satisfaction with the implantation procedure as very high or high. No artifacts were detected in any of the neuroimages performed and no adverse events related with the device or its implantation were reported during the follow-up. There were significantly more scalp depressions associated with uncovered than with Cranial COVER-covered burr holes (P=0.040). Patient satisfaction with covered burr holes located in frontal and parietal areas was 9.0±1.4 over 10. Conclusion: Cranial COVER is a safe and reliable burr hole covering system that offers excellent cosmetic results and high satisfaction rates for both surgeons and patients. Cranial COVER is highly adaptable to the skull surface, and it was predominantly used in frontal locations due to their cosmetic importance.

show abstract

Intraventricular bone dust migration after neuroendoscopy: report of 2 cases

Cited by 3 publications

References 19 publications

Intraventricular Bone Dust Migration after Endoscopic Third Ventriculostomy: Illustrative Report of 2 Cases

Intraventricular Bone Dust Migration after Endoscopic Third Ventriculostomy: Illustrative Report of 2 Cases

Bone Fragment Granuloma Mimicking a Brain Tumor Following Placement of an Intracranial Pressure Monitoring System

Safety and Performance of a New Burr Hole Covering Device: Results of the Multicenter COVER Registry

Contact Info

Product

Resources

About