The Incidence of Depressed Skull Fractures Due to the Use of Pin-Type Head Frame Systems in the Adult Population: 10-year Experience of a Single Neurosurgical Center

Hiwatari, Takaaki; Yamahata, Hitoshi; Yonenaga, Masanori; Shimizu, Fujio; Higa, Nayuta; Hanaya, Ryosuke; Arita, Kazunori; Yoshimoto, Koji

doi:10.1016/j.wneu.2021.08.070

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…Among these, fractures of the skull with or without intracranial hemorrhage are the most frequently reported complications. 2 23) A recent single-center retrospective study by Hiwatari et al 7) found the incidence of this complication to be approximately 0.29% in adults. However, this figure may be somewhat inaccurate, as this study exclusively examined cases associated with the Sugita head frame.…”

Section: Discussionmentioning

confidence: 99%

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Epidural Hematoma, a Rare Complication After the Use of Mayfield Clamp: A Case Report and Review of the Literature

Plevko,

Vybíhal,

Sova

et al. 2023

Korean J Neurotrauma

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Herein, we describe a case of epidural hematoma associated with the use of a Mayfield head clamp. An 18-year old patient with an upper brainstem tumour causing obstructive hydrocephalus underwent a routine third ventriculostomy, which unexpectedly revealed an intracranial hemorrhage. We outline potential risk factors, propose an algorithm for preventing complications associated with the use of pin-type fixation, and conducted a structured review of the literature to identify similar clinical scenarios.

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Section: Discussionmentioning

confidence: 99%

“…2) Type of HID used: While the exact incidence related to different types in adult populations is unknown due to a lack of studies, Hiwatari’s paper 7) suggests that Mayfield fixation may be a safer choice based on their findings, which exclusively linked EDH to the Sugita system.…”

Section: Discussionmentioning

confidence: 99%

Epidural Hematoma, a Rare Complication After the Use of Mayfield Clamp: A Case Report and Review of the Literature

Plevko,

Vybíhal,

Sova

et al. 2023

Korean J Neurotrauma

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“…Guidelines of this HID are missing [7,25]: indication, application and pins placement are often empirical. Only a few authors analysed complications related to its use; they are rare and usually avoidable (skull fractures with or without EDH) [7,8,26,27]. To the best of our knowledge, any authors, data, study or guidelines exclude the use of skull clump in major trauma patients presenting skull fractures; in this case, it is mandatory to confirm the integrity of the skull with a CT brain scan to not place pins in or in the vicinity of fractures avoiding penetration, displacement of a fractured fragment [8,28], enlargement fracture line [7,8], or insufficient stabilisation [7,29].…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines on the correct application of this HID are lacking [7]; indication and position are often empirical. Complications related to using the skull clamp are rare and usually avoidable: most are skull fractures with or without epidural hematomas [8].…”

Section: Development Of Extradural Hematoma (Edh) Associatedmentioning

confidence: 99%

Intracranial Haemorrhage After Decompressive Craniectomies for Trauma: Role of the Skull Clamp

Guarrera,

Giarletta

2024

J Clin Med Surgery

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Background: High Intracranial Pressure (ICP) is the most frequent cause of death and disability after severe Traumatic Brain Injury (TBI); in Europe, 33% of patients with TBI require neurosurgical intervention. Decompressive Craniectomy (DC) represents the extreme surgical treatment; although it is regarded as a relatively simple surgical procedure, it is often accompanied by many complications, including Extradural Hematoma (EDH) associated with an overlying fracture on the contralateral side. It presents an incidence of 5-12%, but Singh et al., analysing 2108 DC performed without the skull clump, estimate it to be about 0.48%. Any authors have indicated the relationship between EDH after DC for trauma in patients showing skull fractures and the use of this Head Immobilisation Device (HID). Materials and methods: We have retrospectively analysed all patients who underwent frontotemporoparietal DC and bifrontal DC after TBI at Venice Angel Hospital during a 5-year and six-month period (January 2017-June, 2022). All patients showed skull bone fractures at CT brain scan, associated with clinical and neuroradiological signs of increasing ICP. For each patient, we analysed: age and sex, neurological status: GCS at the moment of trauma and before surgery, pupillary size and form before and after surgery; neuroimaging evolution; the timing and DC. DORO© Mayfield skull clump was used in all cases. Results: Our surgical cohort counts 20 patients with M/F 3:2 and an average age of 47±17. 16 patients underwent urgent surgery (primary DC), and 4 were operated on after an overage of 50 hours of observation (secondary DC): 90% of patients experienced frontotemporoparietal DC and 10% bifrontal DC. Postoperative CT brain scan showed enlargement of brain contusion in 4 patients (20%); EDH in 4 patients: 2 in the side of skull fracture contralateral at DC, 1 contralateral at DC and skull fracture, 1 occipital in the side of fracture homolateral at DC; SDH in 2 cases, both homolateral at DC. For 3 patients, surgical treatment of EDH was necessary following DC. Conclusion: Our patients showed a higher probability of developing remote-site EDH; other typical complications presented the same or slightly higher frequency of occurrence. Considering the high risk-benefit ratio of skull bone application, we suggest adopting safer HID, such as surgical adhesive tape or a horseshoe headrest.

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“…Cranial fixation systems or devices employed in neurosurgical interventions for the purpose of immobilizing the skull during the neurosurgical procedure have been widely used [1,2,3].…”

Section: Introductionmentioning

confidence: 99%

Lessons Learned about the Mayfield-Type Cranial Fixation System

Pereira,

Setton,

Moura da Paixão Oliveira

2023

Arch Pediatr Neurosurg

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Introduction: Cranial fixation systems are instruments frequently used in cranial and spinal neurosurgical interventions to allow rigid fixation of the patient's head, despite their careful use, they are not free from systemic and intracranial complications. Method: A literature review was carried out in the PubMed database to extract original articles published between the years 1990 to 2021 with the following terms: “Mayfield skull clamp”, “Mayfield head clamp”, “Skull clamp” and “Pin-type head fixation device”. Results: 47 articles were selected that met the citation criteria, respective impacts, and content. Conclusion: The meticulous use of the cranial fixation system has greatly reduced its complications.

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The Incidence of Depressed Skull Fractures Due to the Use of Pin-Type Head Frame Systems in the Adult Population: 10-year Experience of a Single Neurosurgical Center

Cited by 5 publications

References 23 publications

Epidural Hematoma, a Rare Complication After the Use of Mayfield Clamp: A Case Report and Review of the Literature

Epidural Hematoma, a Rare Complication After the Use of Mayfield Clamp: A Case Report and Review of the Literature

Intracranial Haemorrhage After Decompressive Craniectomies for Trauma: Role of the Skull Clamp

Lessons Learned about the Mayfield-Type Cranial Fixation System

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