British journal of neurosurgery
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An amateur scuba (Self Contained Underwater Breathing Apparatus) diver experienced an acute frontal headache following a low-depth dive. After 12 hours of worsening and unremitting headache, CT and MRI imaging were performed; these revealed gas and mucous in the frontal sinus and extradural space. This appears to be the first case of MRI-documented barotrauma of the frontal and ethmoidal sinuses resulting in extradural pneumo- and muco-cephalus.
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Adhesion formation between dura mater and cortex, and the overlying temporalis muscle and galea following decompressive craniectomy, can make subsequent cranioplasty difficult and adds to the risks of the procedure. We describe the implantation of sterile silicone sheeting at decompressive craniectomy to prevent adhesion formation and facilitate subsequent cranioplasty, potentially reducing surgical time, improving outcome and reducing risk.
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To assess the utility of pre-operative 3-dimension (3D) visualisation and surgical planning with the Dextroscope in combination with the use of DEX-Ray-a novel augmented reality surgical navigation platform for resection of meningiomas in the falcine, convexity and parasagittal regions. ⋯ The use of the Dextroscope for pre-operative surgical planning allows for appreciation of complex anatomical relationships in 3D. This appreciation is further translated for use during surgical navigation utilizing the DEX-Ray platform that provided us with the superior advantage of allowing fast and accurate surgical resection confidently.