Bone Grafts Research Today is a free monthly online journal that collates and summarizes the latest research about Bone Grafts, including details on spine fusion, surgery, procedure, risks.

Symptomatic mass effect of a hypertrophied pericranial flap after repair of a dural defect: case report.

Than KD, Kretzer RM, Dorsi MJ, Weingart JD

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

OBJECTIVE: To detail a potential complication of the use of vascularized pericranial flaps in the repair of dural defects, namely, flap hypertrophy secondary to venous engorgement. CLINICAL PRESENTATION: A 23-year-old man with a left parietal lobe hemangiopericytoma underwent a craniotomy for tumor resection. The resultant dural defect was repaired with a vascularized pericranial flap. On postoperative Day 3, the patient developed headache, confusion, aphasia, and right upper extremity apraxia. Imaging revealed an extra-axial collection at the craniotomy site; on reexploration, a swollen, engorged pericranial flap causing mass effect was found. INTERVENTION: The pericranial flap was excised. CONCLUSION: In this case, hypertrophy of the vascularized pericranial flap is hypothesized to have occurred because of venous congestion, possibly secondary to restriction of venous outflow by the overlying bone flap.

Published 6 April 2007 in Neurosurgery, 60(4): E773; discussion E773.
Full-text of this article is available online (may require subscription).

© 2004-2008 Bone Grafts Research Today. All Rights Reserved.