Raising bone lobes when implanted with an intracranial electroencephalogram electrode can avoid complications of brain pressure

Ref: Nagahama Y, et alJ Neurosurg2018 Jul;129 (1): 182-187doi: 10.3171/2017.3.JNS163109Epub 2017 Sep 15.)has a higher spatial and tempor capability than a noninvasive EEG, intracranial electroencephalography (intracranial electroencephalography, iEEG), and plays an important role in determining the spread of epilepsy and seizuresVarious types of electrodes, such as rasters, strips, and deep electrodes, need to be covered at suspected seizures or seizure-borne sitesHowever, due to the fixed volume of the cranial cavity, too many electrodes implanted in the cortex can cause the occupaposition effect, secondary cerebral edema and postoperative neurodysfunctionYasunori Nagahama of neurosurgery at the University of Iowa Hospital in the United States invented a new technique in which, when monitored by an intracranial electroencephalogram, a condescending rectangular titanium plate is used to lift a slight bone lobe higher than the skull bone window, which can expand the cranial cavity volume and reduce the adverse consequences of electrode occupapositionThe results were published in the July 2018 issue of J Neurosurgthe authors evaluated the increased intracranial space size of the curved rectangular titanium plate raised bone flap in 3 cases of iEEG-monitored epileptic surgery (Figure 1) and compared it with the previous line-type titanium plate fixation bone flapThe quertinary rectangular titanium plate raises the bone valve by an average of 6.6 mm, and the wire-type titanium plate is raised by only 1.8 mm, and the former raises by 261%; The use of a condescending rectangular titanium plate can cause an increase in scalp tension after surgery, but the rectangular titanium plate has a stronger ability to resist scalp tension, avoiding bone valve subsidence when using a line-type titanium plate (Figure 2)Figure 1Bone flap elevation techniqueAFixed the rectangular titanium plate to the bone flap, the titanium plate at one end with 2 screws fixed, B, CEach rectangular titanium plate bent inwards and then outwards to form a "step" shape; D The bone flap is returned to the bone window, the other end of the titanium plate is fixed to the bone window edge with two screws, the bone lobe is slightly higher than the adjacent skull Figure 2 After a 26-year-old male epileptic patient is implanted with a cortical electrode, the wire-type titanium plate fixes the reset bone valve Because of the electrode occupaposition effect causes brain pressure and cerebral edema, leading to irreversible aphasia CT showed no elevated bone valves, pressure on brain tissue, and no intracranial bleeding the authors pointed out that the study in the implantation of intracranial electroencephalogram electrodes, the use of a conclining rectangular titanium plate to raise the bone valve, can significantly raise the bone valve, expand the cranial content product, reduce the generation of electrode implantation associated with the complications of neurological dysfunction (Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine
Coka compiled, Professor Wang Zhiqiu , of Huashan Hospital, Fudan University, reviewed, the editor-in-chief of "Outside of God Information" and , huashan Hospital, affiliated with Fudan University
Professor Chen Guancheng ) relevant links