直近一年間の累計
アクセス数 : ?
ダウンロード数 : ?
ID 117553
著者
Takamatsu, Nobutoshi Tokushima Prefecture Naruto Hospital
眞鍋, 裕昭 Tokushima Prefecture Naruto Hospital 徳島大学 教育研究者総覧
Wada, Kazuma Tokushima Prefecture Naruto Hospital
Hirano, Tetsuya Tokushima Prefecture Naruto Hospital
千川, 隆志 Tokushima Prefecture Naruto Hospital
キーワード
Cerebrospinal fluid leakage
Pseudomeningocele
Surgery FXIII deficiency
FXIII replacement
Case report
資料タイプ
学術雑誌論文
抄録
Pseudomeningocele is an extradural cystic collection of cerebrospinal fluid (CSF) and is rare and typically asymptomatic. However, pseudomeningocele is sometimes associated with symptoms. Whether symptomatic pseudomeningocele is best treated conservatively or surgically remains controversial. Factor XIII (FXIII) is a blood coagulation factor that also promotes fibroblast proliferation during wound healing. Although treatment of postsurgical CSF leakage with FXIII has been reported, there have been no reports on surgical treatment and FXIII replacement therapy of pseudomeningocele with FXIII deficiency. We report a case of pseudomeningocele with FXIII deficiency that was successfully treated by surgery and FXIII replacement therapy. The patient presented with symptoms of intracranial hypotension syndrome that had started a few months after laminectomy for thoracic ossification of the ligamentum flavum 2 years earlier. Magnetic resonance imaging and delayed computed tomography myelography confirmed a diagnosis of pseudomeningocele. Epidural blood patch treatment was performed twice but did not result in improvement. Furthermore, the FXIII level decreased to 56%, so the patient was also diagnosed as having acquired FXIII deficiency. We elected to treat the patient by surgery with FXIII replacement therapy. The dural injury was repaired using an artificial dura mater patch, fibrin glue, and polyglycolic acid sheets. The FXIII level was 74%–135% during the perioperative period. The patient had a good postoperative course. Postoperative magnetic resonance images showed resolution of the pseudomeningocele. There was no recurrence during 6 months of follow-up. Perioperative FXIII replacement may be a useful treatment for pseudomeningocele with FXIII deficiency.
掲載誌名
International Journal of Surgery Case Reports
ISSN
22102612
出版者
IJS Publishing Group|Elsevier
92
開始ページ
106851
発行日
2022-02-26
権利情報
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
病院
医学系