聚四氟乙烯人工硬脑膜两面骨化伴骨髓造血。
Massive Ossification with Hematopoietic Marrow on Both Surfaces of the Expanded Polytetrafluoroethylene Artificial Dura Mater.
机构信息
Department of Neurosurgery, Kyushu Rosai Hospital, Kitakyushu, Japan; Department of Neurosurgery, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan.
Department of Neurosurgery, Fukuoka Children's Hospital, Fukuoka, Japan.
出版信息
World Neurosurg. 2020 Jul;139:405-409. doi: 10.1016/j.wneu.2020.04.068. Epub 2020 Apr 25.
BACKGROUND
Artificial dural substitute made from an expanded polytetrafluoroethylene (ePTFE) sheet has been widely used in surgical application.
CASE DESCRIPTION
We describe a 19-year-old woman in whom massive ossification with hematopoietic marrow was noted on both surfaces of an ePTFE sheet during epilepsy surgery. At age 8, she underwent decompressive craniectomy for a ruptured arteriovenous malformation in the right frontal lobe, followed by duraplasty with an ePTFE sheet and autologous cranioplasty fixed with titanium miniplates.
CONCLUSIONS
Since the ossification was prominent in the wrinkle dents of the ePTFE sheet and fibrotic membrane with repetitive hemorrhagic events was noted under the ePTFE sheet, the most plausible mechanism of ossification development is the organization of epiartificial and subartificial dural hematoma. Surgeons should be aware of the possibility of ossification development when working with ePTFE sheets for duraplasty.
背景
膨体聚四氟乙烯（ePTFE）片制成的人工硬脑膜替代品已广泛应用于外科手术。
病例描述
我们描述了一名 19 岁女性，在癫痫手术中发现 ePTFE 片的两面都有大量的骨化和造血骨髓。8 岁时，她因右侧额叶动静脉畸形破裂而行去骨瓣减压术，随后进行了 ePTFE 片硬脑膜成形术和钛微型板固定的自体颅骨成形术。
结论
由于 ePTFE 片的褶皱凹陷处有明显的骨化，且 ePTFE 片下有纤维性膜和反复出血事件，骨化发展的最可能机制是硬脑膜外和硬脑膜下血肿的机化。外科医生在使用 ePTFE 片进行硬脑膜成形术时应注意骨化发展的可能性。
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