Advanced Surgical Techniques for Dural Venous Sinus Repair: A Comprehensive Literature Review

Authors

Humberto José Madriñán-Navia, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA.
Lea Scherschinski, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA.
Arnau Benet, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA.
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA.

Document Type

Article

Abstract

The dural venous sinus (DVS) is a thin-walled blood channel composed of dura mater that is susceptible to injury during common neurosurgical approaches. DVS injuries are highly underreported, which is reflected by a lack of literature on the topic. Neurosurgeons should be familiar with appropriate techniques to successfully repair an injured DVS and prevent associated complications. This study presents a literature review on the surgical techniques for DVS repair after DVS injury during common neurosurgical approaches. The databases PubMed and Scopus were queried using the terms "cranial sinuses," "superior sagittal sinus," "transverse sinuses," "injury," and "surgery." A total of 117 articles underwent full-text review and were analyzed for surgical approach, craniotomy, lesion location, lesion characteristics, and surgical repair techniques. A literature review was performed, and a comprehensive summary is presented. Data from publications describing DVS lacerations related to pathological conditions (eg, meningioma) were excluded. A total of 9 techniques aiding with bleeding control, hemostasis, and sinus repair and reconstruction were identified, including compression, hemostatic agents, bipolar cautery, dural tenting and tack-up suturing, dural flap, direct suturing, autologous patch, venous bypass, and ligation. The advantages and drawbacks of each technique are described. Multiple options to treat DVS injuries are available to the neurosurgeon. Treatment type is based on anatomic location, complexity of the laceration, cardiovascular status, the presence of air embolism, and the dexterity and experience of the surgeon.

Medical Subject Headings

Humans; Cranial Sinuses (surgery); Neurosurgical Procedures (methods); Dura Mater (surgery); Craniotomy (methods)

Publication Date

8-1-2024

Publication Title

Operative neurosurgery (Hagerstown, Md.)

E-ISSN

2332-4260

Volume

27

Issue

2

First Page

137

Last Page

147

PubMed ID

38330415

Digital Object Identifier (DOI)

10.1227/ons.0000000000001069

Recommended Citation

Madriñán-Navia, Humberto José; Scherschinski, Lea; Benet, Arnau; and Lawton, Michael T., "Advanced Surgical Techniques for Dural Venous Sinus Repair: A Comprehensive Literature Review" (2024). Neurosurgery. 1983.
https://scholar.barrowneuro.org/neurosurgery/1983