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Year : 2016  |  Volume : 64  |  Issue : 5  |  Page : 1080-

Falx stitch for retraction of the superior sagittal sinus–technical note

Shyam S Krishnan, Gowtham Devareddy, Madabhushi C Vasudevan 
 Achantha Lakshmipathy Neurosurgical Centre, Voluntary Health Services Taramani, Chennai, Tamil Nadu, India

Correspondence Address:
Shyam S Krishnan
Achantha Lakshmipathy Neurosurgical Centre, Voluntary Health Services Taramani, Chennai, Tamil Nadu
India




How to cite this article:
Krishnan SS, Devareddy G, Vasudevan MC. Falx stitch for retraction of the superior sagittal sinus–technical note.Neurol India 2016;64:1080-1080


How to cite this URL:
Krishnan SS, Devareddy G, Vasudevan MC. Falx stitch for retraction of the superior sagittal sinus–technical note. Neurol India [serial online] 2016 [cited 2019 Dec 6 ];64:1080-1080
Available from: http://www.neurologyindia.com/text.asp?2016/64/5/1080/190239


Full Text



Sir,

In general, in interhemispheric approach, craniotomy is made upto the midline and the dura is reflected towards the superior sagittal sinus. Retraction on brain decreases when the craniotomy crosses the midline. The retraction of falx and superior saggital sinus is safe and increases the corridor for surgery.[1] However, in some patients, the superior sagittal sinus is large with bilateral multiple venous lakes preventing the opening of the dura more medially, thus restricting access to the interhemispheric fissure. The surgeon, therefore, has to retract the brain in order to reach the midline. Brain should not be retracted more than 2 cm away from the falx because this may cause retraction injury to the cortex.[2] The retraction of falx and superior sagittal sinus permits an increase in the surgical corridor and allows a better view while performing surgeries. In general, a Leyla retractor or a dural stitch is used to retract superior saggital sinus. In the presence of a large superior sagittal sinus, however, sinus retraction may not be sufficient; hence, the technique used by us may be beneficial. We take a stitch in the falx and spread it in a “V” pattern along the dural edge that will retract the dural sinus almost upto the level of the falx, thereby availing the maximum possible working space, and at the same time, avoiding excessive retraction to the brain [Figure 1],[Figure 2],[Figure 3].{Figure 1}{Figure 2}{Figure 3}

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest

References

1Salcman M, Heros RC, Laws ER Jr, Sonntag VKH. Falx and parasaggital meningiomas. In: Salcman M, Heros RC, Laws ER Jr, Sonntag VKH, eds. Operative Neurosurgery, Volume 1. 2nd ed. New York: Springer Verlag; 2004.p. 121-37.
2Chang EC, Barker FG II, Curry WT. Surgical approach to falcine meningiomas. Hinoja AQ, editor. Schmidek and Sweet Operative Neurosurgical Techniques-Indications, Methods, and Results. 6th ed. China: Elsevier Saunders; 2012. p. 410-16.