Epidural haematoma by Mayfield head-holder®. Case report and review of literature.

Jacopo Poli, Cesare Zoia, Desiree Lattanzi, Sergio Balbi
3.645 1.849

Abstract


A  lot of neurosurgical interventions require the use of a pin-type head-holder to immobilize the patients' head. We report the case of an epidural haematoma caused by penetration of head holders' pin in a 7-year-old boy. The haematoma was showed by a head CT-scan at the end of surgery performed to treat a cerebellar astrocytoma that was managed surgically. Mmany factors seem to contribute to elevate the risk of complications due to the use of the Mayfield head-holder. Prevention and management measures are discussed also through a review of literature.


Keywords


Mayfield skull clamp; Depressed skull fracture; Epidural haematoma; Cerebellar astrocytoma

Full Text:

E195


References


Agrawal D, Steinbok P: Simple technique of head fixation for image-guided neurosurgery in infants. Childs Nerv Syst. 22(11):1473-4, 2006

Anegawa S, Shigemori M, Yoshida M, Kojo N, Torigoe R, Shirouzu T, Kuramoto S: Postoperative tension pneumocephalus--report of 3 cases. No Shinkei Geka. 14(8):1017-22, 1986 [Article in Japanese]

Aoki N, Sakai T. Modified application of three-point skull clamp for infants. Neurosurgery. 25(4):660-2, 1989

Baerts WD, de Lange JJ, Booij LH, Broere G: Complications of the Mayfield skull clamp. Anesthesiology 61(4):460-1, 1984

Berry C, Sandberg DI, Hoh DJ, Krieger MD, McComb JG: Use of cranial fixation pins in pediatric neurosurgery. Neurosurgery 62(4):913-8; discussion 918-9, 2008.

Cabezudo JM, Gilsanz F, Vaquero J, Areitio E, Martinez R: Air embolism from wounds from a pin-type head-holder as a complication of posterior fossa surgery in the sitting position. Case report. J Neurosurg. Jul;55(1):147-8, 1981

Chi-Tun-Tang, Cheng-Ta Hseigh, YungHsiao Chiang Yih-Huei-Sui: Epidural hematoma and depressed skull fracture resulted from pin head rest: Case report. Cesk Slov neurol N 103:584-6, 2007

Erbayraktar S, Gokmen N, Acar U: Intracranial penetrating injury associated with an intraoperative epidural haematoma caused by a spring-laden pin of a multipose headrest. Br J neurosurg 15:425-8, 2001

Fernández-Portales I, Cabezudo JM, Lorenzana L, Gómez L, Porras L, Rodríguez JA. Traumatic aneurysm of the superficial temporal artery as a complication of pin-type head-holder device. Case report. Surg Neurol 52:400-403, 1999

Gardner W J: Intracranial operations in the sitting position. Ann Surg 101:138-146, 1993

Grinberg F, Slaughter TF, McGrath BJ: Probable venous air embolism associated with removal of the Mayfield skull clamp. Anesth Analg. 80(5):1049-50, 1995

Gupta N: A modification of the Mayfield horseshoe headrest allowing pin fixation and cranial immobilization in infants and young children. Neurosurgery. 58(1 Suppl):ONSE181; discussion ONS-E181, 2006

Heifetz MD. Use and misuse of instruments in Apuzzo MLJ (Ed): Brain surgery : complications avoidance and management. New York: Churchill Livingstone, pp71-90, 1993

Inagawa T, Takeda T, Taguchi H, Kamiya K, Yamada T. Traumatic middle meningeal arteriovenous fistula caused by three-point skull fixation. Case report. J Neurosurg 60:853-855, 1984

Lee M, Rezai AR, Chou J : Depressed skull fractures in children secondary to skull clamp fixation devices. Pediatr Neurosurg. 21(3):174-7; discussion 178, 1994

Lee MJ, Lin EL: The use of the three-pronged Mayfield head clamp resulting in an intracranial epidural hematoma in an adult patient. Eur Spine J. 19 Suppl 2:S187-9, 2010

Martínez-Lage JF, Almagro MJ, Serrano C, Mena L: Depressed skull fracture by a threepin head holder: a case illustration. Childs Nerv Syst. 27(1):163-5, 2011

Matouk CC, Ellis MJ, Kalia SK, Ginsberg HJ: Skull fracture secondary to application of a Mayfield skull clamp in an adult patient: Case report and review of the literature. Clin Neurol Neurosurg. 2012

Muzumdar DP, Bhatjiwale MG, Goel A: Plaster of Paris mould for stereotactic frame fixation. Pediatr Neurosurg. 41(5):229-32, 2005

Naik V, Goyal N, Agrawal D: Pin site bilateral epidural hematoma - a rare complication of using Mayfield clamp in neurosurgery. Neurol India. 59(4):649-51, 2011

Pang D: Air embolism associated with wounds from a pin-type head-holder. Case report. J Neurosurg. 57(5):710-3, 1982

Sade B, Mohr G: Depressed skull frature and epidural haematoma: an unusual postoperative complication of headrest in adult. Acta Neurochir (Wien) 147:101-3, 2005

Sgouros S, Grainger MC, McCallin S: Adaptation of skull clamp for use in imageguided surgery of children in the first 2 years of life. Childs Nerv Syst. 21(2):148-9, 2005

Taira T, Tanikawa T. Breakage of Mayfield head rest. J Neurosurg 77:160-161, 1992

Vitali AM, Steinbok P: Depressed skull fracture and epidural hematoma from head fixation with pins for craniotomy in children. Childs Nerv Syst. 24(8):917-23; discussion 925, 2008

Wilkins RH, Albin MS: An unusual entrance site of venous air embolism during operations in the sitting position. Surg Neurol. 7(2):71-2, 1977

Wong WB, Haynes RJ: Osteology of the pediatric skull. Considerations of halo pin placement. Spine (Phila Pa 1976). 1;19(13):1451-4, 1994

Yan HJ: Epidural hematoma following use of a three-point skull clamp. J Clin Neurosci. 14(7):691-3, 2007