Authors
Tunimanov P.G., Zinov’ev E.V., Manukovskij V.A., Tyulikov K.V., CHechulov P.V., Kostyakov D.V.
Saint-Petersburg I.I. Dzhanelidze Research Institute of emergency medicine, Saint-Petersburg
Abstract
Independent epidermis of the dura mater is rare. In the world literature there are references to isolated cases, one of which is given in this article. Patient L. was hospitalized with a diagnosis of closed traumatic brain injury, acute subdural hematoma above the left hemisphere of the brain. In order to decompress the brain structures, craniotomy was performed, removal of the subdural hematoma, and 4 months after cranioplasty injury with a titanium implant. Six months after discharge, a fistula formed in the cranioplasty area. With repeated hospitalization, the implant was removed with simultaneous plastic surgery with local tissues, and after 6 months, cranioplasty was performed with a titanium implant. In the postoperative period, two soft tissue defects with a diameter of up to 2 cm formed in the area of the operation. In order to restore the integrity of the skin on the 30th day, local plastic surgery was performed with oncoming triangular flaps. The postoperative period was uneventful. Six months later, after a repeated injury to the scalp in the area of the postoperative scar, a new skin defect with a diameter of several millimeters formed. Against the background of conservative treatment, an increase in the area of the wound with the development of purulent inflammation was noted. At the preoperative examination, two skin defects with sizes up to 4 cm in diameter were visualized. The bottom of the wound is represented by a titanium plate, which was removed during surgery. Under the latter, a cicatricial dura mater with signs of epidermis and the presence of hair is visualized.
Keywords: dura mater, cranioplasty, epidermis.
References
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