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1. DOAN TUAN ANH

2. Introduction
 Encounter by all
neurosurgeon
 Massive blood loss
 Venous infarction
 Irreversible
neurologic deficits

3. Anatomy

4. Anatomy

5. Attitude!
 Be prepared
 Remain calm
 Manage wisely

6. Hemostasis
 Exposing the area of the injury
 Clearing the operative field
 Warn the anesthesiologist
 Gentle tamponade using cotton patties
 Head elevation

7. SHOULD NOT
 Indiscriminately pack hemostatic agents
Sinus occlusion and potentially cerebral
swelling
 Bipolar coagulation is contraindicated in
partial sinus tears
Enlarge the tear/opening by shrinking the
dural edges

8. SHOULD NOT
 Indiscriminately pack hemostatic agents
Sinus occlusion and potentially cerebral
swelling
 Bipolar coagulation is contraindicated in
partial sinus tears
Enlarge the tear/opening by shrinking the
dural edges

9. Repair
 Most common