A novel two-layer, intradural and extradural patch graft approach to treating dural defects and tears: illustrative case
BACKGROUND Dural tears must be quickly addressed to avoid the development of positional headaches and pseudomeningoceles, among other complications. However, sizeable areas of friable or absent dura create unique challenges when attempting to achieve a watertight seal. We have developed a two-layer...
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Published in | Journal of neurosurgery. Case lessons Vol. 3; no. 6 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
American Association of Neurological Surgeons
07.02.2022
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Subjects | |
Online Access | Get full text |
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Summary: | BACKGROUND Dural tears must be quickly addressed to avoid the development of positional headaches and pseudomeningoceles, among other complications. However, sizeable areas of friable or absent dura create unique challenges when attempting to achieve a watertight seal. We have developed a two-layer subdural and epidural fibrous patch technique to treat expansive or challenging dural tears as a result of our experience treating spinal fluid leaks. OBSERVATIONS The authors present the treatment of a large necrotic (5 × 1.5 cm) dural defect refractory to initial attempts at standard primary repair with dural patch grafting and requiring a revision with a dual-layer patch to manage persistent cerebrospinal fluid leakage. LESSONS The use of a two-layer (subdural and epidural) patch is both a safe and effective dural repair technique for creating a watertight seal in challenging large areas in which the dura may be damaged, scarred, or absent. We also propose that this technique may be able to be used for smaller challenging tears, as well as potentially for repairs of large blood vessels or other fluid-filled structures in the body. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Disclosures Dr. Jenkins reported a patent for Surgical Implant for Repairing a Defect in Spinal Dura Mater is pending. No other disclosures were reported. INCLUDE WHEN CITING Published February 7, 2022; DOI: 10.3171/CASE21639. |
ISSN: | 2694-1902 2694-1902 |
DOI: | 10.3171/CASE21639 |