Hemorrhagic complications in association with silastic dural substitute: Pediatric and adult case reports with a review of the literature

Abstract

OBJECTIVE AND IMPORTANCE: Delayed intracranial hemorrhage is an unusual complication associated with the use of silastic dural substitute. CLINICAL PRESENTATION: We present three patients with this complication. Two adult patients developed subdural and epidural hemorrhages 9 months and 10 years after posterior fossa surgery for Chiari malformations. The remaining patient, a 13-month-old child, is the youngest reported patient to develop an epidural hematoma 8 months after a craniosynostosis repair. INTERVENTION: The hematomas were removed with the silastic dural substitute from all three patients, and the dural defect was repaired with autologous paracervical fascia. CONCLUSION: Silastic dural grafts have an increased incidence of hemorrhage associated with their use. A slight increase in the prevalence of hemorrhagic complications with silastic dural substitute was observed in women. We report our radiographic and surgical findings, including an extensive review of the literature.