title: Hemorrhagic complications in association with silastic dural substitute: pediatric and adult case reports with a review of the literature.
abstract: OBJECTIVE
  Delayed intracranial hemorrhage is an unusual complication associated with the use of silastic dural substitute.
  
  
  METHODS
  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.
  
  
  METHODS
  The hematomas were removed with the silastic dural substitute from all three patients, and the dural defect was repaired with autologous paracervical fascia.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Neurosurgery, University of Iowa Hospital and Clinics, University of Iowa College of Medicine, Iowa City, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Robertson
authors.forename: A H
authors.initials: AH
authors.lastname: Menezes
mesh_terms: D000328:Adult; D001139:Arnold-Chiari Malformation / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000601:surgery; D003398:Craniosynostoses / Q000601:surgery; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006407:Hematoma, Epidural, Cranial / Q000209:etiology / Q000601:surgery; D006408:Hematoma, Subdural / Q000209:etiology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D019736:Prostheses and Implants; D012086:Reoperation; D012826:Silicone Elastomers
chemical_list: D012826:Silicone Elastomers