title: Recurrence of symptoms after Chiari decompression and duraplasty with nonautologous graft material.
abstract: Nonautologous material is commonly used for dural grafting. Although good results have been reported with the use of some of these materials in cranial surgery, there is a paucity of information regarding their use in craniocervical decompressive surgery. We report three cases of patients with Chiari malformation type I who experienced recurrent or new-onset Chiari symptoms after surgical decompression and duraplasty with bovine pericardium, Gore-Tex or cadaveric dura. We review the use of these materials and propose possible mechanisms by which a reaction to a nonautologous graft could cause recurrent Chiari symptoms. The preferential use of autologous material for dural grafts during posterior fossa decompressive surgery should prevent this cause of symptom recurrence.
authors.affiliation: Section of Neurosurgery, University of Chicago, Chicago, Ill, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Rosen
authors.forename: Robert
authors.initials: R
authors.lastname: Wollman
authors.forename: David M
authors.initials: DM
authors.lastname: Frim
mesh_terms: D000328:Adult; D000818:Animals; D001139:Arnold-Chiari Malformation / Q000473:pathology / Q000601:surgery*; D002417:Cattle; D002648:Child; D019299:Decompression, Surgical; D004388:Dura Mater / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000473:pathology / Q000637:transplantation*; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D012008:Recurrence; D014183:Transplantation, Heterologous; D016042:Transplantation, Heterotopic; D014184:Transplantation, Homologous; D017211:Treatment Failure
chemical_list: D011138:Polytetrafluoroethylene