title: Delayed cauda equina compression after spinal dura repair with BioGlue: magnetic resonance imaging and computed tomography aspects of two cases of "glue-oma".
abstract: BACKGROUND
  Bovine serum albumin and glutaraldehyde (BSAG) (BioGlue) is a surgical adhesive widely used for off-label applications in neurosurgical procedures to minimize the risk of cerebrospinal fluid leakage after dural closure.
  
  
  OBJECTIVE
  To describe magnetic resonance imaging (MRI) and computed tomography (CT) aspects of two cases of postoperative BSAG expansion causing delayed cauda equina compression requiring further surgery.
  
  
  METHODS
  A case report.
  
  
  METHODS
  Two cases of delayed cauda equina compression complicating the closure, with BSAG, of small unintentional tears in the dura requiring lumbar decompressive surgery.
  
  
  METHODS
  They included postoperative CT and MRI findings.
  
  
  METHODS
  We compared postoperative imaging and perioperative findings during subsequent surgery.
  
  
  RESULTS
  In both cases, imaging showed cauda equina compression due to epidural masses found during subsequent surgery comprising BioGlue. These masses appeared slightly hyperdense on CT scans and markedly hypointense on T2-weighted MRI scans.
  
  
  CONCLUSIONS
  When applied as a thick layer during use as a dural sealant, BSAG may swell, leading to a symptomatic "glue-oma" giving a hypointense image on T2-weighted MRI scans.
authors.affiliation: Department of Neuroradiology, CHRU de Tours, CHRU Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France. Electronic address: marieagnes.lauvin@gmail.com.
authors.forename: Marie-Agnès
authors.initials: MA
authors.lastname: Lauvin
authors.affiliation: Department of Neurosurgery, CHRU de Tours, CHRU Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France.
authors.forename: Ilyess
authors.initials: I
authors.lastname: Zemmoura
authors.affiliation: Department of Neuroradiology, CHRU de Tours, CHRU Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Cazals
authors.affiliation: Department of Neuroradiology, CHRU de Tours, CHRU Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Cottier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002420:Cauda Equina / Q000473:pathology*; D004388:Dura Mater / Q000473:pathology*; D004824:Epidural Space / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011128:Polyradiculopathy / Q000209:etiology*; D011506:Proteins / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: C472676:Bio-glue; D011506:Proteins
keywords: BioGlue (BSAG: bovine serum albumin and glutaraldehyde polymer); Cauda equina compression; Dural closure techniques; Dural sealants; MRI; Spinal surgery