title: Efficacy of arachnoid plasty with collagen sheets and fibrin glue: An in vitro experiment and a case review.
abstract: BACKGROUND
  Postoperative subdural fluid collection sometimes occurs after clipping of cerebral aneurysms. Arachnoid plasty is used to prevent such postoperative complications; however, the optimal materials for arachnoid plasty remain unclear. In this study, we aimed to clarify the optimal materials for arachnoid plasty and report our experience of arachnoid plasty after clipping of unruptured aneurysms.
  
  
  METHODS
  In an in vitro experiment, adhesive strengths of three materials permitted for use in the intradural space, such as collagen sheets, gelatin sponge, and oxidized cellulose sheets, were measured by assessing their water pressure resistance. Then, 80 consecutive cases surgically treated unruptured cerebral aneurysms were retrospectively reviewed to examine the occurrence rate of postoperative subdural fluid collection.
  
  
  RESULTS
  The collagen sheet exhibited the greatest adhesive strength, so we used collagen sheets for the arachnoid plasty procedures. In all of these cases, arachnoid plasty was performed with fibrin glue-soaked collagen sheets. No postoperative subdural fluid collection, inflammation, or allergic reactions occurred in any case.
  
  
  CONCLUSIONS
  The present study suggests that collagen sheet might be one of the optimal materials for arachnoid plasty. This technique is simple and may be effective to prevent subdural fluid collection after clipping.
authors.affiliation: Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545 - 8585, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Abe
authors.affiliation: Department of Neurosurgery, Yao Tokushukai General Hospital, 1-11 Wakakusa-cho, Yao city, Osaka, 581 - 0011, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ichinose
authors.affiliation: Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545 - 8585, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Terakawa
authors.affiliation: Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545 - 8585, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tsuyuguchi
authors.affiliation: Department of Neurosurgery, Yao Tokushukai General Hospital, 1-11 Wakakusa-cho, Yao city, Osaka, 581 - 0011, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tsuruno
authors.affiliation: Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545 - 8585, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohata
keywords: Arachnoid plasty; collagen sheets; water pressure resistance