Cerebellum, brainstem and spinal cord adhesions following basilar impression and Chiari malformation surgery.

Neurosurgical Division of the Hospital Geral Santa Isabel, João Pessoa PB, Brazil;Associated Physician. The true importance of performing a watertight dural closure, for neurological procedures, is to avoid several complications such as cerebrospinal fluid (CSF) leakage, pseudomeningocele (PSM), meningitis, cerebral abscess, tonsilar herniation, hydrocephalus, etc. A variety of materials has been used for duraplasty, including autografts: periosteum, acellular human dermis (Allo Derm®);allografts: acellular human dura mater;xenografts: bovine pericardium and ovine pericardium and synthetic grafts: collagen matrix (Dura-Gen®). Dura-Gen® originated from collagen matrix is the unique dural graft which can be used in the dura mater without the necessity of additional fixation. This study is based on three different types of complications of dural grafts used for the posterior fossa decompression in a patient with basilar impression (BI) and Chiari malformation (CM). Several adhesions to the cerebellum, medulla and spinal cord were observed, as well as a partial calcification of the previous graft, along with cerebellar ataxia.