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Postoperative subdural hematoma with blood flow from an epidural hematoma through a tear at the suture point of an artificial dura substitute

  • Hiroaki MatsumotoEmail author
  • Hiroaki Minami
  • Ikuya Yamaura
  • Yasuhisa Yoshida
Original Article - Tumor - Other
Part of the following topical collections:
  1. Tumor - Other

Abstract

Objective

We have recently seen cases of postoperative epidural and subdural hematomas after duraplasty with an artificial dura substitute. In these cases, the epidural hematoma flowed into the subdural space through a tear at the suture point of the artificial dura substitute. In this study, whether such hematomas are specific to a certain artificial dura substitute was investigated, and the cause and risk factors were examined.

Methods

In our institute, 46 patients underwent brain tumor extirpation with duraplasty with an artificial dura substitute; Gore-Tex and SEAMDURA were used as the artificial dura substitutes. Patients with postoperative hemorrhage after brain tumor extirpation with duraplasty with an artificial dura substitute were retrospectively analyzed. Moreover, suture strength was compared experimentally between Gore-Tex and SEAMDURA.

Results

In patients who underwent brain tumor extirpation with duraplasty with an artificial dura substitute, the rate of postoperative hemorrhage was 8.6%. Epidural and subdural hematomas were seen in four patients after tumor extirpation with duraplasty with SEAMDURA, but there were none with Gore-Tex. Exposure of the superior sagittal sinus at craniotomy, older age, and longer operative time were seen more frequently in patients with hematoma than in patients without hematoma. The strength of the suture point was significantly weaker with SEAMDURA than with Gore-Tex (P = 0.00016).

Conclusions

Postoperative epidural and subdural hematomas seem to be specific for SEAMDURA and may be caused by the weak suture strength of SEAMDURA. In cases of duraplasty, a nonabsorbable artificial dura substitute may be suitable.

Keywords

Artificial dura substitute Duraplasty Postoperative hemorrhage 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This was a retrospective analysis. For this type of study, formal consent is not required.

Informed consent

None.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Hiroaki Matsumoto
    • 1
    Email author
  • Hiroaki Minami
    • 1
  • Ikuya Yamaura
    • 1
  • Yasuhisa Yoshida
    • 1
  1. 1.Department of Neurosurgery, Cerebrovascular Research InstituteEisyokai Yoshida HospitalKobeJapan

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