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  • Title: Recurrence of symptoms after Chiari decompression and duraplasty with nonautologous graft material.
    Author: Rosen DS, Wollman R, Frim DM.
    Journal: Pediatr Neurosurg; 2003 Apr; 38(4):186-90. PubMed ID: 12646737.
    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.
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