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Low-grade infection complicating silastic dural substitute 32 years post-operatively
Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Neurosurgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
Umeå University, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Department of Clinical and Experimental Medicine, Neurosurgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
2011 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 25, no 2, 250-254 p.Article in journal (Refereed) Published
Abstract [en]

Background: A complication of a silastic dural substitute is described, which appeared after 32 years-by far the longest latency period reported in the literature. Methods: Case report and literature review. Results: In 1971, a 20-year old woman suffered from an acute subdural haematoma and a temporal cerebral contusion due to a motorbike accident. She underwent an operation with evacuation of these and the dura was mended with a silastic duraplasty. Thirty-two years later she deteriorated with increased memory problems and dysphasia. CT revealed an expanding haemorrhagic mass around the previous duraplasty, which demanded surgery with removal of the silastic dural implant and evacuation of the haemorrhagic mass. Although the haemorrhagic mass enveloped the silastic implant, a contribution of the acrylate flap cannot be ruled out. Bacteriological cultures revealed Acinetobacter spp. in the CSF. Adequate post-operative antibiotic treatment was administered. The patient slowly improved, but the complication represented a major setback in her long-term cognitive and communicative functions. Conclusions: This case widens the previously reported time-frame of late complications by 60%, from 20 to 32 years, and will hopefully serve to increase the awareness of late infections and haemorrhages induced by silastic dural implants, thereby improving diagnosis and treatment in future cases.

Place, publisher, year, edition, pages
Informa Healthcare, 2011. Vol. 25, no 2, 250-254 p.
Keyword [en]
Silastic duraplasty, low-grade infection, acinetobacter, graft complication, head injury
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-66896DOI: 10.3109/02699052.2010.542431ISI: 000288101800011OAI: oai:DiVA.org:liu-66896DiVA: diva2:405245
Available from: 2011-03-21 Created: 2011-03-21 Last updated: 2017-12-11Bibliographically approved

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Ström, JakobBoström, SverreTheodorsson, Annette

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