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Inflammatory reaction to synthetic dural substitute. Case report
A R Cohen1, S Aleksic, J Ransohoff
1Department of Neurosurgery, New England Medical Center, Boston, Massachusetts.
Journal of Neurosurgery
|April 1, 1989
Summary
An inflammatory reaction to Marlex mesh duraplasty mimicked a brain tumor 20 years post-surgery. This rare complication highlights the long-term effects of synthetic dural substitutes.
Area of Science:
- Neurosurgery
- Pathology
Background:
- Dural substitutes are used to repair defects in the dura mater, the protective membrane surrounding the brain.
- Marlex mesh is a synthetic material sometimes employed for duraplasty.
Observation:
- A patient presented with symptoms suggesting a recurrent meningioma 20 years after initial surgery for a convexity meningioma.
- Imaging revealed a lesion mimicking a tumor at the site of a previous Marlex mesh duraplasty.
Findings:
- Histopathological examination revealed a significant inflammatory response to the Marlex mesh.
- The inflammatory infiltrate, not neoplastic cells, was responsible for the mass effect and imaging findings.
Implications:
- This case underscores the potential for delayed inflammatory complications from synthetic dural grafts.
- Long-term monitoring and consideration of inflammatory pseudotumors are crucial in patients with prior synthetic duraplasty.