@article{oai:shiga-med.repo.nii.ac.jp:00003468,
 author = {地藤, 純哉 and 新田, 直樹 and 野﨑, 和彦 and JITO, Junya and NITTA, Naoki and NOZAKI, Kazuhiko},
 issue = {8},
 journal = {Neurologia medico-chirurgica},
 month = {Aug},
 note = {A polyethylene glycol (PEG) hydrogel sealant recently has been approved as an adjunct to sutured dural closure in Japan. We treated consecutive six patients with PEG hydrogel sealant in posterior fossa operation. Three of six cases suffered delayed cerebrospinal fluid (CSF) leak after watertight dural closure with the PEG hydrogel sealant, although there was no leak case which was treated with fibrin glue, before 2 years until the adoption of the new material. These patients underwent posterior fossa craniotomy and discharged without remarkable CSF leak. The pseudomeningocele under the occipital wound caused the CSF leak occurr from 5th to 7th week postoperatively. All CSF leak cases needed surgical repair. At the repair, the PEG hydrogel was liquefied and almost absorbed. A fistula on the closure line and a dead space after the absorption of the PEG hydrogel was observed. When the absorbable PEG hydrogel sealant plugs in small gaps of sutured dura, its properties to prevent adhesion might suppress healing process of dural closure, so that CSF could leak through the gaps and collect as a pseudomeningocele in the dead space after absorption of the PEG hydrogel. In posterior fossa surgery a PEG hydrogel sealant should be applied when dural edges are closed tightly without any gaps., ポリエチレングリコール(PEG)ハイドロジェル硬膜被覆材を用いて硬膜を閉鎖後、遅発性脳脊髄液漏にて偽髄膜瘤を生じた3例について述べた。PEGハイドロジェル硬膜被覆材を用いてwatertightに閉鎖を施行した後頭窩手術を6例に行い、乳突蜂巣修復のため3例には更に有茎皮弁にて被覆した。PEGハイドロジェル被覆材のみにて治療した3例で遅発性脳脊髄漏が生じた。CSF症例には筋肉パッチとフィブリン糊を用いて再手術を行った。術後2週間腰部ドレナージを行い、再手術後2ヵ月経過して再発や遅発性髄膜炎の発症は認めなかった。, Journal Article},
 pages = {634--639},
 title = {Delayed cerebrospinal fluid leak after watertight dural closure with a polyethylene glycol hydrogel dural sealant in posterior fossa surgery: case report.},
 volume = {54},
 year = {2014}
}