Cryocalcium glue: a new formulation for dural repair augmentation

Cerebrospinal fluid leakage is a major problem in neurosurgical operations. For preventing it, the dural closure should be augmented. Current glues which use for augmentation are prepared with mixing cryoprecipitate, bovine thrombin and calcium gluconate in suitable concentrations which are expensive and unavailable anywhere. A new formulation is introduced here. This is a prospective randomized clinical trial in patients who need dural patch graft by using Cryocalcium glue, mixing the cryoprecipitate, calcium gluconate and patient's own blood as the origin of thrombin, in our operating room. Comparing two groups of cases[1o6] and controls[100], we found overall C.S.F leak 3.8% and 15% respectively, with 3.6%, Zero%, Zero% and 16.7% in supratentorial, infratentorial, skull base and spinal cord operations in cases versus 12%, 20%, 33% and 28.6% in controls respectively. Using Cryocalcium glue for dural closure augmentation was with better results in comparison with control group. In addition in reviewing literature, comparing this new formulation and old fashion of fibrin glue, revealed that the new one, if not better, is similar to the old one in quality point of view

CSF ascites: Review of articles and a case presentation

Cerebrospinal fluid [CSF] ascites is a rare complication after ventriculopritoneal [VP] shunts. Most patients have gradual abdominal protrusion without any neurological sign or symptom of shunt malfunction. We presented a girl with posterior third ventricle glioblastoma and acute hydrocephalus who developed increasingly abdominal protrusion one month after VP shunt operation. Ascites fluid examination showed characteristic findings similar to CSF with no evidence of infection or malignant cells. Ventriculo-atrial shunt revision cured patient's ascites. Review articles of patients with CSF ascites after VP shunt were presented in details