POSTERIOR-FOSSA DURAPLASTY IN CHILDREN - REMARKS ON SURGERY AND CLINICAL AND CT FOLLOW-UP

A series of 314 posterior fossa duraplasties in children were performe d at the Department of Neurosurgery, Hradec Kralove, over the past 33 years. Computed tomographic (CT) imaging was used to compare the heali ng of various kinds of collagenic dural substitutes - allogeneic fasci a lata, allogeneic dura mater and xenogeneic pericardium. Early (8 day s to 3 months following surgery) and late (1-18 years following surger y) axial CT scans with sagittal reconstruction for duraplasty in 55 ch ildren were evaluated. In early postoperative CT scans, epidural colle ctions of cerebrospinal fluid, sanguinolent liquid or haematoma and/or pseudocysts or pseudomeningoceles appeared. In late CT follow-up, cal cifications and ossifications in the ''suboccipital coverings complex' ' (SCC) gradually developed and pseudocysts or pseudomeningoceles rare fy persisted. It is concluded, on the basis of perioperative, clinical , and CT examinations, that posterior fossa duraplasties in children f ormed an important anatomical barrier and regardless of the type of gr aft had a favourable outcome; CT was shown to be a suitable method for the demonstration of dural grafts at the site of craniectomies.