A Case of Hydrocephalus and Syringomyelia caused by Eosinophilic Meningitis after Cerebral Aneurysmal Clipping with Resorbable Collagen Dural Substitutes

Abstract

  Eosinophilic meningitis is a rare complication following brain surgery, often triggered by allergic reactions to foreign materials. A limited number of studies have identified a resorbable collagen dural substitute (RCDS) as a potential cause of eosinophilic meningitis.

  We report the case of a 20-year-old female who underwent duraplasty using RCDS. The patient suffered from hydrocephalus and subsequentially faced repeated ventriculoperitoneal shunt malfunctions of unknown cause. Cerebrospinal fluid eosinophilia was identified, and her symptoms and laboratory findings improved following the administration of high-dose corticosteroids. Additionally, the patient developed progressive syringomyelia and presented symptoms in the delayed postoperative period due to craniocervical junction arachnoiditis obstructing cerebrospinal fluid flow. This underscores the necessity for a follow-up whole spine MRI even after resolution of eosinophilic meningitis.

  This case highlights the potential for eosinophilic meningitis and subsequent complications associated with the use of an RCDS. Thus, we should pay attention to possible early and delayed complications following surgery involving RCDS.