Novel therapeutic use of polysaccharide nanosheets for arachnoid plasty and enhancement of venous tensile strength in rat microneurosurgery

Subdural effusion sometimes occurs during neurosurgery after opening the Sylvian fissure, due to cerebrospinal fluid (CSF) leakage from the torn arachnoid membrane. Unexpected bleeding from the fragile bridging veins may also result from brain retraction. Neurosurgeons must always watch carefully for these complications during surgery. To prevent such complications, we have attempted the clinical application of a polysaccharide nanosheet that is semi-absorbent and has a potent physical adhesive strength to investigate its therapeutic utility for arachnoid plasty and enhancement of bridging vein tensile strength in Sprague-Dawley rats. The use of overlapping nanosheets completely prevented CSF leakage from injured arachnoid membranes in the cerebral cortex. No inflammatory infiltration was observed on the cerebral surface after 6 months of follow up. In addition, the use of nanosheet bandages significantly reinforced venous tensile strength. This reinforcement increased with the number of overlaid nanosheets. We report that polysaccharide nanosheets can be used for arachnoid plasty without chemical bonding agents and for reinforcement of venous tensile strength in rat vessels. Nanosheets may be an effective neurosurgical tool.