The reconstructive role of TachoSil in neurosurgery

•Hemorrhages, cerebrospinal fluid (CSF) fistula and infections are challenging post-operative complications.•TachoSil® is a fixed combination of a collagen matrix coated with two coagulation factors such as fibrinogen and thrombin.•TachoSil demonstrated to be able to cover the ventricular wall defect, avoiding the risk of ventricular obstruction.•We pointed out on its effect on the ventricular wall to avoid communication between ventricles and surgical field.

Hemorrhages, cerebrospinal fluid (CSF) fistula and infections are the most challenging post-operative complications in Neurosurgery [1–5]. Fibrin sealant agents have been developed with the aim to provide efficient hemostasis and safe dural closure [3,6–14]. In this study we report our initial experience using TachoSil® (haemostatic surgical patch; Nycomed, Linz, Austria) in achieving hemostasis and CSF leakage repair during cranio-cerebral procedures [15–18]. We describe and show the unique features of this fibrin sealant, pioneered with stunning success in many surgical procedures known to be at high risk of peri- and postoperative bleeding (i.e. nephrectomies, pulmonary lobectomies, ballistic injuries, arthroplasties, coronary bypass graftings), but still not widely exploited at its best in the field of Neurosurgery.