Dural Repair Surgery

Advanced Surgical Solutions for Spontaneous Intracranial Hypotension (SIH)

What Is Dural Repair Surgery?

Dural repair surgery is a specialised procedure designed to treat spontaneous intracranial hypotension (SIH), a condition caused by a cerebrospinal fluid (CSF) leak in the dura mater—the protective membrane surrounding the brain and spinal cord. When CSF leaks occur, they reduce pressure in the brain and spinal cord, leading to debilitating headaches, dizziness, nausea, and neurological symptoms.

Spontaneous CSF leaks can result from weakened dura, connective tissue disorders, minor trauma, or medical procedures such as spinal taps or epidural injections. In cases where conservative treatments fail, surgical dural repair is necessary to prevent further CSF loss, restore pressure balance, and alleviate symptoms.

Whenever possible, Mr Gordan Grahovac prioritises non-surgical treatments such as targeted epidural blood patches before recommending surgery. His patient-first approach ensures that dural repair is considered only when persistent CSF leaks do not respond to conservative management.

Who Benefits from Dural Repair Surgery?

Dural repair for SIH is recommended for individuals experiencing:

  • Chronic or severe headaches that worsen when upright and improve when lying down.

  • Neck stiffness, dizziness, nausea, or visual disturbances due to low CSF pressure.

  • Tinnitus (ringing in the ears), hearing changes, or balance issues caused by CSF depletion.

  • Cognitive difficulties or brain fog due to altered intracranial pressure.

  • Persistent CSF leaks that do not heal with bed rest, hydration, or epidural blood patches.

  • Post-procedural CSF leaks following lumbar punctures, epidural injections, or spinal surgery.

A thorough assessment, including MRI with contrast, digital subtraction myelography (DSM), or CT myelography, is used to locate the site of the leak and determine the best surgical approach.

Surgical Procedures for Dural Repair in SIH

  • Anterior CSF Leak Repair


    Surgical closure of CSF leaks from the anterior dura of the spinal canal, often approached posteriorly.

    How it works: A precise posterior surgical approach is used to access and seal the anterior leak with a graft, sutures, or bio-sealant.

    Conditions it treats: Anterior spinal dural defects causing spontaneous CSF leaks.

    Recovery time: Initial healing occurs within 6–12 weeks, with gradual improvement in symptoms over several months.

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  • Lateral CSF Leak Repair


    Surgical closure of lateral spinal dural defects using advanced sealing techniques.

    How it works: Lateral dural tears or CSF fistulas are repaired with grafts, sutures, or fibrin-based sealants to prevent further leakage.

    Conditions it treats: Lateral dural leaks due to connective tissue disorders, trauma, or spontaneous defects.

    Recovery time: Most patients experience gradual symptom relief over 8–12 weeks, with continued improvement.

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  • Posterior Dural Repair


    Direct suturing and sealing of posterior dural tears, often caused by epidural injections, spinal anaesthesia, or lumbar punctures.

    How it works: A microsurgical approach is used to directly repair the torn dura with sutures or grafts, ensuring proper CSF containment.

    Conditions it treats: Iatrogenic CSF leaks following spinal procedures.

    Recovery time: Most patients recover within 6–12 weeks, with long-term symptom resolution.

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Recovery & Long-Term Results

Recovery from dural repair surgery depends on the location and severity of the leak, as well as the surgical approach used. Mr Gordan Grahovac provides a structured rehabilitation plan to support healing and prevent further CSF leaks.

  • Most patients remain in the hospital for 2–5 days for monitoring and symptom management.

    • Strict avoiding strenuous activity may be required initially to facilitate CSF healing and pressure restoration.

    • Pain management includes prescribed medications and anti-inflammatory treatments.

    • Hydration and dietary adjustments support spinal fluid balance.

    • Gentle movement and posture modifications help prevent strain on the dura.

    • Avoidance of heavy lifting, straining, or bending for several weeks.

    • Most patients resume light activities within 6–12 weeks, with gradual improvements in headaches and neurological symptoms.

    • Strenuous activities should be avoided for at least 3–6 months to allow full dural healing.

    • Significant reduction or elimination of CSF-related headaches and symptoms.

    • Restored spinal fluid balance for normal brain and nervous system function.

    • Prevention and reducing the risk of complications of chronic CSF leak.

Why Choose Mr Gordan Grahovac for Dural Repair Surgery?

With over 20 years of experience, Mr Gordan Grahovac is a leading Consultant Neurosurgeon & Complex Spinal Surgeon specialising in degenerative spinal conditions. He is highly skilled in:

  • Minimally Invasive Techniques – Reducing recovery time, pain, and surgical risks.

  • Patient-Centred Treatment Plans – Tailoring every approach to individual needs.

  • Cutting-Edge Technology – Using advanced techniques for precision and effectiveness.

  • Holistic Recovery Approach – Combining surgery with non-invasive therapies for long-term spinal health.

His patient-first approach ensures the best possible outcomes by integrating precision surgery with conservative recovery strategies.

What Patients Are Saying

Frequently Asked Questions: Dural Repair for SIH

  • No. Conservative treatments like epidural blood patches or bed rest are often tried first. However, persistent leaks that do not heal may require surgery.

  • Many patients experience gradual improvement in headaches and neurological symptoms within weeks, with continued recovery over several months.

  • Yes, when performed by an experienced neurosurgeon, dural repair is a safe and effective treatment for spontaneous or post-procedural CSF leaks.

  • Most patients recover within 6–12 weeks, but full healing and spinal fluid regulation may take several months.

  • Untreated leaks can lead to persistent low-pressure headaches, neurological symptoms, or long-term spinal fluid imbalance, affecting overall health.

Take the First Step Towards Relief

Dural repair surgery effectively treats CSF leaks, restores normal spinal fluid balance, and relieves SIH symptoms. If you are suffering from persistent low-pressure headaches or neurological issues, expert surgical care can help.

Book a consultation with Mr Gordan Grahovac today to discuss whether dural repair surgery is the right treatment for you.