Background: Modern neurosurgeons commonly rely on dural grafts to aid in obtaining watertight closures when the native dura itself cannot be approximated.
Case presentation: We present a patient who developed a symptomatic, delayed hypersensitivity reaction to a cellulose-based synthetic dural graft, which resolved after reoperation and removal of the graft.
Discussion: Dural grafts are a safe and common implant utilized in neurosurgery. Nevertheless, as with all implanted material, there is a chance for symptomatic immune reactions to occur.
Conclusion: This type of response is exceedingly uncommon, but recognition of this rare presentation may help other providers recognize it in the future.
Keywords: Allergic reaction; T-cell; craniotomy; delayed hypersensitivity; dural substitute; inflammation.