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In our case, we introduced a technical variant consisting in primary external drainage from the malformative sac, followed by closure of the encephalocele and, eventually, by CSF shunting.

These findings suggest a role for inflammatory cells, currently present in the granulation tissue of CSDH, in the release of VEG/PF and in the enlargement of these lesions, stating the possibility of a new therapeutic approach to CSDH, based on blocking the physiological effects of VEG/PF.