Complications of spinal drainage in the management of cerebrospinal fluid fistula

Graf, Carl J.; Gross, Cordell E.; Beck, David

doi:10.3171/jns.1981.54.3.0392

Cited by 66 publications

(37 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…30 Pneumocephalus with brainstem compression after overdrainage has been reported. 24 Other side effects associated with overdrainage include headaches, nausea, and vomiting. Moreover, the standard practice of keeping patients with lumbar drains on bed rest to prevent rapid CSF drainage due to positional change may increase the risk of postoperative morbidity due to the development of deep venous thrombosis and pulmonary embolism after prolonged immobilization.…”

Section: Intraoperative Strategiesmentioning

confidence: 99%

Management of cerebrospinal fluid leaks after anterior decompression for ossification of the posterior longitudinal ligament: a review of the literature

Mazur¹,

Jost²,

Schmidt³

et al. 2011

FOC

View full text Add to dashboard Cite

Object Anterior decompression is an effective way to treat cervical myelopathy associated with ossification of the posterior longitudinal ligament (OPLL); however, this approach is associated with an increased risk of a dural tear and resultant CSF leak because fusion of the dura with the ossified PLL is common in these cases. The authors review the literature and present an algorithm for treatment of CSF leaks in these patients. Methods A MEDLINE review was performed to identify papers related to CSF leak after anterior decompression for OPLL, and data were summarized to identify treatment options for various situations. A treatment algorithm was identified based on these findings and the experience of the authors. Results Eleven studies were identified that presented data on intra- and postoperative management of a CSF leak during ventral surgery for OPLL. The incidence of cervical dural tears and CSF leaks after anterior decompression procedures for OPLL ranged from 4.3% to 32%. Techniques including preventative measures, intraoperative dural repair with various materials, and postoperative drainage or shunt placement have all been used. Conclusions Although direct dural repair is the preferred treatment for CSF leak, this technique is not always technically possible. In these cases, intraoperative adjuncts in combination with postoperative measures can be used to decrease the pressure gradient across the dural tear.

show abstract

Section: Intraoperative Strategiesmentioning

confidence: 99%

Management of cerebrospinal fluid leaks after anterior decompression for ossification of the posterior longitudinal ligament: a review of the literature

Mazur¹,

Jost²,

Schmidt³

et al. 2011

FOC

View full text Add to dashboard Cite

show abstract

“…1,3,5) The CSF leakage from the dural tear usually ceases spontaneously after catheter removal due to the tamponade effect of the surrounding soft tissue. In the present case, the CSF leakage was continuous and uncontrolled from surgery into the postoperative period, which might have resulted in a large amount of CSF loss and the consequent introduction of a large amount of intracranial air.…”

Section: Discussionmentioning

confidence: 99%

Tension Pneumocephalus as a Complication of Lumbar Drainage for Cerebral Aneurysm Surgery -Case Report-

Saito

Inamasu

Kuramae

et al. 2009

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 66-year-old man developed tension pneumocephalus after failed lumbar drainage before clipping surgery for a ruptured anterior communicating artery aneurysm. After puncture with a Tuohy needle, the spinal catheter could not be inserted into the spinal dura, so surgery proceeded without the catheter placement. The patient's neurological status deteriorated suddenly into coma within 15 hours after uneventful clipping of the aneurysm. Computed tomography revealed tension pneumocephalus with marked brain shift. Intracranial hypotension was probably caused by continuous cerebrospinal fluid leakage from the iatrogenic spinal dural tear, resulting in air entry and accumulation into the cranium from an unidentified opening of the cranial dura. The patient was immediately treated with autologous epidural blood patch administration in the lumbar spine, followed by reopening of the craniotomy incision and flap to evacuate the accumulated air. The patient made a quick and uneventful neurological recovery after the rescue procedure.

show abstract

“…In particular, any alteration in the head of bed level or patient positioning can significantly alter the rate of drainage in a pressure-regulated system, resulting in over- or under-drainage symptoms. Serious complications, such as tension pneumocephalus, have been described [15]. Volume-regulated strategies, although labor intensive and therefore more prone to error, are less influenced by patient position, but still require compliance and nonambulatory status in most cases.…”

Section: Discussionmentioning

confidence: 99%

Pump-Regulated Cerebrospinal Fluid Drainage

Vender¹,

Houle²,

Flannery³

et al. 2000

Pediatr Neurosurg

View full text Add to dashboard Cite

The drainage of cerebrospinal fluid (CSF) from the lumbar subarachnoid space is an effective technique for the treatment of CSF fistula and control of intracranial pressure in children and adults. The use of the lumbar drain poses unique challenges, however, in the pediatric population. We present a safe and effective method of pump-controlled lumbar subarachnoid drainage. This technique allows accurate titration of CSF removal while providing a closed system which is not sensitive to position changes or patient activity. Four case histories are reviewed.

show abstract

Complications of spinal drainage in the management of cerebrospinal fluid fistula

Cited by 66 publications

References 6 publications

Management of cerebrospinal fluid leaks after anterior decompression for ossification of the posterior longitudinal ligament: a review of the literature

Management of cerebrospinal fluid leaks after anterior decompression for ossification of the posterior longitudinal ligament: a review of the literature

Tension Pneumocephalus as a Complication of Lumbar Drainage for Cerebral Aneurysm Surgery -Case Report-

Pump-Regulated Cerebrospinal Fluid Drainage

Contact Info

Product

Resources

About