Persistent pleural effusion and post-traumatic subarachnoidal-pleural fistula

Jiménez, Marcelo F.; Roca, Rafael Alonso; Alvarez, Camila Wenceslau; Loinaz, Carmelo; Toledo, João Felipe Barros de

doi:10.1016/1010-7940(91)90112-w

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…The first case was reported in 1959 by Milloy, et al 33 A search of Medline records revealed that since that first publication 54 cases have been reported. Thirty-seven were secondary to traumatic injury, [1][2][3][5][6][7][8]11,14,15,17,[20][21][22][23][24]26,29,30,[32][33][34][35][36][37][38][39][40][41][42]44,[47][48][49][50][51][52]55 and 15 to surgery. 4,9,10,12,13,16,19,25,27,28,34,43,45,...…”

Section: Discussionmentioning

confidence: 99%

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Treatment of the subarachnoid–pleural fistula

Özgen

Boran²,

Elmacı³

et al. 2000

FOC

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Subarachnoid–pleural fistula is a rare type of cerebrospinal fluid (CSF) fistula, and there are only several cases reported in the literature. The authors describe a 65-year-old male patient in whom a diagnosis of T7–8 disc herniation had been made. He underwent surgery via a right lateral extracavitary approach. Postoperatively he developed progressive respiratory distress and headache. A chest x-ray film revealed a pleural effusion, and computerized tomography (CT) myelography demonstrated a subarachnoidal-pleural fistula at the level at which the herniated disc had been removed. The patient had been managed via a CSF drainage system and a chest tube. He was discharged after relief of symptoms was attained. Subarachnoid–pleural fistulas can be secondary to traumatic injury and surgery, or they can be spontaneous. Patients present with rapidly filling pleural effusion and headache. A diagnosis can be established using CT myelography or myeloscintigraphy. Treatment is conservative, with the placement of a chest tube and insertion of a CSF drainage catheter, and surgical repair should be considered only if the conservative therapy fails.

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Section: Discussionmentioning

confidence: 99%

“…Several authors 6,11,13,14,53 have postulated that conservative therapy is suitable in most of the patients. However, other authors 15,19,26,48 have argued that surgical repair of the fistula is essential and that early intervention in these cases is rewarding. There are also other suggested treatment options.…”

Section: Treatment Strategiesmentioning

confidence: 99%