Pseudohypoxic Brain Swelling After Uncomplicated Lumbar Decompression and Fusion for Spondylolisthesis

Chidambaram, Swathi; Swong, Kevin; Ander, Michael; Nockels, Russel P.

doi:10.1016/j.wneu.2019.07.228

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…leakage during the surgery, which is often considered a significant factor in the development of PIHV secondary to durotomies and violation of the subarachnoid space at the surgical site [ 9 , 10 ]. There are few cases of PIHV in literature without obvious intraoperative CSF leakage and it was first reported in 2019 by Chidambaram et al [11] . Their case presents a patient who underwent an uneventful lumbar decompression and fusion with postoperative complications characteristic of pseudohypoxic brain swelling with full neurological recovery similar to our patient.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Pseudohypoxic brain swelling following elective lumbar laminectomy: A rare case report and review of literature

Maule,

Creamer,

Elsadek

et al. 2024

Radiology Case Reports

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Pseudohypoxic brain swelling following elective lumbar laminectomy: A rare case report and review of literature

Maule,

Creamer,

Elsadek

et al. 2024

Radiology Case Reports

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“…During a brain or spine surgical procedure, it has been speculated that a rapid reduction in CSF volume may initiate a series of events, including a downward descent of the brainstem and a compensatory increase in cerebral blood volume with venous congestion. 4 )…”

Section: Discussionmentioning

confidence: 99%

Pseudohypoxic Brain Swelling after Unilateral Burr Hole Drainage: A Novel Case Report

Nakamura

Sato

Hirayama

et al. 2022

NMC Case Report Journal

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An 85-year-old man underwent emergency right trepanation and drainage for a symptomatic chronic subdural hematoma. Pseudohypoxic brain swelling (PHBS) was suspected because magnetic resonance imaging revealed diffuse brain swelling. Although cerebrospinal fluid (CSF) leakage was not obvious during or after surgery, most of the reported PHBS cases have leaked CSF during craniotomy or spine surgery. PHBS has not been previously reported in patients without obvious CSF leakage or after unilateral burr hole drainage. Herein, we report an extremely rare case with a literature review investigating its pathogenesis and clinical features.

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“…On imaging, PIHV shares common findings with hypoxicischemic encephalopathy. 1,2,[4][5][6] The clinical outcome spans from complete recovery to fatal outcome. 1,[3][4][5][6] We describe the clinical and radiologic course of a patient who presented with PIHV after an uneventful revision surgery for wound dehiscence.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Intracranial Hypotension-Associated Venous Congestion after Spinal Surgery Managed with Multiple Blood Patches: Case Report

Kurzbuch

Bourlond

Martínez

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Background Postoperative intracranial hypotension-associated venous congestion (PIHV) is a rare event. The authors report the case of a patient presenting with PIHV after spinal surgery following the sudden loss of cerebrospinal fluid (CSF) induced by suction drainage. Methods A 69-year-old patient underwent uneventful revision surgery for wound dehiscence after lumbar surgery with placement of a subfascial suction drain. Results Postoperatively, the patient presented with fluctuating consciousness and a generalized tonic–clonic seizure. Computed tomography (CT) and serial magnetic resonance imaging (MRI) were performed showing convexity subarachnoid hemorrhages (SAHs), diffuse swelling of the brain and thalami and striatum bilaterally without diffusion restriction, and signs of intracranial hypertension resulting in pseudohypoxic brain swelling in PIHV. A dural leak at L3–L4 was treated with several CT-guided patches combining autologous blood and fibrin glue injections. The patient recovered without neurologic deficit and follow-up MRI revealed progressive complete reversal of brain swelling, and re-expansion of CSF spaces. Conclusion PIHV is a rare but potentially fatal entity. Awareness of PIHV after cranial or spinal surgery leads to early treatment of CSF hypovolemia and possibly better clinical outcome. Following acute CSF volume loss, an acute elevation of cerebral blood volume overcoming autoregulatory mechanisms seems a likely explanation for diffuse cerebral vasogenic edema and SAH in PIHV.

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Pseudohypoxic Brain Swelling After Uncomplicated Lumbar Decompression and Fusion for Spondylolisthesis

Cited by 6 publications

References 16 publications

Pseudohypoxic brain swelling following elective lumbar laminectomy: A rare case report and review of literature

Pseudohypoxic brain swelling following elective lumbar laminectomy: A rare case report and review of literature

Pseudohypoxic Brain Swelling after Unilateral Burr Hole Drainage: A Novel Case Report

Postoperative Intracranial Hypotension-Associated Venous Congestion after Spinal Surgery Managed with Multiple Blood Patches: Case Report

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