Symptomatic Pneumocephalus after Lumbar Disc Surgery: a Case Report

Kızılay, Zahir; Yılmaz, Ali; İsmailoğlu, Özgür

doi:10.3889/oamjms.2015.028

Cited by 8 publications

(3 citation statements)

References 7 publications

(20 reference statements)

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“…In the same study, it was thought that when the vacuum suction device was placed on the fascia after spinal surgeries, it could be a predisposing factor in the development of pneumocephalus. 11) Apart from these surgical cases, pneumocephalus was observed in a patient who developed symptoms mimicking stroke after lomber epidural steroid injection. Pneumocephalus is a well-known complication of spinal and epidural anesthesia, but it is very rare after lumbar epidural steroid injection.…”

Section: Discussionmentioning

confidence: 99%

A Rare Complication of Lumbar Spinal Surgery: Pneumocephalus

Özdemir

2017

Korean J Neurotrauma

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A 25-year-old male patient with severe thigh and right side pain was presented. In the lumbar magnetic resonance images, there was a contrasting spinal cord tumor image with 1 cm in diameter at the level of the L3 vertebra. The patient was operated and the tumor was totally removed. All the pain of the patient recovered. The patient's postoperative two days were very comfortable and the patient was early mobilized. On the third postoperative day, the patient complained of severe headache, nausea and vomiting. Immediate cranial computed tomography (CT) images was performed. Cerebral pneumocephalus was present in CT. The patient was treated with definite bed rest and plenty of fluid replacement. After three days, the patient's complaints were completely improved. This improvement was confirmed by performing a cerebral CT scan. In the formation of pneumocephalus, air is compressed into the intradural space during operation and this passes to the cerebral space. Definite bed rest, abundant fluid replacement and, in addition, highly inspired oxygen therapy are sufficient to correct the condition.

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Section: Discussionmentioning

confidence: 99%

A Rare Complication of Lumbar Spinal Surgery: Pneumocephalus

Özdemir

2017

Korean J Neurotrauma

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“…Lateral yüzde olan yırtıkların hiçbir tanesinde sütürasyon yapılmadı. Hastalar yağ grefti ve kanama durdurucu ajanlar kullanılarak bölge mikrotamponize (10,11). Semptomatik hastalarda problemi ve oluşabilecek komplikasyonları (subdural hematom, intraserebellar hemoraji vb.)…”

Section: Sonuçunclassified

Effects of the Location of Dural Tear and Repair in the Development of Pneumocephalus after Spinal Surgery

Öğrenci¹

2019

Haseki

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To investigate the incidence of pneumocephalus related to location of iatrogenic dural defects and the role of dural defect repair in the development of pneumocephalus. Methods: In this prospective study, 18 patients, who underwent surgery for spinal pathologies between 2014 and 2017 and had iatrogenic dural injury, were included. The location of dural defects and whether dural repair was done were recorded. Cranial computed tomography was performed in patients having severe headache or nausea-vomiting after surgery. Asymptomatic patients underwent magnetic resonance imaging (MRI) after providing informed consent. Whether pneumocephalus was developed or not was compared. Results: Six of eight symptomatic patients had pneumocephalus on cranial CT. It was seen that five of six patients had posterior dural defect and one had lateral dural defect. Pneumocephalus was detected on the cranial MR in two of 10 asymptomatic patients. These two patients had posterior dural defect. Pneumocephalus was detected in seven of eight patients in whom primary suture repair of dural defect was performed. Only one of ten patients with posterolateral defects had pneumocephalus. Conclusion: Symptomatic patients with dural tear have a high rate of pneumocephalus. The risk of pneumocephalus in patients with posterolateral dural defect is low. Pneumocephalus is more likely to occur in patients having posterior dural defect, even if the defect is repaired.

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“…The first involves the “inverted bottle theory,” where cerebrospinal fluid (CSF) leaks out creating negative pressure in the subarachnoid space allowing air to enter. 6 7 8 9 10 The second theory is described as a “ball valve mechanism,” where a dural tear resulting from a fracture allows air to enter but cannot exit, similar to a tension pneumothorax. 6 7 8 9 10 …”

Section: Introductionmentioning

confidence: 99%

Tension Pneumocephalus after Cervical Spine Surgery: A Case Report with Review of the Literature

et al. 2018

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This is the case of a 66-year-old male with cervical myelopathy secondary to severe cervical stenosis manifesting as worsening dexterity and numbness in his right hand. The patient underwent C3–C6 laminoplasty with bilateral foraminotomies. During the procedure an incidental durotomy occurred which was patched intraoperatively with Duragen and Tisseel. At 1 month follow-up, the patient reported that he was doing well and skin sutures were removed. Two days later, the patient presented to the emergency department with postoperative wound dehiscence, cerebrospinal fluid (CSF) drainage, altered mental status and lethargy. At that time, a computed tomography (CT) scan confirmed a tension pneumocephalus which was treated with a cranial burr hole and revision durotomy repair. The patient improved and was discharged to a rehabilitation facility with intact motor and cognitive function. At the 1-year follow-up appointment, he continued to do well without sequelae.

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Symptomatic Pneumocephalus after Lumbar Disc Surgery: a Case Report

Cited by 8 publications

References 7 publications

A Rare Complication of Lumbar Spinal Surgery: Pneumocephalus

A Rare Complication of Lumbar Spinal Surgery: Pneumocephalus

Effects of the Location of Dural Tear and Repair in the Development of Pneumocephalus after Spinal Surgery

Tension Pneumocephalus after Cervical Spine Surgery: A Case Report with Review of the Literature

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