Tension pneumocephalus following an implant removal from spine

Kundangar, Raghuraj; Bhat, Shyamasunder N; Mohanty, S. P.

doi:10.1136/bcr-2020-239694

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Regarding treatment, pneumocephalus are a known complication of spinal surgery with either accidental dural dear (rare) or from intra-dural tumor [2,7,8]. The treatment is often conservative with neurologic monitoring and dorsal decubitus, helped by the fast reconstitution of CSF-volume (0,4mL/min, 450-550mL per 24 hours) [11].…”

Section: Discussionmentioning

confidence: 99%

Incidental dural tear in spinal surgery complicated by pneumocephalus with abducens (VI) paralysis: a case-report and literature review

Marie-Hardy

Kalamaridès

Pascal‐Moussellard

2023

Preprint

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Introduction: Incidental dural tears are a frequent complication of spinal surgery that may lead to various neurologic complications. Case presentation: Here is describe the case of an 83 years-old female, that underwent a lumbar decompression revision surgery, complicated by an incidental dural. The patient presented in post-operative care an acute onset monocular horizontal diplopia with homolateral ptosis and multiple extra-axial bi-frontal signal voids on the cerebral CT-scan, evoking pneumencephalus. The symptomatology resolved with conservative treatment (dorsal decubitus, monocular external occlusion, and close monitoring). The initial presentation with predominant ophthalmologic clinical signs is at our knowledge the first one to be described after lumbar laminectomy. Conclusion: Diplopia in a context of post-operative spinal surgery must evoke pneumencephalus and might require an urgent cerebral imaging to assess diagnosis.

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Section: Discussionmentioning

confidence: 99%

Incidental dural tear in spinal surgery complicated by pneumocephalus with abducens (VI) paralysis: a case-report and literature review

Marie-Hardy

Kalamaridès

Pascal‐Moussellard

2023

Preprint

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Tension Pneumocephalus Associated with Negative Pressure Wound Therapy with Instillation and Dwell Time for Methicillin-resistant Staphylococcus aureus Infection After Spinal Deformity Surgery

et al. 2022

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Delayed tension pneumocephalus and pneumorrhacis after routine cervical spine surgery treated successfully without burr holes

Lim

Dahapute

Clarke

et al. 2024

annals

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Tension pneumocephalus (TP) after spinal surgery is very rare with only a few cases reported in the English literature. Most cases of TP occur rapidly after spinal surgery. Traditionally, TP is managed using burr holes to relieve intracranial pressure. However, our case highlights a rare delayed presentation of TP and pneumorrhacis 1 month after routine cervical spine surgery. It is to our knowledge the first case of TP after spinal surgery to be treated using dural repair and supportive care. A 75-year-old woman presented with TP after having routine cervical decompression and stabilisation for cervical myelopathy. She re-presented 1 month after her initial operation with a leaking wound and altered mental status, which deteriorated rapidly shortly after admission. This, in combination with her radiographic features, influenced the decision to explore her surgical wound emergently. She made a full recovery and was discharged after 2 weeks in hospital. We hope to emphasise the need for a high index of suspicion for cerebrospinal fluid leaks and the low threshold to return to theatre to repair a potential dural defect, as well as illustrate that TP after spinal surgery can be treated successfully without burr holes.

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Tension pneumocephalus following an implant removal from spine

Cited by 3 publications

References 17 publications

Incidental dural tear in spinal surgery complicated by pneumocephalus with abducens (VI) paralysis: a case-report and literature review

Incidental dural tear in spinal surgery complicated by pneumocephalus with abducens (VI) paralysis: a case-report and literature review

Tension Pneumocephalus Associated with Negative Pressure Wound Therapy with Instillation and Dwell Time for Methicillin-resistant Staphylococcus aureus Infection After Spinal Deformity Surgery

Delayed tension pneumocephalus and pneumorrhacis after routine cervical spine surgery treated successfully without burr holes

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