Symptomatic tension pneumocephalus: An unusual post-operative complication of posterior spinal surgery |
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| Affiliation: | 1. Department of Neurosurgery, University of Michigan, Room 3552, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5338, USA;2. Department of Radiology, University of Michigan, Ann Arbor, MI, USA;1. Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, USA;2. Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA;3. HW Neurological Institute, Nashville, Tennessee, USA;1. Department of Neurosurgery University of Michigan, Ann Arbor, Michigan;2. Bronson Methodist Hospital, Kalamazoo, Michigan;1. Department of Radiology, Division of Interventional Neuroradiology, University of Maryland, 22 South Greene Street, Baltimore, MD 21201.;2. Department of Neurology, University of Maryland, 22 South Greene Street, Baltimore, MD 21201. |
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| Abstract: | Pneumocephalus is a rare, but serious complication of spinal surgery and its management and physiology is not widely recognized. Symptomatic tension pneumocephalus secondary to iatrogenic cerebrospinal fluid (CSF) leak after surgical intervention, and drainage with a vacuum suction device, has not been previously reported. We report a patient who underwent intervertebral disc surgery who developed pneumoencephalus after drainage with a vacuum suction device. Imaging showed significant pneumocephalus in the subarachnoid space of the frontal region and in the cisterns. The condition was resolved by discontinuation of the suction drainage, bed rest and hyperhydration. Thus, spinal drainage may predispose to entry of air intracranially and pneumocephalus. It is important to be aware of this serious post-operative complication in patients with a CSF fistula. |
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