Bhimani Rohan, Bhimani Fardeen, Singh Preeti
Department of Orthopaedics, Hinduja Healthcare Surgicals, 11th Road, Khar (West), Mumbai 400052, India.
Department of Orthopaedics, Bharati Hospital, Pune 411043, India.
Case Rep Med. 2018 Apr 2;2018:5061898. doi: 10.1155/2018/5061898. eCollection 2018.
Intracranial hypotension may occur when CSF leaks from the subarachnoid space. Formation of intracranial, subdural, and subarachnoid hemorrhage has been observed after significant CSF leak as seen in lumbar puncture or ventricular shunt placement. However, very few cases, referring to these remote complications following spine surgery, have been described in literature. We present a case of a 10-year-old male child operated for idiopathic scoliosis with low-lying conus medullaris who postoperatively developed subdural hemorrhage.
A case of a 10-year-old male operated for idiopathic scoliosis with low-lying conus medullaris is presented. To correct this, detethering was done at the L3 level, laminectomy was done from L2 to L3 with pedicular screw fixation from T3 to L2, and bone grafting with right costoplasty was done from the 3rd to the 6th ribs. On the 5th day postoperatively, the patient developed convulsions and drowsiness and recovered subsequently by postoperative day 7.
We report a rare case of an acute intracranial subdural hemorrhage caused by intracranial hypotension following scoliosis and detethering of cord surgery. This report highlights the potential morbidity associated with CSF leak occurring after this surgery.
当脑脊液从蛛网膜下腔漏出时，可能会发生颅内低压。在腰椎穿刺或脑室分流置入等明显脑脊液漏后，已观察到颅内、硬膜下和蛛网膜下腔出血的形成。然而，关于脊柱手术后这些远期并发症的病例，文献中描述的非常少。我们报告一例10岁男性儿童，因特发性脊柱侧凸伴低位圆锥脊髓接受手术，术后发生硬膜下出血。
报告一例10岁男性因特发性脊柱侧凸伴低位圆锥脊髓接受手术。为纠正此情况，在L3水平进行脊髓松解，从L2至L3进行椎板切除术，从T3至L2进行椎弓根螺钉固定，并从第3至第6肋骨进行带右侧肋骨成形术的植骨。术后第5天，患者出现惊厥和嗜睡，随后在术后第7天恢复。
我们报告一例脊柱侧凸及脊髓松解术后因颅内低压导致急性颅内硬膜下出血的罕见病例。本报告强调了该手术后发生脑脊液漏相关的潜在发病率。
