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择期腰椎手术后脑脊液漏继发脑疝

Brain Herniation Secondary to Cerebrospinal Fluid Leak Following Elective Lumbar Spine Surgery.

作者信息

Zhang Andrew, Song Junho, Czerwein John K

机构信息

Orthopaedic Surgery, Louisiana State University Health Sciences Center, Shreveport, USA.

Orthopaedic Surgery, Hospital for Special Surgery, New York, USA.

出版信息

Cureus. 2021 Dec 8;13(12):e20266. doi: 10.7759/cureus.20266. eCollection 2021 Dec.

DOI:10.7759/cureus.20266
PMID:35004068
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8735843/
Abstract

Lumbar spine surgery can be complicated by perioperative cerebrospinal fluid (CSF) leak. However, development of brain herniation secondary to CSF leak following lumbar spine surgery has not been previously reported in the current literature. This case report describes a 48-year-old woman who, after a revision lumbar decompression and fusion, experienced CSF leak followed by development of brain herniation, which resulted in patient demise. The postoperative period was complicated by patient nonadherence to conservative management of CSF leak.

摘要

腰椎手术可能因围手术期脑脊液漏而变得复杂。然而，目前文献中此前尚未报道过腰椎手术后因脑脊液漏继发脑疝的情况。本病例报告描述了一名48岁女性，在腰椎翻修减压融合术后发生脑脊液漏，随后出现脑疝，导致患者死亡。术后患者未坚持脑脊液漏的保守治疗，使病情复杂化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc1f/8735843/224a5222ac6f/cureus-0013-00000020266-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc1f/8735843/979da5c4c7e4/cureus-0013-00000020266-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc1f/8735843/224a5222ac6f/cureus-0013-00000020266-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc1f/8735843/979da5c4c7e4/cureus-0013-00000020266-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc1f/8735843/224a5222ac6f/cureus-0013-00000020266-i02.jpg

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Brain Herniation Secondary to Cerebrospinal Fluid Leak Following Elective Lumbar Spine Surgery.择期腰椎手术后脑脊液漏继发脑疝
Cureus. 2021 Dec 8;13(12):e20266. doi: 10.7759/cureus.20266. eCollection 2021 Dec.
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本文引用的文献

1
Outcome after surgical treatment of cerebrospinal fluid leaks in spontaneous intracranial hypotension-a matter of time.自发性颅内低血压性脑脊液漏的手术治疗结果——时间问题。
J Neurol. 2022 Mar;269(3):1439-1446. doi: 10.1007/s00415-021-10710-7. Epub 2021 Jul 18.
2
Dural Leak: Is It Deterrent to Outcomes in Spine Surgery?: 10 Years Retrospective Analysis of Incidence, Management Protocol, and Surgical Outcomes.硬脊膜漏：它是否会对脊柱手术结果产生影响？：10 年回顾性分析发病率、管理方案和手术结果。
Spine (Phila Pa 1976). 2020 Dec 1;45(23):E1615-E1621. doi: 10.1097/BRS.0000000000003662.
3
Extreme Intracranial Hypotension With Brain Herniation Treated With Repeat Bolus Intrathecal Infusions.
重复推注鞘内输注治疗伴脑疝的极重度颅内低压
Cureus. 2020 May 13;12(5):e8089. doi: 10.7759/cureus.8089.
4
A rare case of concomitant pneumocephalus and pneumorachis after lumbar spine surgery with late presenting dural leak.一例罕见的腰椎手术后并发气颅和气脊膜，伴有迟发性硬脊膜漏。
Spinal Cord Ser Cases. 2019 Oct 21;5:86. doi: 10.1038/s41394-019-0235-3. eCollection 2019.
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Incidence of Asymptomatic Chiari Malformation.无症状性Chiari畸形的发病率
Ir Med J. 2019 Aug 1;112(7):972.
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Intracranial Hypotension and Cerebrospinal Fluid Leak.颅内低血压和脑脊液漏
Neuroimaging Clin N Am. 2019 May;29(2):213-226. doi: 10.1016/j.nic.2019.01.002. Epub 2019 Feb 21.
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A Review of Spontaneous Intracranial Hypotension.自发性颅内低血压的综述。
Curr Neurol Neurosci Rep. 2019 Mar 19;19(5):22. doi: 10.1007/s11910-019-0938-7.
8
Assessing Spinal Cerebrospinal Fluid Leaks in Spontaneous Intracranial Hypotension With a Scoring System Based on Brain Magnetic Resonance Imaging Findings.基于脑磁共振成像结果的评分系统评估自发性颅内低血压性脊髓脑脊液漏。
JAMA Neurol. 2019 May 1;76(5):580-587. doi: 10.1001/jamaneurol.2018.4921.
9
Treatment of cerebrospinal fluid leak after spine surgery.脊柱手术后脑脊液漏的治疗。
Chin J Traumatol. 2017 Apr;20(2):81-83. doi: 10.1016/j.cjtee.2016.12.002. Epub 2017 Feb 24.
10
Posterior reversible encephalopathy syndrome following a thoracic discectomy-induced dural leak: case report.胸椎椎间盘切除术后硬膜漏引发的后部可逆性脑病综合征：病例报告
J Neurosurg Spine. 2016 Nov;25(5):586-590. doi: 10.3171/2016.4.SPINE1623. Epub 2016 Jun 3.