Pseudohypoxic Brain Swelling After Uncomplicated Lumbar Decompression and Fusion for Spondylolisthesis.
Aged
Brain Edema
/ diagnostic imaging
Decompression, Surgical
/ adverse effects
Female
Humans
Intracranial Hypotension
/ diagnostic imaging
Magnetic Resonance Imaging
Postoperative Complications
/ diagnostic imaging
Spinal Fusion
/ adverse effects
Spondylolisthesis
/ surgery
Tomography, X-Ray Computed
Treatment Outcome
Lumbar decompression and fusion
Postoperative complications
Postoperative intracranial hypotension−associated venous
Pseudohypoxic brain swelling
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
25
07
2019
accepted:
30
07
2019
pubmed:
8
9
2019
medline:
25
1
2020
entrez:
8
9
2019
Statut:
ppublish
Résumé
Pseudohypoxic brain swelling (PHBS), also known as postoperative intracranial hypotension-associated venous congestion, is a rare complication after neurosurgery characterized by rapid and often severe postoperative deterioration in consciousness and distinct imaging findings on brain magnetic resonance imaging. Imaging findings associated with PHBS include computed tomography and magnetic resonance imaging findings that resemble hypoxic changes and intracranial hypotensive changes in basal ganglia and thalamus, telencephalic, and infratentorial regions without notable changes in intracranial vasculature. This report describes the case of an L4-5 microdiskectomy with posterior decompression and fusion complicated by clinical and radiographic findings resembling PHBS without a known intraoperative durotomy. Spine surgeons should be alerted to the possibility that PHBS may occur in patients even after an operation without known durotomy or cerebrospinal fluid leakage and with spontaneous clinical resolution unrelated to suction drainage changes or epidural blood patches.
Sections du résumé
BACKGROUND
BACKGROUND
Pseudohypoxic brain swelling (PHBS), also known as postoperative intracranial hypotension-associated venous congestion, is a rare complication after neurosurgery characterized by rapid and often severe postoperative deterioration in consciousness and distinct imaging findings on brain magnetic resonance imaging. Imaging findings associated with PHBS include computed tomography and magnetic resonance imaging findings that resemble hypoxic changes and intracranial hypotensive changes in basal ganglia and thalamus, telencephalic, and infratentorial regions without notable changes in intracranial vasculature.
CASE DESCRIPTION
METHODS
This report describes the case of an L4-5 microdiskectomy with posterior decompression and fusion complicated by clinical and radiographic findings resembling PHBS without a known intraoperative durotomy.
CONCLUSIONS
CONCLUSIONS
Spine surgeons should be alerted to the possibility that PHBS may occur in patients even after an operation without known durotomy or cerebrospinal fluid leakage and with spontaneous clinical resolution unrelated to suction drainage changes or epidural blood patches.
Identifiants
pubmed: 31493605
pii: S1878-8750(19)32144-8
doi: 10.1016/j.wneu.2019.07.228
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
155-158Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.