A Case of a Cerebrospinal Fluid Leak Secondary to Chiropractic Manipulation of the Thoracic Spine.
Journal
A&A practice
ISSN: 2575-3126
Titre abrégé: A A Pract
Pays: United States
ID NLM: 101714112
Informations de publication
Date de publication:
01 Sep 2024
01 Sep 2024
Historique:
medline:
9
9
2024
pubmed:
9
9
2024
entrez:
9
9
2024
Statut:
epublish
Résumé
Chiropractic spinal manipulation therapy (CSMT) of the cervical spine has been reported to cause mechanical dural injuries that result in cerebrospinal fluid (CSF) leaks. We present a case of symptomatic intracranial hypotension after isolated thoracic CSMT. Initial imaging was unable to definitively localize the CSF leak, but dynamic imaging was able to better identify the defect. Multiple epidural blood patches were attempted, including image-guided approaches and with fibrin sealant, but surgical repair was ultimately required. Our case illustrates the risk of dural tear in the setting of recent CSMT and the challenges of managing such an injury.
Identifiants
pubmed: 39248364
doi: 10.1213/XAA.0000000000001844
pii: 02054229-202409000-00002
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e01844Informations de copyright
Copyright © 2024 International Anesthesia Research Society.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Lin JP, Zhang SD, He FF, Liu MJ, Ma XX. The status of diagnosis and treatment to intracranial hypotension, including SIH. J Headache Pain. 2017;18:1–8.
Fernando EZ, Jamora RDG, Torio EF, Mariano MM, Cuanang JR, de Guzman VE. Acute subdural hemorrhage as the initial presentation of intracranial hypotension following cervical chiropractic manipulation: a case report and systematic review. Neurohospitalist. 2022;12:57–62.
Suh SI, Koh SB, Choi EJ, et al. Intracranial hypotension induced by cervical spine chiropractic manipulation. Spine. 2005;30:E340–E342.
Morelli N, Gallerini S, Gori S, et al. Intracranial hypotension syndrome following chiropractic manipulation of the cervical spine. J Headache Pain. 2006;7:211–213.
Mathews MK, Frohman L, Lee HJ, Sergott RC, Savino PJ. Spinal fluid leak after chiropractic manipulation of the cervical spine. Arch Ophthalmol. 2006;124:283.
Lin SF, Weng HY. Postural headaches due to cerebrospinal fluid leakage through subarachnoid-pleural fistula: a case report. Headache. 2017;57:467–471.
Wilson D, Steel T, Sutton I. Surgical treatment of cervical disc protrusion causing intracranial hypotension following chiropractic manipulation. J Clin Neurosci. 2015;22:1523–1525.
Shin HY. Recent update on epidural blood patch. Anesth Pain Med. 2022;17:12–23.
Feltracco P, Galligioni H, Barbieri S, Ori C. Thoracic epidural blood patches in the treatment of spontaneous intracranial hypotension: a retrospective case series. Pain Physician. 2015;18:343–348.
Chuang YS, Ju DT, Chiu TH, Huang YH, Cherng CH, Wu ZF. Thoracic epidural blood patch with high volume blood for cerebrospinal fluid leakage of cervical spine (C2–3) complicated with spontaneous intracranial hypotension. Acta Anaesthesiol Taiwan. 2015;53:112–113.
Prasad S, El-Haddad G, Zhuang H, Khella S. Intracranial hypotension following chiropractic spinal manipulation. Headache. 2006;46:1456–1458.
Lloyd RA, Butler JE, Gandevia SC, et al. Respiratory cerebrospinal fluid flow is driven by the thoracic and lumbar spinal pressures. J Physiol. 2020;598:5789–5805.
Amrhein TJ, Befera NT, Gray L, Kranz PG. CT Fluoroscopy-guided blood patching of ventral CSF leaks by direct needle placement in the ventral epidural space using a transforaminal approach. AJNR Am J Neuroradiol. 2016;37:1951–1956.
Kewlani B, Garton ALA, Hussain I, et al. Intracranial hypotension due to ventral thoracic dural tear secondary to osteophyte complex: resolution after transdural thoracic microdiscectomy with dural repair. Illustrative case. J Neurosurg Case Lessons. 2022;3:CASE21615.