The authors present a rare case of fatal cerebral and cerebellar hemorrhagic infarction following an uneventful thoracoscopic microdiscectomy. They hypothesize that this complication was associated with cortical venous thrombosis secondary to intracranial hypotension, which was caused by an unnoticed leak of cerebrospinal fluid (CSF) into the thoracic cavity. Cortical venous thrombosis and intrathoracic CSF were confirmed at autopsy. The former disorder is the most severe manifestation of the pathophysiological mechanism occurring to a lesser degree in patients affected by mild intracranial hypotension, and occurs more frequently in these patients. Intracranial hypotension (of an orthostatic nature or not) must be considered in the differential diagnosis of every patient who complains of headaches after thoracoscopic or open transthoracic microdiscectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.3171/spi.2007.6.3.276 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prevalence and characteristics of microspurs in patients with spontaneous intracranial hypotension compared to the general population.
AJNR Am J Neuroradiol
January 2025
From the Department of Neurosurgery (D.N., L.H., J.G., T.P., R.T.S., A.R., C.M.J.); Department of Neuroradiology (T.D., E.I.P.), Institute of Diagnostic and Interventional Neuroradiology, and Department of Neurology (C.S.), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Department of Neurosurgery (J.B.), Medical Center, University of Freiburg, Freiburg, Germany.
Background And Purpose: In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature.
Materials And Methods: This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between SIH patients with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age-and sex matched cohort of trauma patients.
Defining the typical characteristics of orthostatic headache in patients with spontaneous intracranial hypotension.
Cephalalgia
January 2025
Headache and Facial Pain Group, University College London (UCL) Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Background: Orthostatic headache (OH) is a common feature of various conditions, including spontaneous intracranial hypotension (SIH), but no precise definition currently exists outlining the typical OH characteristics. This ambiguity risks misdiagnosis with unnecessary investigations and delay in institution of treatment. The present study aimed to carry out structured phenotyping of OH in patients with SIH with the aim of outlining its typical characteristics.
View Article and Find Full Text PDFIntroduction to Digital Subtraction Myelography for CSF-Venous Fistula Detection.
AJNR Am J Neuroradiol
January 2025
From the Mayo Clinic, Department of Radiology, Rochester, Minnesota.
The purpose of this video is to introduce digital subtraction myelography for CSF-venous fistula (CVF) detectection. CVF is the most recently identified and likely the most prevalent type of spinal CSF leak that leads to spontaneous intracranial hypotension CVFs are occult on conventional MRI and CT, necessitating the use of myelography for the diagnosis. This video highlights one such technique, which is important because an increasing number of centers are starting to diagnose CVF.
View Article and Find Full Text PDFIntrathecal fluorescein guidance in the treatment of intracranial hypotension due to spinal CSF-venous fistula.
BMJ Case Rep
January 2025
Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Lombardia, Italy.
Among the causes of spontaneous intracranial hypotension (SIH), cerebrospinal fluid (CSF)-venous fistulas (CVFs) represent a recently discovered and poorly understood aetiology, for which invasive treatment (surgery vs endovascular treatment) may be required. However, CVFs are not always immediately identified during surgery. We describe a case of a woman with a 2-year history of SIH who was found to harbour a T8 CVF.
View Article and Find Full Text PDFLeptomeningeal Masses or Masquerades: A Spectrum of Diseases with Leptomeningeal Enhancement and their Mimics.
Curr Med Imaging
January 2025
Department of Radiology, Sengkang General Hospital, Singapore.
Background: Leptomeningeal enhancement, visible on MRI, can indicate a variety of diseases, both neoplastic and non-neoplastic.
Objective: This comprehensive pictorial review aims to equip radiologists and trainees with a thorough understanding of the diverse imaging presentations of leptomeningeal disease.
Methods: Drawing from a retrospective analysis of MRI scans conducted between 1 January 2008 and 30 September 2022, at two tertiary teaching hospitals in Singapore, this review covers a wide range of conditions.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!