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

Cureus ◽  
2021 ◽  
Author(s):  
Andrew Zhang ◽  
Junho Song ◽  
John K Czerwein
Keyword(s):  
Cerebrospinal Fluid ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Cerebrospinal Fluid Leak ◽  
Lumbar Spine Surgery ◽  
Brain Herniation ◽  
Fluid Leak

scholarly journals Remote Hemorrhage in the Cerebellum and Temporal Lobe after Lumbar Spine Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Shotaro Watanabe ◽  
Seiji Ohtori ◽  
Sumihisa Orita ◽  
Kazuyo Yamauchi ◽  
Yawara Eguchi ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Lumbar Spine ◽  
Temporal Lobe ◽  
Dura Mater ◽  
Spine Surgery ◽  
Cerebrospinal Fluid Leak ◽  
Leg Pain ◽  
Lumbar Spine Surgery ◽  
Neurosurgical Procedures ◽  
Fluid Leak

Cerebellar hemorrhage remote from the site of surgery can complicate neurosurgical procedures. However, this complication after lumbar surgery is rare. Furthermore, hemorrhage in both the cerebellum and the temporal lobe after spine surgery is rarer still. Herein we present a case of remote hemorrhage in both the cerebellum and the temporal lobe after lumbar spine surgery. A 79-year-old woman with a Schwannoma at the L4 level presented with low back and bilateral leg pain refractory to conservative management. Surgery was undertaken to remove the Schwannoma and to perform posterior fusion. During the surgery, the dura mater was removed in order to excise the Schwannoma. Reconstruction of the dura mater was performed; postoperatively the patient had a cerebrospinal fluid leak. Five days after surgery, clouding of consciousness started gradually, and hemorrhage in the cerebellum and the temporal lobe was revealed by computed tomography. Emergent evacuation of the hemorrhage was performed and the patient recovered consciousness after the surgery. Leakage of cerebrospinal fluid may have induced this hemorrhage. While rare, intracranial hemorrhage after spine surgery can occur, sometimes requiring emergent intervention.

Pneumocephalus leading to the diagnosis of cerebrospinal fluid leak and esophageal perforation after cervical spine surgery

2016 ◽  
Vol 26 ◽  
pp. 141-142 ◽  
Author(s):  
C. Rory Goodwin ◽  
Christine E. Boone ◽  
James Pendleton ◽  
Benjamin D. Elder ◽  
Zhikui Wei ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Esophageal Perforation ◽  
Cerebrospinal Fluid Leak ◽  
Cervical Spine Surgery ◽  
Fluid Leak

Management of Brain Herniation and Cerebrospinal Fluid Leak in Revision Chronic Ear Surgery

2005 ◽  
Vol 115 (7) ◽  
pp. 1256-1261 ◽  
Author(s):  
Christopher T. Wootten ◽  
David M. Kaylie ◽  
Frank M. Warren ◽  
C Gary Jackson
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Brain Herniation ◽  
Ear Surgery ◽  
Fluid Leak

Management of temporal bone meningo-encephalocoele

2008 ◽  
Vol 122 (11) ◽  
pp. 1168-1174 ◽  
Author(s):  
K K Ramalingam ◽  
R Ramalingam ◽  
T M SreenivasaMurthy ◽  
G R Chandrakala
Keyword(s):  
Cerebrospinal Fluid ◽  
Temporal Bone ◽  
Otitis Media ◽  
Cerebrospinal Fluid Leak ◽  
Ossicular Chain ◽  
Brain Herniation ◽  
Suppurative Otitis Media ◽  
Ossicular Chain Reconstruction ◽  
Fluid Leak ◽  
Mastoid Surgery

AbstractMeningo-encephalocoele of the temporal bone, also known as fungus cerebri, is a rare occurrence in clinical practice. We present a series of 13 patients with chronic otitis media who suffered brain herniation into the mastoid cavity. We also discuss the presentation and management of brain herniation with or without cerebrospinal fluid leak.Study design:Retrospective.Methods:Among 963 cases undergoing revision mastoid surgery, 13 patients suffered brain herniation. These cases were identified and analysed.Results:All 13 patients' initial diagnosis was chronic suppurative otitis media with cholesteatoma, and all had undergone previous mastoid surgery resulting in a defect in the tegmen and weakening of the dura mater. The revision procedures performed included 10 (76.9 per cent) modified radical mastoidectomies without ossicular chain reconstruction and one (7.6 per cent) modified radical mastoidectomy with ossicular chain reconstruction; two (15.3 per cent) patients required a blind sac closure. Brain herniation and/or cerebrospinal fluid leak were repaired by a transmastoid ± minicraniotomy procedure.Conclusions:Injury to the tegmen and dura should be avoided during surgery for chronic middle-ear disease. Cerebrospinal fluid leaks, if encountered, should be managed in the same surgical session. The transmastoid approach is helpful in repairing defects smaller than 1 cm in diameter, whereas the combined transmastoid-minicraniotomy approach provides good access when closing defects larger than 1 cm in diameter and also enables auto-calvarial grafting.

A Novel Technique for Endoscopic Repair of Large Anterior Skull Base Defects: The PDS Wrap

2019 ◽  
Vol 34 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Karan Jolly ◽  
Okechukwu Okonkwo ◽  
Georgios Tsermoulas ◽  
Shahzada K. Ahmed
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Cerebrospinal Fluid Leak ◽  
Anterior Skull Base ◽  
Brain Herniation ◽  
Novel Technique ◽  
Endoscopic Skull Base Surgery ◽  
Fluid Leak ◽  
The Brain

Background Endoscopic skull base surgery continues to push boundaries with increased complexity of work and subsequently larger defects requiring repair. Robust repair following endoscopic skull base surgery is essential to reduce significant postoperative complications such as cerebrospinal fluid leak, meningitis, and pneumocephalus. Objective To describe and further validate our novel technique of using a polydioxanone plate wrap used in large anterior skull base resections where brain herniation can be of concern. Method After large resections where there is obvious brain herniation, our PDS (polydioxanone) wrap can be deployed to provide rigid support to the brain. The PDS plate is wrapped in a dural graft material and sutured closed in order to allow deployment by releasing the sutures when in position under the bony ridge of the defect. Conclusion Till date we have successfully used this technique in 3 patients following large skull base resections of olfactory meningiomas, where there was herniation of the brain. Postoperatively, there was no evidence of cerebrospinal fluid leak. We therefore recommend the use of the PDS wrap to prevent brain herniation and provide additional support to the repair.

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