Delayed hydrocephalus as an unusual complication of a stab injury to the spine

Joseph, Gregory J.; Johnston, R. A.; Fraser, Matthew; McLean, Andrew N.

doi:10.1038/sj.sc.3101655

Cited by 14 publications

(5 citation statements)

References 10 publications

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“…Several cases have been reported as late complications: 1 month after a C2 dumbbell tumor resection, 27 10 months after lumbar decompression and fusion, 28 and 5 months after a stab injury to the upper cervical spine. 29 They do not appear to be specific to Down syndrome but are related to dural tear and repair. In case 9, the detailed cause of hydrocephalus is unclear.…”

Section: Discussionmentioning

confidence: 99%

Complications of Posterior Fusion for Atlantoaxial Instability in Children With Down Syndrome

et al. 2021

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Objective: To clarify the complications of posterior fusion for atlantoaxial instability (AAI) in children with Down syndrome and to discuss the significance of surgical intervention.Methods: Twenty pediatric patients with Down syndrome underwent posterior fusion for AAI between February 2000 and September 2018 (age, 6.1 ± 1.9 years). C1–2 or C1–3 fusion and occipitocervical fusion were performed in 14 and 6 patients, respectively. The past medical history, operation time, estimated blood loss (EBL), duration of Halo vest immobilization, postoperative follow-up period, and intra- and perioperative complications were examined.Results: The operation time was 257.9 ± 55.6 minutes, and the EBL was 101.6 ± 77.9 mL. Complications related to the operation occurred in 6 patients (30.0%). They included 1 major complication (5.0%): hydrocephalus at 3 months postoperatively, possibly related to an intraoperative dural tear. Other surgery-related complications included 3 cases of superficial infections, 1 case of bone graft donor site deep infection, 1 case of C2 pedicle fracture, 1 case of Halo ring dislocation, 1 case of pseudoarthrosis that required revision surgery, and 1 case of temporary neurological deficit after Halo removal at 2 months postoperatively. Complications unrelated to the operation included 2 cases of respiratory infections and 1 case of implant loosening due to a fall at 9 months postoperatively.Conclusion: The complication rate of upper cervical fusion in patients with Down syndrome remained high; however, major complications decreased substantially. Improved intra- and perioperative management facilitates successful surgical intervention for upper cervical instability in pediatric patients with Down syndrome.

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Section: Discussionmentioning

confidence: 99%

Complications of Posterior Fusion for Atlantoaxial Instability in Children With Down Syndrome

et al. 2021

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“…It may follow hemorrhage or trauma when blood is present in the CSF. This may degrade the absorption of CSF at the arachnoid villi3). Hydrocephalus that results from head injury is usually communicating8).…”

Section: Discussionmentioning

confidence: 99%

Acute Hydrocephalus as a Complication of Cervical Spine Fracture and Dislocation: A Case Report

Chung

Kim

et al. 2014

Korean J Spine

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Hydrocephalus is a well-known complication of head injury, but an uncommon complication of a spinal lesion. Here, we present a rare case of acute obstructive hydrocephalus secondary to a cervical fracture and dislocation. A 60-year-old female patient was transferred to the emergency department with quadriplegia and respiratory difficulty. Imaging studies showed a cervical fracture and dislocation at the C3-4 level. She required intubation and mechanical ventilation. Twenty-four hours after admission, her mental status had deteriorated and both pupils were dilated. Computed tomography of the brain showed acute hydrocephalus; therefore, extraventricular drainage (EVD) was performed. After the EVD, her mental status recovered and she became alert, but she remained quadriplegic and dependent on the ventilator. Two months after injury, she died because of respiratory failure caused by pneumonia.

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“…Joseph et al4) reported on a case of hydrocephalus after a penetrating stab injury to the spinal cord at the C1-2 level. He postulated that blood entering the subarachnoid space cuased delayed absorption of CSF at the arachnoid villi and communicating hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

Acute Hydrocephalus Following Cervical Spinal Cord Injury

Son

Lee

Park

et al. 2013

J Korean Neurosurg Soc

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We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drowsiness with dilatation of the right pupil. Findings on brain computed tomography revealed acute hydrocephalus and subarachnoid hemorrhage in the cerebellomedullary cistern, therefore, extraventricular drainage was performed immediately. Acute hydrocephalus as a complication of cervical spine trauma is rare, however, it should be considered if the patient shows deterioration of neurologic symptoms.

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Delayed hydrocephalus as an unusual complication of a stab injury to the spine

Cited by 14 publications

References 10 publications

Complications of Posterior Fusion for Atlantoaxial Instability in Children With Down Syndrome

Complications of Posterior Fusion for Atlantoaxial Instability in Children With Down Syndrome

Acute Hydrocephalus as a Complication of Cervical Spine Fracture and Dislocation: A Case Report

Acute Hydrocephalus Following Cervical Spinal Cord Injury

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