Pneumocephalus complicating routine thoracotomy: Symptoms, diagnosis, and management

Brown, W. Morris; Symbas, Panagiotis N.

doi:10.1016/0003-4975(94)00434-9

Cited by 23 publications

(7 citation statements)

References 4 publications

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“…Knafo et al [ 20 ] reported the thorax pain after injection of onyx. Infection [ 22 ] and neurological defects [ 4 ] were reported separately by Wilson and Jumer and Brown and Symbas. Milloy et al [ 11 ] reported a 19-year-old man complaining headache after repairing the pleural-subarachnoid fistula.…”

Section: Discussionmentioning

confidence: 99%

Diagnose and treatment of traumatic pleural-subarachnoid fistula in children: A case report and systematic review

Yang

Chen

et al. 2020

Chin Neurosurg Jl

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Background: Pleural-subarachnoid fistula (PSF) is a rare disease that is difficult to diagnose and treat. Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF. Case presentation: A 1-year-old boy diagnosed PSF developed into secondary intracranial hypertension after conservative treatment. He was finally cured by down-step treatment of mannitol, avoiding form ventricleperitoneal shunt. Then, we reviewed the literature of pleural-subarachnoid fistula. Fifty-six cases have been reported so far. Most of the cases (51.8%) were caused by surgery; only 17.9% were caused by car accidents. Regarding the treatment, half of the cases cured by surgery and the other by conservative measures. Our case is the first one involving secondary intracranial hypertension and cured by down-step treatment of mannitol. Conclusions: A comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies. Secondary acute intracranial hypertension may be cured by down step treatment of mannitol, evading from the long-term ventriculoperitoneal shunt.

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Section: Discussionmentioning

confidence: 99%

Diagnose and treatment of traumatic pleural-subarachnoid fistula in children: A case report and systematic review

Yang

Chen

et al. 2020

Chin Neurosurg Jl

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“…Furthermore, 27% of the fistulae developing postthoracotomy closed spontaneously2). Conservative therapy, which includes bed rest, external lumbar drainage, and chest tube insertion, has been advocated as the initial treatment strategy.…”

Section: Discussionmentioning

confidence: 99%

Pneumocephalus and Pneumorrhachis due to a Subarachnoid Pleural Fistula That Developed after Thoracic Spine Surgery

Lee

Kim

et al. 2016

Korean J Spine

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Development of a communication between the spinal subarachnoid space and the pleural space after thoracic spine surgery is uncommon. Subarachnoid pleural fistula (SAPF), a distressing condition, involves cerebrospinal fluid leakage. Here we report an unusual case of SAPF, occurring after thoracic spine surgery, that was further complicated by pneumocephalus and pneumorrhachis postthoracentesis, which was performed for unilateral pleural effusion.

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“…Accumulation of intracranial air under tension is a neurosurgical emergency and may indicate ventricular drain placement for decompression. The most characteristic physical finding of this condition would be bruit hydroaerique , a splashing sound induced by a rapid change in head position [36]. Chadduck [37] and Ladehoff [38] describe a rare but morbid complication of remote cerebellar hemorrhage following spinal surgery, with a consensus that downward cerebellar displacement accompanies the relative CSF hypovolemia, leading to tension and occlusion on the superior cerebellar bridging veins with consequent venous infarction and hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Subarachnoid-Pleural Fistula: Applied Anatomy of the Thoracic Spinal Nerve Root

et al. 2011

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Subarachnoid-pleural fistula (SPF) is a rare complication of chest or spine operations for neoplastic disease. Concomitant dural and parietal pleural defects permit flow of cerebrospinal fluid into the pleural cavity or intrapleural air into the subarachnoid space. Dural injury recognized intraoperatively permits immediate repair, but unnoticed damage may cause postoperative pleural effusion, intracranial hypotension, meningitis, or pneumocephalus. We review two cases of SPF following surgical intervention for chest wall metastatic disease to motivate a detailed review of the anatomy of neural, osseous, and ligamentous structures at the intervertebral foramen. We further provide recommendations for avoidance and detection of such complication.

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Pneumocephalus complicating routine thoracotomy: Symptoms, diagnosis, and management

Cited by 23 publications

References 4 publications

Diagnose and treatment of traumatic pleural-subarachnoid fistula in children: A case report and systematic review

Diagnose and treatment of traumatic pleural-subarachnoid fistula in children: A case report and systematic review

Pneumocephalus and Pneumorrhachis due to a Subarachnoid Pleural Fistula That Developed after Thoracic Spine Surgery

Subarachnoid-Pleural Fistula: Applied Anatomy of the Thoracic Spinal Nerve Root

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