Symptomatic Intracranial Hemorrhage after Dural Tear in Spinal Surgery–A Series of 10 Cases and Review of the Literature

Intracranial hemorrhage after spinal surgery: a literature review

“…According to the current literature, dural tears, cerebrospinal fluid leakage, and secondary cerebral tissue shift have been widely accepted as the leading causes of intracranial hemorrhage following spine surgery ( 2 ). In the present review, we observed intraoperative dural tears or incisions in 56 cases, and no dural tears or incisions were found in five cases.…”

“…In the present review, we observed intraoperative dural tears or incisions in 56 cases, and no dural tears or incisions were found in five cases. One postulation is that latent dural tears contribute to intracranial hemorrhage ( 2 ). If too much serosanguineous fluid drains postoperatively, the possibility of occult cerebrospinal fluid leakage should be considered.…”

“…Due to its rarity, the mechanism, clinical characteristics, and treatment have not yet been fully elucidated. A previous study indicated that this complication might be associated with intraoperative dural tears or durotomy (2). However, some cases involving remote cerebellar hemorrhage after lumbar spine surgery without an intraoperative dural tear have also been reported (3).…”

Postoperative Bildgebung der Wirbelsäule

“…Bei postoperativen Kopfschmerzen mit fokalen, neuen neurologischen Ausfällen wie Schwindel sollte man auch an entfernte intrakranielle Blutungen denken, die sehr selten nach Wirbelsäulenoperationen mit Eröffnung der Dura und intrakranieller Hypotension auftreten können [ 22 ]. In allen bislang beschriebenen Fällen lag eine Duraverletzung vor, auch wenn diese teils okkult war [ 1 ].…”

“…Abb 1. 9 Intrathekale Kontrastmittelaussparung (Pfeil) in der CT-Myelographie bei absoluter spinaler Enge auf Höhe LW 3/4 verursacht durch einen Rezidivbandscheibenvorfall.…”