Traumatic Subarachnoid-Pleural Fistula

Lovaas, Mark E.; Castillo, Reynaldo G.; Deutschman, Clifford S.

doi:10.1227/00006123-198510000-00020

Cited by 14 publications

(4 citation statements)

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“…Subarachnoid‐pleural fistula is rare in humans, reported in conjunction with trauma, such as gunshot wounds, automobile accidents, or in association with thoracic spinal surgery 1–16 . Such trauma results in separation of the fascial planes of the hypaxial muscles as well as the parietal pleura, either because of direct penetration or indirectly from extreme extension of the spine.…”

Section: Discussionmentioning

confidence: 99%

“…Subarachnoid‐pleural fistulas may become clinically apparent because of the acute onset of respiratory distress from pleural effusion, 1–5 or may manifest as a delayed sequela to a prior trauma or surgery, often not apparent until weeks or months later 6–12 . When it occurs, the pleural effusion develops because of negative intrathoracic pressure created during inhalation, which draws cerebrospinal fluid into the pleural cavity.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic Subarachnoid‐pleural Fistula in a Dog

Packer

Frank

Chambers

2004

Vet Radiology Ultrasound

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Subarachnoid-pleural fistula is a rare occurrence in humans as a result of trauma or spinal surgery. Such fistulas commonly remain undiagnosed until sufficient cerebrospinal fluid accumulates in the pleural space to cause respiratory distress. We describe a subarachnoid-pleural fistula in a dog that occurred subsequent to blunt trauma sustained during a fall, with concurrent acute, traumatic intervertebral disc rupture. The extruded disc material penetrated the dura mater, allowing communication between the subarachnoid space and the extrapleural thoracic cavity. Radiographic, myelographic, and computed tomographic (CT) findings are reviewed. Abnormalities noted during myelography included an intradural-extramedullary lesion at T11-T12, with epidural leakage of contrast medium from the region of T12 extending cranially. In images from myelography and CT there was extravasation of contrast medium extending from the subarachnoid and epidural space into the extrapleural thoracic cavity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Traumatic Subarachnoid‐pleural Fistula in a Dog

Packer

Frank

Chambers

2004

Vet Radiology Ultrasound

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“…Other options include sealing the defect with a plug of methyl-methacrylate plastic adhesive covered with a pleural flap [6], gelatin soaked in thrombin [7]and an autogenic blood patch [1, 8, 9]. Ligation of the dural sac could be considered when the neural elements have been disrupted [10]. Smaller fistulae without significant respiratory compromise could be managed without surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Massive Pleural Effusion as the Presenting Feature of a Subarachnoid-Pleural Fistula

Dsouza

Doshi²,

Bhojraj³

et al. 2002

Respiration

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A 14-year-old boy presented with a large symptomatic transudative pleural effusion 4 months after spinal surgery for kyphoscoliosis. Computed tomography myelography confirmed a subarachnoid-pleural fistula (SPF) with a pseudo-meningocele communicating with the left pleural space. A review of the literature indicates this to be a rare finding. The possibility of SPF should be entertained in patients who present with a pleural effusion following transthoracic spinal surgeries.

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“…The first case was reported in 1959 by Milloy, et al 33 A search of Medline records revealed that since that first publication 54 cases have been reported. Thirty-seven were secondary to traumatic injury, [1][2][3][5][6][7][8]11,14,15,17,[20][21][22][23][24]26,29,30,[32][33][34][35][36][37][38][39][40][41][42]44,[47][48][49][50][51][52]55 and 15 to surgery. 4,9,10,12,13,16,19,25,27,28,34,43,45,...…”

Section: Discussionmentioning

confidence: 99%

Treatment of the subarachnoid–pleural fistula

Özgen

Boran²,

Elmacı³

et al. 2000

FOC

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Subarachnoid–pleural fistula is a rare type of cerebrospinal fluid (CSF) fistula, and there are only several cases reported in the literature. The authors describe a 65-year-old male patient in whom a diagnosis of T7–8 disc herniation had been made. He underwent surgery via a right lateral extracavitary approach. Postoperatively he developed progressive respiratory distress and headache. A chest x-ray film revealed a pleural effusion, and computerized tomography (CT) myelography demonstrated a subarachnoidal-pleural fistula at the level at which the herniated disc had been removed. The patient had been managed via a CSF drainage system and a chest tube. He was discharged after relief of symptoms was attained. Subarachnoid–pleural fistulas can be secondary to traumatic injury and surgery, or they can be spontaneous. Patients present with rapidly filling pleural effusion and headache. A diagnosis can be established using CT myelography or myeloscintigraphy. Treatment is conservative, with the placement of a chest tube and insertion of a CSF drainage catheter, and surgical repair should be considered only if the conservative therapy fails.

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Traumatic Subarachnoid-Pleural Fistula

Cited by 14 publications

References 0 publications

Traumatic Subarachnoid‐pleural Fistula in a Dog

Traumatic Subarachnoid‐pleural Fistula in a Dog

Massive Pleural Effusion as the Presenting Feature of a Subarachnoid-Pleural Fistula

Treatment of the subarachnoid–pleural fistula

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