Hypoliquorreic headache and pneumocephalus caused by thoraco-subarachnoid fistula.
One month after having a right upper lobectomy to remove a squamous cell carcinoma, a 43-year-old man presented with a 4-day history of postural headache, worsened by standing and relieved by lying. Skull films showed prominent ventricular pneumocephalus. Iophendylate myelography was unrewarding, but isotope cisternography revealed a CSF fistula at the T4 level, extending into the thoracic cavity. Thoracoplastic removal of the first four ribs successfully prevented air passage and the patient had a rapid uneventful recovery.
D000328:Adult; D002493:Central Nervous System Diseases / Q000150:complications*; D005402:Fistula / Q000150:complications*; D006261:Headache / Q000209:etiology*; D006801:Humans; D008297:Male; D011007:Pneumocephalus / Q000209:etiology*; D011013:Pneumonectomy; D011183:Postoperative Complications; D013346:Subarachnoid Space; D013896:Thoracic Diseases / Q000150:complications*