Subarachnoid hemorrhage following chymopapain chemonucleolysis. Case report.
Subarachnoid hemorrhage is a frequent finding in patients who have incurred neurological complications following chymopapain chemonucleolysis, but the basis for this occurrence remains controversial. The authors report the clinical and postmortem findings in a 42-year-old man who died 5 days after chemonucleolysis at the L4-5 and L5-S1 disc spaces. The predominant histological abnormality was a severe inflammatory arteritis of a medium-sized artery at the upper cervical level with disruption of the vessel wall. The potential causative role of chymopapain in this situation and the correlation of a vascular basis for many of the complications found after inadvertent intrathecal chymopapain injector are discussed.
D000328:Adult; D002917:Chymopapain / Q000009:adverse effects*; D006801:Humans; D007404:Intervertebral Disc Chemolysis / Q000009:adverse effects*; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000209:etiology*
D002917:Chymopapain