title: Complications of venous insufficiency after neurotologic-skull base surgery.
abstract: OBJECTIVE
  To characterize the incidence and complications resulting from venous insufficiency after neurotologic-skull base surgery.
  
  
  METHODS
  Retrospective case review of >3,500 cases.
  
  
  METHODS
  Tertiary referral center, inpatient surgery.
  
  
  METHODS
  Six patients: four with complications related to chronic venous insufficiency and two with complications related to acute venous insufficiency.
  
  
  METHODS
  Medical (steroids, acetazolamide, hyperventilation, mannitol) and surgical (lumboperitoneal shunt, optic nerve decompression, embolectomy) interventions were undertaken.
  
  
  METHODS
  Chronic venous insufficiency: nonobstructive hydrocephalus manifested by headache, disequilibrium, and papilledema with resultant visual loss. Acute venous insufficiency: acute nonobstructive hydrocephalus resulting in mental status abnormalities in the postoperative period.
  
  
  CONCLUSIONS
  (1) Incidence of 1.5 per 1,000 cases. (2) Acute and chronic forms with different pathogenesis. (3) Acute form presents postoperatively with change in consciousness and herniation, and may proceed to death. (4) Chronic form presents months or years postoperatively with headache, disequilibrium, and visual changes from papilledema. (5) Occurs almost solely in patients with preoperative abnormalities of the venous collecting system. (6) Causes mental status changes postoperatively.
authors.affiliation: House Ear Clinic, Los Angeles, California 90057, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Roberson
authors.forename: D E
authors.initials: DE
authors.lastname: Brackmann
authors.forename: J N
authors.initials: JN
authors.lastname: Fayad
mesh_terms: D000208:Acute Disease; D000328:Adult; D002544:Cerebral Infarction / Q000175:diagnosis; D002550:Cerebral Veins / Q000503:physiopathology*; D002908:Chronic Disease; D004427:Ear Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*; D013702:Temporal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014689:Venous Insufficiency / Q000175:diagnosis* / Q000503:physiopathology*