Complications of venous insufficiency after neurotologic-skull base surgery.
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.
Roberson
J B
JB
House Ear Clinic, Los Angeles, California 90057, USA.
Brackmann
D E
DE
Fayad
J N
JN
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*