Intracranial hemorrhage associated with cerebrospinal fluid drainage during thoraco-abdominal aortic surgery.
A 69-year-old woman underwent thoraco-abdominal aortic aneurysm repair with cerebrospinal fluid drainage (CSFD). The initial CSF pressure was elevated to approximately 25 cmH(2)O, and clear CSF was continuously drained at a rate of 30 ml/h with the drainage level at 10-20 cmH(2)O. The CSF became bloody when cardiopulmonary bypass was terminated. The total volume of CSF drained was approximately 300 ml at the conclusion of the 638 min operation. Three hours later, she suffered a series of generalized seizures because of intracranial hemorrhage (ICH). It was suggested that excessive drainage of CSF was associated with ICH. Meticulous control of drainage volume combined with standard pressure-based management may be the key to avoiding these complications.
Iizuka
Yusuke
Y
Department of Anesthesiology and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya-ku, Saitama, 330-8503, Japan. zukarinn@hotmail.co.jp
Sanui
Masamitsu
M
Ishioka
Haruhiko
H
Shiotsuka
Junji
J
Otsuka
Yuji
Y
Murayama
Takanori
T
Lefor
Alan
A
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D002555:Cerebrospinal Fluid; D015170:Cerebrospinal Fluid Pressure; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology*