Intracranial hypotension caused by dural-pleural fistula.
This report describes a rare complication in a woman who underwent thoracic spinal surgery. One month postoperatively, her rehabilitation was interrupted by the development of a severe headache, nausea, vomiting, and a right-side occulomotor nerve palsy. Imaging of her brain revealed changes typical of intracranial hypotension, and subsequent imaging of the spine revealed a cerebrospinal fluid (CSF) leak at the site of surgery. The CSF was seen to track into the right pleural space via a dural-pleural fistula. Surgical repair of the fistula led to a definitive resolution in symptoms, thus highlighting the importance of early recognition of this highly unusual complication.
Department of Haematology, Hammersmith Hospital, London, UK. suhailc1000@hotmail.com
Mohammed Suhail
MS
Chaudhry
D000368:Aged; D017586:Diskectomy / Q000009:adverse effects; D005260:Female; D005402:Fistula / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D019585:Intracranial Hypotension / Q000209:etiology* / Q000601:surgery; D010995:Pleural Diseases / Q000150:complications* / Q000601:surgery; D013353:Subdural Effusion / Q000150:complications* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome