title: Hydrocephalus communicans after traumatic upper cervical spine injury with a cerebrospinal fluid fistula: a rare complication.
abstract: Secondary hydrocephalus communicans after traumatic upper cervical spine injuries with leakage of cerebrospinal fluid is a rare and hardly described complication. A case of a 75-year-old woman sustained a type II dens axis without other injuries, especially without evidence of a hydrocephalus in the primary CT scan. Dorsal atlanto-axial fusion was performed. Postoperative drainage was prolonged and positive for β2-transferrin. Wound revision with an attempt to seal the leakage was not successful. Secondary CT scans of the brain were performed due to neurological deterioration and showed a hydrocephalus with typical EEG findings. No anatomical reason for a circulative obstruction was found in the CT scan. After application of a ventriculo-peritoneal shunt the neurological status improved and the patient could be discharged to neurological rehabilitation.
authors: Department of Trauma Surgery, University Hospital of Zürich, Zürich, Switzerland.
authors: Ladislav
authors: L
authors: Mica
authors: Valentin
authors: V
authors: Neuhaus
authors: Enrico
authors: E
authors: Pöschmann
authors: Dilek
authors: D
authors: Könü-Leblebicioglu
authors: Urs
authors: U
authors: Schwarz
authors: Guido A
authors: GA
authors: Wanner
authors: Clément M L
authors: CM
authors: Werner
authors: Hans-Peter
authors: HP
authors: Simmen
mesh_terms: D000368:Aged; D002555:Cerebrospinal Fluid; D003937:Diagnosis, Differential; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D009809:Odontoid Process / Q000293:injuries*; D013124:Spinal Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt