title: Intracranial complications associated with spinal surgery.
abstract: OBJECTIVE
  Though rare, intracranial complications have been reported as a result from spinal surgery. Most if not all of these are a result of intracranial hypotension from durotomy and cerebrospinal fluid (CSF) leak. We aimed to characterize these complications across a large postoperative population at our institution.
  
  
  METHODS
  We conducted a retrospective review of all patients who underwent spinal surgery at our institution by four neurosurgeons from July 2008 to August 2013.
  
  
  RESULTS
  Our review yielded 1113 consecutive patients who underwent spinal surgery for a total of 1396 procedures. Intracranial imaging using either computed tomography or magnetic resonance imaging was obtained on 59 (4.2%) patients after a procedure due to neurologic change. Six patients (0.4%) were found to have intracranial findings of subdural hygroma (4 patients), remote cerebellar hemorrhage (1 patient), or subdural hematoma (1 patient).
  
  
  CONCLUSIONS
  Intracranial complications from spinal surgery are a rare event. We demonstrate an incidence of 0.4% of total intracranial pathology after spinal surgery. A strong clinical suspicion must be maintained after durotomy or CSF leak due to these infrequent but potentially life-threatening complications.
authors.affiliation: Department of Neurosurgery, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90089, USA. martinpham@gmail.com.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Pham
authors.affiliation: Department of Neurosurgery, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90089, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Tuchman
authors.affiliation: Department of Neurosurgery, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90089, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Platt
authors.affiliation: Department of Neurosurgery, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90089, USA.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000209:etiology; D003389:Cranial Nerve Diseases / Q000209:etiology; D005260:Female; D006408:Hematoma, Subdural / Q000209:etiology; D006801:Humans; D019585:Intracranial Hypotension / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D013131:Spine / Q000601:surgery*; D013353:Subdural Effusion / Q000209:etiology
keywords: Complications; Durotomy; Intracranial hypotension; Spinal surgery