Communicating Hydrocephalus Due to Traumatic Lumbar Spine Injury: Case Report and Literature Review.
: Hydrocephalus is a rare complication of traumatic spine injury. A literature review reflects the rare occurrence with cervical spine injury. We present a case of traumatic injury to the lumbar spine from a gunshot wound, which caused communicating hydrocephalus. The patient sustained a gunshot wound to the lumbar spine and had an L4-5 laminectomy with exploration and removal of foreign bodies. At the time of surgery, the patient was found to have dense subarachnoid hemorrhage in the spinal column. He subsequently had intermittent headaches and altered mental status that resolved without intervention. The headaches worsened, so a computed tomography scan of the brain was obtained, which revealed hydrocephalus. A ventriculoperitoneal shunt was placed, and subsequent computed tomography scan of the brain showed reduced ventricle size. The patient returned to rehabilitation with complete resolution of hydrocephalus symptoms. Intrathecal hemorrhage with subsequent obstruction or decreased absorption of cerebrospinal fluid at the distal spinal cord was thought to lead to communicating hydrocephalus in this case of lumbar penetrating trauma. In patients with a history of hemorrhagic, traumatic spinal injury who subsequently experience headaches or altered mental status, hydrocephalus should be included in the differential diagnosis and adequately investigated.
From the Departments of Physical Medicine & Rehabilitation (ND, AS, WD) and Neurosurgery (RSK, KMS), University of Texas Health Science Center at Houston, Houston, Texas; and TIRR Memorial Hermann, Houston, Texas (AS).
Nikola
N
Dragojlovic
Argyrios
A
Stampas
Ryan S
RS
Kitagawa
Karl M
KM
Schmitt
William
W
Donovan