title: Acute obstructive hydrocephalus complicating decompression surgery of the craniovertebral junction.
abstract: Obstructive hydrocephalus has been described as a rare complication following foramen magnum decompression for Chiari malformation. However, there are few reports of obstructive hydrocephalus after spinal surgery for other pathologies of the craniovertebral junction (CVJ). The authors herein report a 52-year-old female with achondroplasia presenting with an 8-month history of myelopathy due to spinal cord compression at CVJ. She underwent resection of the C1 posterior arch and part of the edge of the occipital bone. A computed tomography (CT) scan obtained 1-week after the surgery revealed bilateral infratentorial fluid collection. The patient was first managed conservatively; however, on the 17(th) day, her consciousness level showed sudden deterioration. Emergency CT demonstrated marked hydrocephalus due to obstruction of the cerebral aqueduct. Acute obstructive hydrocephalus can occur late after decompression surgery at the CVJ, and thus should be included in the differential diagnosis of a deteriorating mental status.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ohya
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Chikuda
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakatomi
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sakamoto
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Saito
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Sakae
authors.initials: S
authors.lastname: Tanaka
keywords: Achondroplasia; complication; craniovertebral junction; obstructive hydrocephalus; remote cerebellar hemorrhage