Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Burr Hole Drainage : Could Be Another Treatment Option for Cerebrospinal Fluid Leakage after Unidentified Dural Tear during Spinal Surgery?

  • Huh, Jisoon (Department of Neurosurgery, Jeju National University Hospital, Jeju National University School of Medicine)
  • Received : 2012.02.25
  • Accepted : 2013.01.07
  • Published : 2013.01.28
Download PDF
⟨ Previous Next ⟩

Abstract

Authors report a rare case of acute intracranial subdural and intraventricular hemorrhage that were caused by intracranial hypotension resulted from cerebrospinal fluid leakage through an unidentified dural tear site during spinal surgery. The initial brain computed tomography image showed acute hemorrhages combined with preexisting asymptomatic chronic subdural hemorrhage. One burr hole was made over the right parietal skull to drain intracranial hemorrhages and subsequent drainage of cerebrospinal fluid induced by closure of the durotomy site. Among various methods to treat cerebrospinal fluid leakage through unidentified dural injury site, primary repair and spinal subarachnoid drainage are well known treatment options. The brain imaging study to diagnose intracranial hemorrhage should be taken before selecting the treatment method, especially for spinal subarachnoid drainage. Similar mechanism to its spinal counterpart, cranial cerebrospinal fluid drainage has not been mentioned in previous article and could be another treatment option to seal off an unidentified dural tear in particular case of drainage of intracranial hemorrhage is needed.

Keywords

References

  1. Asghar M, Adhiyaman V, Greenway MW, Bhowmick BK, Bates A : Chronic subdural haematoma in the elderly--a North Wales experience. J R Soc Med 95 : 290-292, 2002 https://doi.org/10.1258/jrsm.95.6.290
  2. Bosacco SJ, Gardner MJ, Guille JT : Evaluation and treatment of dural tears in lumbar spine surgery : a review. Clin Orthop Relat Res : 238-247, 2001
  3. Cammisa FP Jr, Girardi FP, Sangani PK, Parvataneni HK, Cadag S, Sandhu HS : Incidental durotomy in spine surgery. Spine (Phila Pa 1976) 25 : 2663-2667, 2000 https://doi.org/10.1097/00007632-200010150-00019
  4. Eismont FJ, Wiesel SW, Rothman RH : Treatment of dural tears associated with spinal surgery. J Bone Joint Surg Am 63 : 1132-1136, 1981 https://doi.org/10.2106/00004623-198163070-00010
  5. Friedman JA, Ecker RD, Piepgras DG, Duke DA : Cerebellar hemorrhage after spinal surgery : report of two cases and literature review. Neurosurgery 50 : 1361-1363; discussion 1363-1364, 2002
  6. Grahovac G, Vilendecic M, Chudy D, Srdoc D, Skrlin J : Nightmare complication after lumbar disc surgery : cranial nontraumatic acute epidural hematoma. Spine (Phila Pa 1976) 36 : E1761-E1764, 2011 https://doi.org/10.1097/BRS.0b013e31821cb9fd
  7. Jones AA, Stambough JL, Balderston RA, Rothman RH, Booth RE Jr : Long-term results of lumbar spine surgery complicated by unintended incidental durotomy. Spine (Phila Pa 1976) 14 : 443-446, 1989 https://doi.org/10.1097/00007632-198904000-00021
  8. Jung YY, Ju CI, Kim SW : Bilateral subdural hematoma due to an unnoticed dural tear during spine surgery. J Korean Neurosurg Soc 47 : 316-318, 2010 https://doi.org/10.3340/jkns.2010.47.4.316
  9. Kitchel SH, Eismont FJ, Green BA : Closed subarachnoid drainage for management of cerebrospinal fluid leakage after an operation on the spine. J Bone Joint Surg Am 71 : 984-987, 1989 https://doi.org/10.2106/00004623-198971070-00004
  10. Maycock NF, van Essen J, Pfitzner J : Post-laminectomy cerebrospinal fluid fistula treated with epidural blood patch. Spine (Phila Pa 1976) 19 : 2223-2225, 1994 https://doi.org/10.1097/00007632-199410000-00018
  11. McMahon P, Dididze M, Levi AD : Incidental durotomy after spinal surgery : a prospective study in an academic institution. J Neurosurg Spine 17 : 30-36, 2012 https://doi.org/10.3171/2012.3.SPINE11939
  12. Nam TK, Park SW, Min BK, Hwang SN : Remote cerebellar hemorrhage after lumbar spinal surgery. J Korean Neurosurg Soc 46 : 501-504, 2009 https://doi.org/10.3340/jkns.2009.46.5.501
  13. Sciubba DM, Kretzer RM, Wang PP : Acute intracranial subdural hematoma following a lumbar CSF leak caused by spine surgery. Spine (Phila Pa 1976) 30 : E730-E732, 2005 https://doi.org/10.1097/01.brs.0000192208.66360.29
  14. Shapiro SA, Snyder W : Spinal instrumentation with a low complication rate. Surg Neurol 48 : 566-574, 1997 https://doi.org/10.1016/S0090-3019(97)00296-6
  15. Stolke D, Sollmann WP, Seifert V : Intra- and postoperative complications in lumbar disc surgery. Spine (Phila Pa 1976) 14 : 56-59, 1989 https://doi.org/10.1097/00007632-198901000-00011
  16. Zimmerman RM, Kebaish KM : Intracranial hemorrhage following incidental durotomy during spinal surgery. A report of four patients. J Bone Joint Surg Am 89 : 2275-2279, 2007 https://doi.org/10.2106/JBJS.F.01550

Cited by

  1. The intra- and postoperative management of accidental durotomy in lumbar spine surgery: results of a German survey vol.157, pp.3, 2015, https://doi.org/10.1007/s00701-014-2325-0
  2. Biodegradable Mineralized Collagen Plug for the Reconstruction of Craniotomy Burr-Holes: A Report of Three Cases vol.1, pp.1, 2013, https://doi.org/10.18679/cn11-6030_r.2015.002
  3. Subarachnoid Hemorrhage Presenting with Seizure due to Cerebrospinal Fluid Leakage after Spinal Surgery vol.59, pp.1, 2013, https://doi.org/10.3340/jkns.2016.59.1.62
  4. Clinical case-series report of traumatic cauda equina herniation : A pathological phenomena occurring with thoracolumbar and lumbar burst fractures vol.96, pp.14, 2013, https://doi.org/10.1097/md.0000000000006446
  5. Obstructive Hydrocephalus Due to Intraventricular Hemorrhage After Incidental Durotomy During Lumbar Spine Surgery vol.43, pp.5, 2018, https://doi.org/10.1097/brs.0000000000001074
  6. Symptomatic Intracranial Hemorrhage after Dural Tear in Spinal Surgery–A Series of 10 Cases and Review of the Literature vol.150, pp.None, 2013, https://doi.org/10.1016/j.wneu.2021.02.071