Supratentorial extradural hematoma secondary to intracranial hypotension following spinal cerebrospinal fluid release: A case report and review of literature
- Author:
TJ Aniruddha
;
A Arivazhagan
;
BA Chandramouli
- Publication Type:Journal Article
- From:Neurology Asia
2013;18(3):331-336
- CountryMalaysia
- Language:English
-
Abstract:
Closed continuous lumbar subarachnoid drainage is an accepted strategy in the management of
cerebrospinal fluid (CSF) leaks. Post lumbar drain haematoma as a complication has been reported in
various planes including intraventricular, subdural, subarachnoid, intraparenchymal and spinal extradural
locations, most often in patients receiving anticoagulants. Supratentorial extradural haematoma secondary
to intracranial hypotension due to spinal CSF drainage are extremely rare and have been reported
in a few cases. We present a rare case of near fatal fronto-temporo-parietal extradural haematoma
following a lumbar CSF drain and review the literature. We report a 50 year old lady who developed
CSF rhinorrhea following trans-sphenoidal decompression of non-functioning pituitary macroadenoma.
A lumbar CSF drainage was placed to manage the CSF leak. She became unconscious within 24 hours
of placement of lumbar drain and an urgent CT scan demonstrated a large supratentorial extradural
hematoma which required an emergency evacuation. A review of the five previously reported similar
cases was performed in the light of the present case and salient features highlighted. The present report
emphasizes the fact that a simple procedure like lumbar CSF drainage can have rare life threatening
complications and needs immediate recognition and management.
- Full text:P020150706579492048271.pdf
