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Intracranial subdural hematoma after unintended durotomy during spine surgery

2002; Springer Science+Business Media; Volume: 49; Issue: 1 Linguagem: Inglês

10.1007/bf03020428

1496-8975

Chueng‐He Lu, Shung‐Tai Ho, Shang-Shung Kong, Chen‐Hwan Cherng, Chih‐Shung Wong,

Head and Neck Surgical Oncology

To report a case of intracranial subdural hematoma occurring after a spinal dural tear that was made unintentionally during the course of a posterior laminectomy and spinal fusion at the L5-S1 level. The possible physiopathological mechanisms are discussed. On the fourth postoperative day, a 59-yr-old woman displayed persistent headache following unintended durotomy during spine implant revision. Perioperative blood loss was 2840 mL and intravascular replacement was about 3000 mL. She was hydrated with iv fluids and treated with non-steroidal antiinflammatory drugs. The symptoms improved but persisted. With the aggravation of the headache complicated with unconsciousness and the appearance of focal neurological signs on the eighth day, a computed tomography was obtained and revealed a right subdural hematoma. Following surgical drainage, the patient made an uneventful recovery. This case reminds us that subdural hematoma formation can complicate durotomy during spine surgery. Neurological deterioration in the postoperative period should prompt clinicians to rule out the diagnosis and intervene rapidly as appropriate.