Delayed Iatrogenic Intracranial Hypotension After Thoracotomy

Christine K. Federspiel; Jesper Kelsen; Kare Fugleholm

doi:10.1016/j.athoracsur.2019.11.020

Delayed Iatrogenic Intracranial Hypotension After Thoracotomy

Christine K. Federspiel^*, Jesper Kelsen, Kare Fugleholm

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

2 Citations (Scopus)

Abstract

We report a case of intracranial hypotension (IH) after thoracotomy. A 56-year-old woman presented 10 days after a left upper lobectomy with severe headache due to pneumocephalus and pneumorrhachis, which resolved on conservative treatment. Two months later, the patient was readmitted in an unconscious state with characteristics of IH and "sagging brain." Subsequent magnetic resonance imaging revealed a fistula at the level of the left Th5 pedicle. The patient underwent operation with closure of the fistula and recovered without complications. The presence of pneumocephalus and pneumorrhachis after thoracotomy should raise the suspicion of a persistent subarachnoid-pleural fistula to prevent IH and "sagging brain." (C) 2020 by The Society of Thoracic Surgeons

Original language	English
Journal	Annals of Thoracic Surgery
Volume	110
Issue number	1
Pages (from-to)	E35-E37
Number of pages	3
ISSN	0003-4975
DOIs	https://doi.org/10.1016/j.athoracsur.2019.11.020
Publication status	Published - Jul 2020

Keywords

PNEUMOCEPHALUS
SURGERY

Access to Document

10.1016/j.athoracsur.2019.11.020

Cite this

@article{e6cdee061edc4a2592518ec5c19a3a98,

title = "Delayed Iatrogenic Intracranial Hypotension After Thoracotomy",

abstract = "We report a case of intracranial hypotension (IH) after thoracotomy. A 56-year-old woman presented 10 days after a left upper lobectomy with severe headache due to pneumocephalus and pneumorrhachis, which resolved on conservative treatment. Two months later, the patient was readmitted in an unconscious state with characteristics of IH and {"}sagging brain.{"} Subsequent magnetic resonance imaging revealed a fistula at the level of the left Th5 pedicle. The patient underwent operation with closure of the fistula and recovered without complications. The presence of pneumocephalus and pneumorrhachis after thoracotomy should raise the suspicion of a persistent subarachnoid-pleural fistula to prevent IH and {"}sagging brain.{"} (C) 2020 by The Society of Thoracic Surgeons",

keywords = "PNEUMOCEPHALUS, SURGERY",

author = "Federspiel, {Christine K.} and Jesper Kelsen and Kare Fugleholm",

year = "2020",

month = jul,

doi = "10.1016/j.athoracsur.2019.11.020",

language = "English",

volume = "110",

pages = "E35--E37",

journal = "The Annals of Thoracic Surgery",

issn = "0003-4975",

publisher = "Elsevier",

number = "1",

}

TY - JOUR

T1 - Delayed Iatrogenic Intracranial Hypotension After Thoracotomy

AU - Federspiel, Christine K.

AU - Kelsen, Jesper

AU - Fugleholm, Kare

PY - 2020/7

Y1 - 2020/7

N2 - We report a case of intracranial hypotension (IH) after thoracotomy. A 56-year-old woman presented 10 days after a left upper lobectomy with severe headache due to pneumocephalus and pneumorrhachis, which resolved on conservative treatment. Two months later, the patient was readmitted in an unconscious state with characteristics of IH and "sagging brain." Subsequent magnetic resonance imaging revealed a fistula at the level of the left Th5 pedicle. The patient underwent operation with closure of the fistula and recovered without complications. The presence of pneumocephalus and pneumorrhachis after thoracotomy should raise the suspicion of a persistent subarachnoid-pleural fistula to prevent IH and "sagging brain." (C) 2020 by The Society of Thoracic Surgeons

AB - We report a case of intracranial hypotension (IH) after thoracotomy. A 56-year-old woman presented 10 days after a left upper lobectomy with severe headache due to pneumocephalus and pneumorrhachis, which resolved on conservative treatment. Two months later, the patient was readmitted in an unconscious state with characteristics of IH and "sagging brain." Subsequent magnetic resonance imaging revealed a fistula at the level of the left Th5 pedicle. The patient underwent operation with closure of the fistula and recovered without complications. The presence of pneumocephalus and pneumorrhachis after thoracotomy should raise the suspicion of a persistent subarachnoid-pleural fistula to prevent IH and "sagging brain." (C) 2020 by The Society of Thoracic Surgeons

KW - PNEUMOCEPHALUS

KW - SURGERY

U2 - 10.1016/j.athoracsur.2019.11.020

DO - 10.1016/j.athoracsur.2019.11.020

M3 - Journal article

C2 - 31904369

VL - 110

SP - E35-E37

JO - The Annals of Thoracic Surgery

JF - The Annals of Thoracic Surgery

SN - 0003-4975

IS - 1

ER -