Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature
Symptomatic pneumocephalus is a rare complication of degenerative lumbar spine surgery. This is a case report of a patient who developed transient diplopia associated with pneumocephalus following lumbar spine surgery complicated by a dural tear. The diplopia improved as the pneumocephalus resolved...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/792168 |
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| author | Stephen M. Pirris Eric W. Nottmeier |
| author_facet | Stephen M. Pirris Eric W. Nottmeier |
| author_sort | Stephen M. Pirris |
| collection | DOAJ |
| description | Symptomatic pneumocephalus is a rare complication of degenerative lumbar spine surgery. This is a case report of a patient who developed transient diplopia associated with pneumocephalus following lumbar spine surgery complicated by a dural tear. The diplopia improved as the pneumocephalus resolved. Factors involved in the development of pneumocephalus include an unintended durotomy and intraoperative reverse Trendelenburg positioning that was utilized to decrease the risk of postoperative vision loss. When encountering cerebrospinal fluid (CSF) leakage intraoperatively, spine surgeons should level the operating table until closure of the dural defect to prevent potential complications associated with pneumocephalus. If postoperative patients complain of severe headaches or display a focal cranial neurologic deficit, then a computed tomography (CT) scan of the brain should be ordered and evaluated. Consulting neurologists should be aware of the circumstances surrounding this rare complication. |
| format | Article |
| id | doaj-art-35e6e4456ec4452b85032ccd1ce85eaf |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-35e6e4456ec4452b85032ccd1ce85eaf2025-02-03T05:59:47ZengWileyCase Reports in Neurological Medicine2090-66682090-66762013-01-01201310.1155/2013/792168792168Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the LiteratureStephen M. Pirris0Eric W. Nottmeier1Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USADepartment of Neurosurgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USASymptomatic pneumocephalus is a rare complication of degenerative lumbar spine surgery. This is a case report of a patient who developed transient diplopia associated with pneumocephalus following lumbar spine surgery complicated by a dural tear. The diplopia improved as the pneumocephalus resolved. Factors involved in the development of pneumocephalus include an unintended durotomy and intraoperative reverse Trendelenburg positioning that was utilized to decrease the risk of postoperative vision loss. When encountering cerebrospinal fluid (CSF) leakage intraoperatively, spine surgeons should level the operating table until closure of the dural defect to prevent potential complications associated with pneumocephalus. If postoperative patients complain of severe headaches or display a focal cranial neurologic deficit, then a computed tomography (CT) scan of the brain should be ordered and evaluated. Consulting neurologists should be aware of the circumstances surrounding this rare complication.http://dx.doi.org/10.1155/2013/792168 |
| spellingShingle | Stephen M. Pirris Eric W. Nottmeier Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature Case Reports in Neurological Medicine |
| title | Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature |
| title_full | Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature |
| title_fullStr | Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature |
| title_full_unstemmed | Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature |
| title_short | Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature |
| title_sort | symptomatic pneumocephalus associated with lumbar dural tear and reverse trendelenburg positioning a case report and review of the literature |
| url | http://dx.doi.org/10.1155/2013/792168 |
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