Publication:
Postoperative epidural hematoma contributes to delayed upper cord tethering after decompression of Chiari malformation type I.

Loading...
Thumbnail Image
Date
2014-08-21
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
Medknow Publications
Export
Research Projects
Organizational Units
Journal Issue
Abstract
Symptomatic arachnoiditis after posterior fossa surgical procedures such as decompression of Chiari malformation is a possible complication. Clinical presentation is generally insidious and delayed by months or years. It causes disturbances in the normal flow of cerebrospinal fluid and enlargement of a syrinx cavity in the upper spinal cord. Surgical de-tethering has favorable results with progressive collapse of the syrinx and relief of the associated symptoms. Case Description: A 30-year-old male with Chiari malformation type I was treated by performing posterior fossa bone decompression, dura opening and closure with a suturable bovine pericardium dural graft. Postoperative period was uneventful until the fifth day in which the patient suffered intense headache and progressive loose of consciousness caused by an acute posterior fossa epidural hematoma. It was quickly removed with complete clinical recovering. One year later, the patient experienced progressive worsened of his symptoms. Upper spinal cord tethering was diagnosed and a new surgery for debridement was required. Conclusions: The epidural hematoma compressing the dural graft against the neural structures contributes to the upper spinal cord tethering and represents a nondescribed cause of postoperative fibrosis, adhesion formation, and subsequent recurrent hindbrain compression.
Description
MeSH Terms
Medical Subject Headings::Organisms::Eukaryota::Animals
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Central Nervous System Infections::Meningitis::Arachnoiditis
Medical Subject Headings::Diseases::Nervous System Diseases::Nervous System Malformations::Neural Tube Defects::Arnold-Chiari Malformation
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Artiodactyla::Ruminants::Cattle
Medical Subject Headings::Psychiatry and Psychology::Psychological Phenomena and Processes::Mental Processes::Cognition::Consciousness
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Debridement
Medical Subject Headings::Anatomy::Nervous System::Central Nervous System::Meninges::Dura Mater
Medical Subject Headings::Diseases::Nervous System Diseases::Neurologic Manifestations::Pain::Headache
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Intracranial Hemorrhages::Intracranial Hemorrhage, Traumatic::Hematoma, Epidural, Cranial
Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage::Hematoma::Hematoma, Epidural, Spinal
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Anatomy::Cardiovascular System::Heart::Pericardium
Medical Subject Headings::Anatomy::Nervous System::Central Nervous System::Brain::Rhombencephalon
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Spinal Cord Diseases::Syringomyelia
DeCS Terms
CIE Terms
Keywords
Arachnoiditis, Arnold-Chiary malformation, Dural graft, Posterior fossa, Tethering, Aracnoiditis, Estado de conciencia, Hematoma epidural craneal, Hematoma espinal epidural
Citation
López-González A, Plaza E, Márquez-Rivas FJ. Postoperative epidural hematoma contributes to delayed upper cord tethering after decompression of Chiari malformation type I. Surg Neurol Int. 2014; 5(Suppl 4):S278-81