RT Journal Article
T1 Postoperative epidural hematoma contributes to delayed upper cord tethering after decompression of Chiari malformation type I.
A1 López-González, Antonio
A1 Plaza, Estela
A1 Márquez-Rivas, Francisco Javier
K1 Arachnoiditis
K1 Arnold-Chiary malformation
K1 Dural graft
K1 Posterior fossa
K1 Tethering
K1 Aracnoiditis
K1 Estado de conciencia
K1 Hematoma epidural craneal
K1 Hematoma espinal epidural
AB 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.
PB Medknow Publications
YR 2014
FD 2014-08-21
LK http://hdl.handle.net/10668/2138
UL http://hdl.handle.net/10668/2138
LA en
NO 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
DS RISalud
RD Apr 10, 2025