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Accidental intrathecal mercury application.

Andreas M Stark1, Harald Barth, Jean-Paul Grabner

  • 1Department of Neurosurgery, University of Kiel Medical Center, Germany. andstark@hotmail.com

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|October 31, 2003
PubMed
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Accidental intrathecal mercury injection caused severe neurological damage, including meningitis and encephalitis. Prompt treatment with lumbar drainage, chelating agents, and surgery led to recovery, but long-term deficits persisted.

Area of Science:

  • Neurology
  • Toxicology
  • Neurosurgery

Background:

  • A 69-year-old woman developed a cerebrospinal fluid (CSF) fistula post-spinal stenosis surgery.
  • A mercury-containing disinfectant was inadvertently injected into the surgical wound cavity.

Observation:

  • The patient experienced rapid neurological decline, presenting with meningitis and encephalitis.
  • Lumbar puncture revealed stained CSF, and MRI confirmed the fistula and cavity.
  • Extremely high mercury levels were detected in CSF, blood, and urine.

Findings:

  • Intrathecal mercury application led to acute neurological deterioration.
  • Treatment involved lumbar drainage for mercury washout, chelating agents (DMPS, DMSA), and surgical closure of the fistula and cavity.
  • Initial recovery was observed within 4 weeks, with intensive care support.

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Implications:

  • This case highlights the critical danger of mercury disinfectant misuse in medical settings.
  • Prompt and multimodal treatment can mitigate severe mercury intoxication effects.
  • Long-term neurological sequelae, including polyneuropathy and neuropsychological deficits, may persist despite treatment.