Duret hemorrhage after lumbar drainage
Xunhui Yuan1, Hongyan Zhao, Cuiling Zhao
1From the *Departments of Neurosurgery, †Finance, Yidu Central Hospital of Weifang, Qing Zhou, Shandong Province, China; ‡Qingzhou Office; §Department of Pharmacy, Yidu Central Hospital of Weifang, Qing Zhou, Shandong Province; and ∥Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Lumbar drainage can cause severe complications like transtentorial herniations and Duret hemorrhage. Neurosurgeons must consider these risks, especially after thalamic hematoma removal, to prevent fatal outcomes.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Lumbar drainage (LD) is a common procedure for intracerebral hemorrhage with ventricular involvement.
- Potential complications of LD include cerebrospinal fluid overdrainage and hypovolemia.
- These complications can lead to severe neurological events such as transtentorial herniation and infratentorial hemorrhage.
Abstract:
Lumbar drainage (LD) is considered as a simple and effective procedure for the treatment of intracerebral hemorrhage with ventricular involvement. However, cerebrospinal fluid overdrainage and hypovolemia due to LD could induce severe fatal complications, which include transtentorial herniation and infratentorial hemorrhage. Here, we describe a 63-year-old man with transtentorial herniations and Duret hemorrhage attributable to LD after the operation of thalamic hematoma removal. This is probably the first reported case of severe complications of LD. Thus, complications related to transtentorial herniations and Duret hemorrhage should be kept in mind while performing LD.
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