Intracranial complications associated with spinal surgery.
Martin H Pham1, Alexander Tuchman2, Andrew Platt2
1Department of Neurosurgery, Keck School of Medicine, LAC+USC Medical Center, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90089, USA. martinpham@gmail.com.
Summary
Intracranial complications after spinal surgery are rare, occurring in 0.4% of patients. These serious complications, often linked to cerebrospinal fluid (CSF) leaks, require clinical vigilance.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Intracranial complications following spinal surgery are infrequent but significant.
- These complications are often associated with intracranial hypotension secondary to dural tear and cerebrospinal fluid (CSF) leakage.
Purpose of the Study:
- To characterize the incidence and nature of intracranial complications after spinal surgery.
- To assess these rare events in a large postoperative patient cohort.
Main Methods:
- Retrospective review of patients undergoing spinal surgery between July 2008 and August 2013.
- Analysis of intracranial imaging (CT or MRI) in patients with postoperative neurological changes.
Main Results:
- 1396 procedures were performed on 1113 patients.
- Intracranial imaging was obtained in 59 patients (4.2%) due to neurological changes.
- Six patients (0.4%) exhibited intracranial pathology: subdural hygroma, remote cerebellar hemorrhage, or subdural hematoma.
Conclusions:
- Intracranial complications after spinal surgery are rare, with an observed incidence of 0.4%.
- A high index of clinical suspicion is crucial for patients with a history of durotomy or CSF leak.
- Prompt recognition and management are vital due to the potentially life-threatening nature of these complications.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
450
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
450
01:19Cranial and Spinal Meninges
4.9K
The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
4.9K
01:19Veins of Head and Neck
7.0K
The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
7.0K
01:22Aneurysm IV: Nursing Management
582
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
582