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Acute obstructive hydrocephalus complicating decompression surgery of the craniovertebral junction
Junichi Ohya1, Hirotaka Chikuda1, Hirofumi Nakatomi2
1Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Asian Journal of Neurosurgery
|July 2, 2016
Summary
Obstructive hydrocephalus is a rare complication after craniovertebral junction decompression surgery. This case highlights its potential for late onset, even in patients with achondroplasia.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Obstructive hydrocephalus is a rare complication following foramen magnum decompression for Chiari malformation.
- Few reports exist on obstructive hydrocephalus after spinal surgery for other craniovertebral junction (CVJ) pathologies.
Observation:
- A 52-year-old female with achondroplasia presented with myelopathy due to CVJ spinal cord compression.
- She underwent C1 posterior arch resection and occipital bone decompression.
- Post-operative CT revealed infratentorial fluid collection, initially managed conservatively.
Findings:
- The patient experienced sudden deterioration in consciousness on day 17 post-surgery.
- Emergency CT confirmed marked hydrocephalus due to cerebral aqueduct obstruction.
- This indicates acute obstructive hydrocephalus can occur late after CVJ decompression.
Implications:
- Clinicians should consider late-onset obstructive hydrocephalus in the differential diagnosis for patients with deteriorating mental status after CVJ surgery.
- This case expands the understanding of potential complications following craniovertebral junction decompression procedures.
- Early recognition and management are crucial for favorable outcomes in such cases.
