Intraventricular hemorrhage as complication after spinal surgery. Case report
P Sánchez Zamora1, B Gómez Del Pulgar Vázquez1, S Gholamian Ovejero1
1Servicio de Anestesiología, Reanimación y Terapéutica del dolor, Hospital Universitario Severo Ochoa, Leganés, Madrid, España.
Revista Espanola De Anestesiologia Y Reanimacion
|June 21, 2021
Summary
Remote intracranial hemorrhage (ICH) is a rare complication after spinal surgery, often due to cerebrospinal fluid (CSF) loss. This case highlights intraventricular hemorrhage, presenting diagnostic challenges for anesthesiologists.
Area of Science:
- Neurosurgery
- Anesthesiology
- Neurology
Background:
- Remote intracranial hemorrhage (ICH) is a rare but serious complication following spinal surgery.
- It is primarily linked to cerebrospinal fluid (CSF) loss from incidental durotomy during spinal procedures.
- Cerebellar hemorrhage is common, but intraventricular hemorrhage is less frequently reported.
Observation:
- The patient presented with impaired consciousness and seizures immediately after spinal surgery.
- This neurological deterioration suggested cerebral hypotension due to decreased CSF volume.
- Diagnostic challenges arise from non-specific symptoms mimicking other postoperative complications.
Findings:
- The patient experienced an intraventricular hemorrhage in the right ventricle.
- Cerebral and cerebellar edema were also noted in the immediate postoperative period.
- This case underscores the possibility of intraventricular ICH after spinal surgery.
Implications:
- Anesthesiologists must maintain a high index of suspicion for remote ICH in patients with sudden neurological decline post-spinal surgery.
- Prompt diagnosis and management are crucial for favorable outcomes.
- This case expands the understanding of ICH locations and clinical presentations following spinal procedures.
