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Pneumocephalus in thoracoabdominal aortic aneurysm repair after lumbar drain removal and blood patch

Jack Bontekoe1, Kyla Bennett1

  • 1Division of Vascular Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wis.

Journal of Vascular Surgery Cases and Innovative Techniques
|July 19, 2021
PubMed

Lumbar spinal drain use during thoracic and thoracoabdominal aortic aneurysm repair has reduced the incidence of ischemic spinal cord injury with relatively low risk. We report a case of pneumocephalus in a 55-year-old woman who had undergone open repair of a 6.7-cm type IV thoracoabdominal aortic aneurysm. After lumbar spinal drain removal, she developed a postdural headache, which was subsequently treated with blood patch placement. After discharge, she had presented with transient headaches, perioral numbness, and left-hand weakness. Computed tomography revealed intraventricular gas within the lateral ventricles. Pneumocephalus is an exceedingly rare and potentially dangerous complication of lumbar spinal drains and blood patch placement.

Keywords:
Abdominal aortic aneurysmCerebrospinal fluid pressurePneumocephalusPostdural puncture headachePostoperative complicationThoracic aortic aneurysm

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