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Rapidly filling pleural effusion due to a subarachnoid-pleural fistula
Insights
Subarachnoid-pleural fistula is rare in children, often linked to trauma and neurological issues. This case highlights its possibility even without neurological deficits, emphasizing prompt investigation in children with unexplained pleural effusion and trauma history.
Area of Science:
- Pediatric Surgery
- Neurology
- Pulmonology
Background:
- Subarachnoid-pleural fistula (SPF) is a rare condition, with only five pediatric cases previously reported.
- Previous cases typically presented with a history of trauma and associated neurological deficits, aiding diagnosis.
- Massive, rapidly accumulating pleural effusion in children can indicate serious underlying pathology.
Abstract:
Only five cases of subarachnoid-pleural fistula in children have been reported previously. All had a history of trauma and associated neurologic deficit which gave clue to the diagnosis. The authors present a child who presented with a massive, rapidly filling, clear pleural effusion in whom there was no neurologic deficit. The history of an automobile accident in the past had almost been forgotten. A subarachnoid-pleural fistula was discovered on exploratory thoracotomy. The entity should be thought of, and actively investigated, in a child with a history of trauma and a pleural effusion of obscure etiology, even if there is no associated neurologic deficit.