Pneumocephalus, coma and seizures following lumbar decompression surgery
C Bonome Roel1, M Goday Etxebarria1, C Domenech Bendaña1
1Servicio de Cirugía Ortopédica y Traumatología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
Revista Espanola De Anestesiologia Y Reanimacion
|February 26, 2023
Summary
Pneumocephalus, or air in the skull, can cause altered mental status and seizures after lumbar surgery. Prompt diagnosis and treatment led to rapid patient recovery without neurological deficits.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Lumbar decompression surgery can rarely lead to intracranial complications.
- Altered mental status and seizures are potential postoperative neurological emergencies.
Observation:
- A patient developed altered mental status, seizures, and a Glasgow Coma Scale score of 7 post-lumbar surgery.
- Cranial CT revealed a large pneumocephalus causing significant mass effect on cerebral structures.
Findings:
- Initial management included anti-epileptic therapy (diazepam, levetiracetam) and neurological monitoring.
- Repeat CT at 12 hours showed significant resolution of pneumocephalus.
- Continuous epileptiform activity on EEG necessitated phenytoin infusion, leading to improved consciousness and extubation.
Implications:
- Pneumocephalus is a critical consideration in the differential diagnosis of altered mental status after lumbar surgery.
- Early recognition and management of pneumocephalus can lead to favorable neurological outcomes.
- This case highlights the importance of multimodal monitoring and timely intervention in managing postoperative neurological complications.
Keywords:
AnestesiaAnesthesiaCirugía espinalComaConvulsionesPneumocephalusPneumoencéfaloSeizuresSpine surgeryMore Related Videos
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