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Traumatic subarachnoid-pleural fistula.

W H Brown, J C Stothert

    The Journal of Trauma
    |November 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Traumatic subarachnoid-pleural fistulas are rare but serious, often linked to vertebral trauma. Diagnosis involves imaging, and treatment typically includes drainage and antibiotics, with surgery sometimes needed.

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    Area of Science:

    • Neurosurgery
    • Thoracic Surgery
    • Diagnostic Imaging

    Background:

    • Traumatic subarachnoid-pleural fistulas are exceedingly rare, with only nine cases reported since 1959.
    • These fistulas are predominantly associated with trauma (seven cases) and less commonly with thoracotomy (two cases).

    Observation:

    • One reported death was directly attributed to the subarachnoid-pleural fistula.
    • Clinical suspicion for this condition should arise in patients presenting with pleural effusion and concurrent vertebral trauma.

    Findings:

    • Diagnosis is typically confirmed using contrast myelography or radioisotopic myelography.
    • The primary management involves closed tube drainage and antibiotic therapy, often leading to spontaneous fistula closure.

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    Implications:

    • Early diagnosis and appropriate management are crucial to prevent mortality associated with subarachnoid-pleural fistulas.
    • While conservative measures are often successful, surgical intervention (thoracotomy) may be required in refractory cases to repair dural rents.