Subarachnoid-pleural fistula in traumatic paraplegia

Subarachnoid-pleural fistulas caused persistent pleural effusion in 2 patients with traumatic paraplegia. The fistulas were diagnosed by myelography and radioisotope scan. Most of the previously reported cases of this rare entity have been treated by operative closure of the fistula. Both of the reported patients recovered: one underwent insertion of chest tubes to promote drainage and the other had no specific therapy. The authors believe conservative treatment should be attempted before surgery is considered.