A Case of Intracranial Hemorrhage Following a Incidental Dural Tear during Lumbar Spine Surgery

DOI 2 Citations 5 References
  • Tanaka Tetsuya
    Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
  • Saito Taichi
    Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
  • Saikawa Isao
    Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
  • Irie Tsutomu
    Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
  • Ogata Junya
    Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
  • Miyaoka Ken
    Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
  • Hirakawa Katsuyuki
    Department of Neurosurgery, Fukuoka City Hospital, Fukuoka, Japan
  • Yoshino Shinichiro
    Department of Neurosurgery, Fukuoka City Hospital, Fukuoka, Japan

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Other Title
  • 腰椎手術後に頭蓋内出血を生じた１例

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Abstract

We report a case of intracranial hemorrhage following an incidental dural tear during lumbar spine surgery. The case was a 65-year-old female who had severe right leg pain. She had received lumbar spine surgery about 15 years ago. The current lumbar MRI revealed disc herniation in the right side of L4-5 level. She underwent revision posterior lumbar interbody fusion. During operation, a dural tear was made, resulting in a little outflow of CSF. But at the time of wound closure, leakage of the CSF was not seen. The next morning, she suddenly lost consciousness following headache and vomiting. A computed tomography scan of the head was performed and revealed subdural hematoma.<BR>Open head operation was urgently performed. Eventually, she became fully alert and oriented, and was able to leave hospital walking on her own. In the head operation findings, there was no evidence of traumatic and idiopathic subdural bleeding. It is guessed that loss of CSF volume caused intracranial hypotension, leading to the brain hernia. Caudal brain displacement may cause characteristic subdural vein bleeding.

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