Title : Immediate interacrinial heamohrrage after lumbar spinal surgery case report with review of literatures
Abstract:
Background: Intracranial hemorrhage following spinal surgery is an infrequent but severe complication. Due to its rarity, the etiology, clinical characteristics, and treatment have not yet been fully elucidated. It has been implicated due to intracranial hypotension secondary to persistent cerebrospinal fluid leakage. The resultant drop in intracranial pressure presumably causes traction and tearing of venous structures. Patients typically present with postural headaches. However, other symptoms of subdural hematoma, intracranial hypotension and cerebrospinal fluid leak must also be cautioned. In this report, the authors describe the patient who developed to intracranial hemorrhage after lumbar spinal surgery.
Case presentation: A 55-year-old lady complained of left side leg pain for three months perior to presentation to hospital. Signs correlated with L4-5 root radiculopathy. The operated L4-5 discectomy and fixation was done, 8 hours post operative posterior fossa hematoma, then the patient admitted to ICU, she death after 14 days.
Conclusion: Intracranial SDH is a potential fatal complication that can occur after lumbar surgery. A thorough inspection of the dura intra-operatively is mandatory to prevent this complication. Surgeons and clinicians should be aware regarding symptoms of ICH and intracranial SDH apart from signs of CSF leak.
