Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature

Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature

Symptomatic pneumocephalus is a rare complication of degenerative lumbar spine surgery. This is a case report of a patient who developed transient diplopia associated with pneumocephalus following lumbar spine surgery complicated by a dural tear. The diplopia improved as the pneumocephalus resolved....

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Main Authors: Pirris, Stephen M., Nottmeier, Eric W.
Format: Online
Language:English
Published: Hindawi Publishing Corporation 2013
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881439/
id pubmed-3881439
recordtype oai_dc
spelling pubmed-38814392014-01-20 Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature Pirris, Stephen M. Nottmeier, Eric W. Case Report Symptomatic pneumocephalus is a rare complication of degenerative lumbar spine surgery. This is a case report of a patient who developed transient diplopia associated with pneumocephalus following lumbar spine surgery complicated by a dural tear. The diplopia improved as the pneumocephalus resolved. Factors involved in the development of pneumocephalus include an unintended durotomy and intraoperative reverse Trendelenburg positioning that was utilized to decrease the risk of postoperative vision loss. When encountering cerebrospinal fluid (CSF) leakage intraoperatively, spine surgeons should level the operating table until closure of the dural defect to prevent potential complications associated with pneumocephalus. If postoperative patients complain of severe headaches or display a focal cranial neurologic deficit, then a computed tomography (CT) scan of the brain should be ordered and evaluated. Consulting neurologists should be aware of the circumstances surrounding this rare complication. Hindawi Publishing Corporation 2013 2013-12-22 /pmc/articles/PMC3881439/ /pubmed/24455345 http://dx.doi.org/10.1155/2013/792168 Text en Copyright © 2013 S. M. Pirris and E. W. Nottmeier. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Pirris, Stephen M.
Nottmeier, Eric W.
spellingShingle Pirris, Stephen M.
Nottmeier, Eric W.
Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature
author_facet Pirris, Stephen M.
Nottmeier, Eric W.
author_sort Pirris, Stephen M.
title Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature
title_short Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature
title_full Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature
title_fullStr Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature
title_full_unstemmed Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature
title_sort symptomatic pneumocephalus associated with lumbar dural tear and reverse trendelenburg positioning: a case report and review of the literature
description Symptomatic pneumocephalus is a rare complication of degenerative lumbar spine surgery. This is a case report of a patient who developed transient diplopia associated with pneumocephalus following lumbar spine surgery complicated by a dural tear. The diplopia improved as the pneumocephalus resolved. Factors involved in the development of pneumocephalus include an unintended durotomy and intraoperative reverse Trendelenburg positioning that was utilized to decrease the risk of postoperative vision loss. When encountering cerebrospinal fluid (CSF) leakage intraoperatively, spine surgeons should level the operating table until closure of the dural defect to prevent potential complications associated with pneumocephalus. If postoperative patients complain of severe headaches or display a focal cranial neurologic deficit, then a computed tomography (CT) scan of the brain should be ordered and evaluated. Consulting neurologists should be aware of the circumstances surrounding this rare complication.
publisher Hindawi Publishing Corporation
publishDate 2013
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881439/
_version_ 1612044455822491648

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