Acute communicating hydrocephalus as spinal cord surgery complication in a patient with lumbar lipomyelocele. Case report.

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Acute communicating hydrocephalus as spinal cord surgery complication in a patient with lumbar lipomyelocele. Case report.

World Neurosurg. 2018 Apr 17;:

Authors: Prior A, Severino M, Rossi A, Pavanello M, Piatelli G, Consales A

Abstract
BACKGROUND: A lumbar lipomyelocele is a closed spinal dysraphism that can cause tethered cord syndrome. Between 5-15% of spinal dysraphism surgery cases are burdened with complications, the most common being wound infections or dehiscence and cerebrospinal fluid leak. Acute communicating hydrocephalus has never been described as a complication of this type of surgery.
CASE DESCRIPTION: A 6-year-old girl, who had undergone several surgeries in another Institution for lumbar lipomyeloschisis, came to our attention for a second opinion about the management of her spinal dysraphism. During the visit, she experienced sudden loss of consciousness. An emergent CT scan revealed an acute communicating hydrocephalus. External ventricular drainage was performed with quick recovery of consciousness. Further craniospinal MRI revealed small droplets of fat in the intracranial subarachnoid spaces and ventricular system, suggestive of rupture of the lipoma with consequent aseptic meningitis.
CONCLUSION: This is the first description of acute communicating hydrocephalus as a complication of lipomyelocele surgery. We discuss the possible pathophysiological mechanisms leading to cerebrospinal fluid dynamics alteration.

PMID: 29678699 [PubMed - as supplied by publisher]

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