J Neurol Surg A Cent Eur Neurosurg 2022; 83(05): 507-510
DOI: 10.1055/s-0041-1728765
Case Report

Iatrogenic Intracranial Hypotension after Surgery of Adolescent Idiopathic Scoliosis due to a Misplaced Screw within the Thoracic Thecal Sac

Ute Heiler
1   Department of Spine Surgery, SRH Klinikum Karlsbad-Langensteinbach GmbH, Karlsbad, Germany
,
Tobias Pitzen
1   Department of Spine Surgery, SRH Klinikum Karlsbad-Langensteinbach GmbH, Karlsbad, Germany
,
Michael Ruf
1   Department of Spine Surgery, SRH Klinikum Karlsbad-Langensteinbach GmbH, Karlsbad, Germany
› Author Affiliations

Abstract

We present the case of a postoperative intracranial hypotension due to a misplaced intrathecal screw. Although typical symptoms such as orthostatic headache were present immediately after surgery, diagnosis was hidden until 20 years later, resulting in a disastrous clinical course.



Publication History

Received: 06 October 2020

Accepted: 26 November 2020

Article published online:
30 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Li M, Mao S, Tang R. et al. Delayed diagnosis and treatment of cerebrospinal fluid leakage in current practice. J Craniofac Surg 2019; 30 (06) 1657-1661
  • 2 Atkinson JL, Weinshenker BG, Miller GM, Piepgras DG, Mokri B. Acquired Chiari I malformation secondary to spontaneous spinal cerebrospinal fluid leakage and chronic intracranial hypotension syndrome in seven cases. J Neurosurg 1998; 88 (02) 237-242
  • 3 Hattingen E, DuMesnil R, Pilatus U, Raabe A, Kahles T, Beck J. Contrast-enhanced MR myelography in spontaneous intracranial hypotension: description of an artefact imitating CSF leakage. Eur Radiol 2009; 19 (07) 1799-1808
  • 4 Beck J, Gralla J, Fung C. et al. Spinal cerebrospinal fluid leak as the cause of chronic subdural hematomas in nongeriatric patients. J Neurosurg 2014; 121 (06) 1380-1387
  • 5 Inamasu J, Guiot BH. Intracranial hypotension with spinal pathology. Spine J 2006; 6 (05) 591-599
  • 6 Beck J, Raabe A, Seifert V, Dettmann E. Intracranial hypotension after chiropractic manipulation of the cervical spine. J Neurol Neurosurg Psychiatry 2003; 74 (06) 821-822
  • 7 Beck J, Ulrich CT, Fung C. et al. Diskogenic microspurs as a major cause of intractable spontaneous intracranial hypotension. Neurology 2016; 87 (12) 1220-6
  • 8 Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA 2006; 295 (19) 2286-2296
  • 9 Schievink WI. Spontaneous spinal cerebrospinal fluid leaks. Cephalalgia 2008; 28 (12) 1345-1356
  • 10 Fichtner J, Ulrich CT, Fung C. et al. Management of spontaneous intracranial hypotension : transorbital ultrasound as discriminator. J Neurol Neurosurg Psychiatry 2016; 87 (06) 650-655