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Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma

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Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma. / Sporns, Peter Bernhard; Zimmer, Sebastian; Hanning, Uta; Zoubi, Tarek; Wölfer, Johannes; Herbort, Mirco; Schwindt, Wolfram; Niederstadt, Thomas.

In: SPINE J, Vol. 15, No. 7, 01.07.2015, p. e13-6.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Sporns, PB, Zimmer, S, Hanning, U, Zoubi, T, Wölfer, J, Herbort, M, Schwindt, W & Niederstadt, T 2015, 'Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma', SPINE J, vol. 15, no. 7, pp. e13-6. https://doi.org/10.1016/j.spinee.2015.04.025

APA

Sporns, P. B., Zimmer, S., Hanning, U., Zoubi, T., Wölfer, J., Herbort, M., Schwindt, W., & Niederstadt, T. (2015). Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma. SPINE J, 15(7), e13-6. https://doi.org/10.1016/j.spinee.2015.04.025

Vancouver

Sporns PB, Zimmer S, Hanning U, Zoubi T, Wölfer J, Herbort M et al. Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma. SPINE J. 2015 Jul 1;15(7):e13-6. https://doi.org/10.1016/j.spinee.2015.04.025

Bibtex

@article{70b0a82e2814435f8f021e0f2576f708,
title = "Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma",
abstract = "BACKGROUND CONTEXT: Cases of cerebral hypotension and tonsillar herniation after accidental lumbar cerebrospinal fluid (CSF) drainage or chest tube drainage with intrathoracic CSF leaks have been reported. To the authors' knowledge, this case presents the first report of severe intracranial hypotension because of suction of CSF by a Vacuum-Assisted Closure (VAC) device.PURPOSE: The purpose of this study was to report a life-threatening intracranial hypotension in a polytraumatized patient after VAC therapy.STUDY DESIGN: This study is a case report.METHODS: A 23-year-old woman suffered of a Grade 3 open pelvic fracture after a motor vehicle accident. After a VAC therapy, the patient became nonresponsive. A cranial computer tomography (CCT) showed signs of intracranial hypotension with narrowing of the basal cisterns and sagging of the cerebellar tonsils. The VAC was removed. Further neuroradiological diagnostic showed a tear in the dural sac at the L5-S1 level. The patient consequently underwent neurosurgery. After a dural patch, she was oriented postoperatively and the CCT improved to a normal state.RESULTS: Fifteen days after admission, the patient was discharged without neurologic sequelae.CONCLUSIONS: Severely injured patients undergoing VAC therapy with secondary neurologic deterioration not because of head injury should be appropriately diagnosed to rule out dural laceration and cranial hypotension.",
keywords = "Accidents, Traffic, Cerebrospinal Fluid Leak, Encephalocele, Female, Humans, Intracranial Hypotension, Negative-Pressure Wound Therapy, Neurosurgical Procedures, Young Adult, Journal Article",
author = "Sporns, {Peter Bernhard} and Sebastian Zimmer and Uta Hanning and Tarek Zoubi and Johannes W{\"o}lfer and Mirco Herbort and Wolfram Schwindt and Thomas Niederstadt",
note = "Copyright {\textcopyright} 2015 Elsevier Inc. All rights reserved.",
year = "2015",
month = jul,
day = "1",
doi = "10.1016/j.spinee.2015.04.025",
language = "English",
volume = "15",
pages = "e13--6",
journal = "SPINE J",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "7",

}

RIS

TY - JOUR

T1 - Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma

AU - Sporns, Peter Bernhard

AU - Zimmer, Sebastian

AU - Hanning, Uta

AU - Zoubi, Tarek

AU - Wölfer, Johannes

AU - Herbort, Mirco

AU - Schwindt, Wolfram

AU - Niederstadt, Thomas

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - BACKGROUND CONTEXT: Cases of cerebral hypotension and tonsillar herniation after accidental lumbar cerebrospinal fluid (CSF) drainage or chest tube drainage with intrathoracic CSF leaks have been reported. To the authors' knowledge, this case presents the first report of severe intracranial hypotension because of suction of CSF by a Vacuum-Assisted Closure (VAC) device.PURPOSE: The purpose of this study was to report a life-threatening intracranial hypotension in a polytraumatized patient after VAC therapy.STUDY DESIGN: This study is a case report.METHODS: A 23-year-old woman suffered of a Grade 3 open pelvic fracture after a motor vehicle accident. After a VAC therapy, the patient became nonresponsive. A cranial computer tomography (CCT) showed signs of intracranial hypotension with narrowing of the basal cisterns and sagging of the cerebellar tonsils. The VAC was removed. Further neuroradiological diagnostic showed a tear in the dural sac at the L5-S1 level. The patient consequently underwent neurosurgery. After a dural patch, she was oriented postoperatively and the CCT improved to a normal state.RESULTS: Fifteen days after admission, the patient was discharged without neurologic sequelae.CONCLUSIONS: Severely injured patients undergoing VAC therapy with secondary neurologic deterioration not because of head injury should be appropriately diagnosed to rule out dural laceration and cranial hypotension.

AB - BACKGROUND CONTEXT: Cases of cerebral hypotension and tonsillar herniation after accidental lumbar cerebrospinal fluid (CSF) drainage or chest tube drainage with intrathoracic CSF leaks have been reported. To the authors' knowledge, this case presents the first report of severe intracranial hypotension because of suction of CSF by a Vacuum-Assisted Closure (VAC) device.PURPOSE: The purpose of this study was to report a life-threatening intracranial hypotension in a polytraumatized patient after VAC therapy.STUDY DESIGN: This study is a case report.METHODS: A 23-year-old woman suffered of a Grade 3 open pelvic fracture after a motor vehicle accident. After a VAC therapy, the patient became nonresponsive. A cranial computer tomography (CCT) showed signs of intracranial hypotension with narrowing of the basal cisterns and sagging of the cerebellar tonsils. The VAC was removed. Further neuroradiological diagnostic showed a tear in the dural sac at the L5-S1 level. The patient consequently underwent neurosurgery. After a dural patch, she was oriented postoperatively and the CCT improved to a normal state.RESULTS: Fifteen days after admission, the patient was discharged without neurologic sequelae.CONCLUSIONS: Severely injured patients undergoing VAC therapy with secondary neurologic deterioration not because of head injury should be appropriately diagnosed to rule out dural laceration and cranial hypotension.

KW - Accidents, Traffic

KW - Cerebrospinal Fluid Leak

KW - Encephalocele

KW - Female

KW - Humans

KW - Intracranial Hypotension

KW - Negative-Pressure Wound Therapy

KW - Neurosurgical Procedures

KW - Young Adult

KW - Journal Article

U2 - 10.1016/j.spinee.2015.04.025

DO - 10.1016/j.spinee.2015.04.025

M3 - SCORING: Journal article

C2 - 25912500

VL - 15

SP - e13-6

JO - SPINE J

JF - SPINE J

SN - 1529-9430

IS - 7

ER -