Hydrocephalus Secondary to Cervical Spinal Cord Surgery

Background: Cerebrospinal fluid (CSF) leakage is a common complication after spinal tumor resection that resolves naturally in many cases. Hydrocephalus with CSF leakage as a complication after spinal surgery is rare. Here, we report a rare case of delayed hydrocephalus due to CSF leakage after cervical cord tumor surgery.

Case Description: A 60-year-old lady with gait disturbance and numbness of both hands underwent uneventful surgery of C1–C2 partial laminectomy and excision of schwannoma. Three months after surgery she was readmitted with features of postoperative meningitis. CSF examination was normal while CT scan showed very small pseudomeningocele. She improved with antipyretics and empirical antibiotics. Two months after this episode she presented in a deeply comatose state. CT brain revealed gross hydrocephalus and she became conscious only after VP shunt.

Conclusion: Hydrocephalus due to CSF leakage is a rare complication after spinal surgery. In our case, CSF did not prove septic meningitis. However, inflammation may have been caused by aseptic meningitis, and microhemorrhage and fibrinogenic components might have been causes of CSF circulation disorder and absorption disorder in the subarachnoid space. This situation may have then led to delayed hydrocephalus. This is a rare case of delayed hydrocephalus after CSF leakage following spine tumor surgery.

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Artikel online veröffentlicht:
25. März 2020