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 Spine Test 5: Recent Topics in Spine Surgery
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The Journal of Bone and Joint Surgery (American) 86:2033-2037 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Cranial Subdural Hygroma Complicating Thoracic Disc Surgery

A Case Report

George Samandouras, MD, FRCS1, Vladan Bajtajic, MD, MSc2, Frank Cross, FRCS2 and Peter John Hamlyn, MD, FRCS2

1 Department of Neurosurgery, The Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, England
2 Departments of Neurosurgery (V.B., P.J.H.) and Cardiothoracic Surgery (F.C.), The Royal London Hospital, London E1 1BB, England. E-mail address for P.J. Hamlyn: peterjhamlyn@aol.com

Investigation performed at the Departments of Neurosurgery and Cardiothoracic Surgery, The Royal London Hospital, Saint Bartholomew's and the Royal London School of Medicine, London, England

The first 150 words of the full text of this article appear below.


   Introduction
 
Apersistent dural opening is one of the most frequent complications of spinal surgery. The most common cause is an inadvertent durotomy, the prevalence of which has varied notably in different studies. Previous reviews revealed that seventeen of 450 and eighty-eight of 641 patients sustained an incidental durotomy during lumbar spine surgery1,2. In the thoracic spine, dural defects are most commonly traumatic and less frequently iatrogenic. Previous accounts of thoracic dural defects have described cerebrospinal fluidpleural space fistulae leading to pleural effusion and, more rarely, to pneumocephalus3,4.

In this report, we describe the case of a patient in whom the surgical treatment of two adjacent, massive, calcified thoracic disc herniations resulted in the development of bilateral cranial subdural hygroma due to a cerebrospinal fluid-pleural space fistula. This appears to be the first such report. The pathogenetic, diagnostic, and operative aspects of this case are discussed. Our patient was informed . . . [Full Text of this Article]


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