Posterior fossa epidural hematomas:a uncommon however severe complication of occipito-cervical fusion surgical procedure.
World Neurosurg. 2018 Apr 17;:
Authors: Zhu CR, Wang J, Jianqiang D, Chen Ok, Hong X
BACKGROUND: Posterior occipito-cervical fusion surgical procedure is a generally used surgical technique to deal with numerous craniovertebral junction pathologies. Although it’s an efficient technique, there even have been some stories about issues of occipito-cervical fusion. Nonetheless, there have been no stories about posterior fossa epidural hematomas after occipito-cervical fusion.
CASE DESCRIPTION: A 44-year-old feminine was referred to our Hospital with a 6-month historical past of neck ache and numbness limbs for two months. Primarily based on the imaging findings of the affected person, analysis had been basilar invagination with atlantoaxial dislocation related to Klipple-Feil syndrome and O-C1 assimilation. In line with the precept of therapy, occipito-cervical fusion surgical procedure was carried out for her. The operation was accomplished efficiently and the affected person was woke up from anesthesia 10 minutes later after which again to the orthopedic intensive care ward. 20 hours after the surgical procedure, her psychological standing had deteriorated to stupor, and each her pupils had dilated to five mm. Acute posterior fossa epidural hematomas was revealed by Emergent CT of the mind . Emergency craniectomy decompression and epidural hematoma removing surgical procedure was carried out for her well timed. Nonetheless, her psychological standing nonetheless didn’t enhance and he or she fell right into a deep coma and the pupillary reflex disappeared, after which she died.
CONCLUSIONS: Posterior fossa epidural hematomas is a uncommon complication of occipito-cervical fusion surgical procedure. However as soon as occurred, it could be very severe and even led the affected person to die. It will be important for the surgeons to understand that posterior fossa epidural hematomas might happen after the occipito-cervical fusion surgical procedure.
PMID: 29678713 [PubMed – as supplied by publisher]