Epidural hematoma of the cervical spine after cervical laminectomy in a patient with ventriculo-peritoneal shunt.

Abstract

Cervical laminectomy is one of the most common procedures performed in the sitting position. However in the presence of intracranial hypotension, a negative intradural pressure develops when the patients are in the sitting position. They are therefore at risk of developing cervical spinal epidural hematomas after cervical laminectomy. We report a case of a shunted patient who developed an epidural hematoma 3 days after a cervical laminectomy procedure in a seated position when he began to ambulate. When performing a cervical laminectomy procedure on a shunted patient, an upright position should be avoided during the operation. Intra-operative hypercapnia as well as intra- and post-operative intravenous hydration should be maintained in order to increase intradural pressure, preventing the formation of cervical spinal epidural hematoma after cervical laminectomy.

• Authors: Sai-Cheung Lee, Shih-Tseng Lee, Tai-Ngar Lui
• Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia (J Clin Neurosci) Vol. 11 Issue 3 Pg. 302-4 (Apr 2004) ISSN: 0967-5868 [Print] Scotland
• PMID: 14975423 (Publication Type: Case Reports, Journal Article)

Topics

• Hematoma, Epidural, Spinal (diagnostic imaging, etiology, surgery)
• Humans
• Hydrocephalus, Normal Pressure (surgery)
• Laminectomy (adverse effects)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neurosurgical Procedures (adverse effects)
• Posture (physiology)
• Spinal Stenosis (surgery)
• Tomography, X-Ray Computed
• Ventriculoperitoneal Shunt (adverse effects)