Extensive spinal cord infarction after posterior fossa surgery in the sitting position: case report.

Abstract:

OBJECTIVE AND IMPORTANCE:Spinal cord injury is a rare complication of neurosurgery performed with the patient in the sitting position. Previous reports showed that the level of injury is usually located at or near the C5 segmental spinal level, and the term midcervical quadriplegia has been proposed. Extensive spinal cord and lower brainstem infarction also can occur after posterior fossa surgery performed with the patient in the sitting position. CLINICAL PRESENTATION:We describe a 45-year-old woman who was operated on in the sitting position because of a fourth ventricular pilocytic astrocytoma. After surgery, the patient experienced quadriplegia. INTERVENTION:T2-weighted magnetic resonance imaging scans revealed a long, hyperintense area within the cervicothoracic spinal cord that was extended to the lower pons and was consistent with infarction. There was no evidence of previous spine disease. The patient died 6 weeks later of respiratory failure. CONCLUSION:We speculate that alteration of spinal cord blood flow by stretching of the cervical spinal cord and spinal epidural venous engorgement might have caused this devastating complication.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Morandi X,Riffaud L,Amlashi SF,Brassier G

doi

10.1227/01.neu.0000125008.93625.5e

keywords:

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

1512-5; discussion 1515-6

issue

6

eissn

0148-396X

issn

1524-4040

journal_volume

54

pub_type

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