Low-pressure hydrocephalic state complicating hemispherectomy: a case report.

Abstract:

UNLABELLED:Low-pressure hydrocephalic state (LPHS) has only recently been described as a distinct clinical entity occurring in patients with bioatrophic lesions of the brain. We report a patient in whom this syndrome developed after subtotal hemispherectomy for intractable epilepsy. METHODS:A 30-year-old man developed cerebrospinal fluid (CSF) rhinorrhea after subtotal hemispherectomy. After repair of the CSF dural fistula, clinical and radiological features of an LPHS developed. After external ventricular drainage for 26 days, a programmable low-pressure shunt system was instituted. RESULTS:Worsening neurologic status and ventriculomegaly in the face of normal intraventricular pressures is diagnostic of this condition. The clinical status clearly correlated with ventricular size and not ventricular pressure. CONCLUSION:LPHS is a clinically significant perioperative complication that rarely occurs after large brain excisions. Restoration of the baseline brain compliance is critical in the management of this condition.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Daniel RT,Lee GY,Halcrow SJ

doi

10.1046/j.1528-1157.2002.46101.x

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

563-5

issue

5

eissn

0013-9580

issn

1528-1167

pii

epi46101

journal_volume

43

pub_type

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