Treatment of the subarachnoid-pleural fistula. Case report.

Abstract:

:Subarachnoid-pleural fistula is a rare type of cerebrospinal fluid (CSF) fistula, and there are only several cases reported in the literature. The authors describe a 65-year-old male patient in whom a diagnosis of T7-8 disc herniation had been made. He underwent surgery via a right lateral extracavitary approach. Postoperatively he developed progressive respiratory distress and headache. A chest x-ray film revealed a pleural effusion, and computerized tomography (CT) myelography demonstrated a subarachnoidal-pleural fistula at the level at which the herniated disc had been removed. The patient had been managed via a CSF drainage system and a chest tube. He was discharged after relief of symptoms was attained. Subarachnoid-pleural fistulas can be secondary to traumatic injury and surgery, or they can be spontaneous. Patients present with rapidly filling pleural effusion and headache. A diagnosis can be established using CT myelography or myeloscintigraphy. Treatment is conservative, with the placement of a chest tube and insertion of a CSF drainage catheter, and surgical repair should be considered only if the conservative therapy fails.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Ozgen S,Boran BO,Elmaci I,Ture U,Pamir MN

doi

10.3171/foc.2000.9.1.9

subject

Has Abstract

pub_date

2000-07-15 00:00:00

pages

ecp1

issue

1

issn

1092-0684

pii

0901cp1

journal_volume

9

pub_type

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