J Korean Neurosurg Soc.  1997 Jul;26(7):995-998.

Severe Intracranial Hypotension Syndrome Following Lumbar Drainage

• Kim DJ
• Hong YK
• Kong ST
• Kang JK

Abstract

We present a case of severe intracranial hypotension syndrome following lumbar drainage. A 60-year-old woman developed recurrent attacks of vertigo, nausea and vomiting a week prior to admission. Brain MRI revealed a homogeneously well-enhanced mass in the right frontal lobe ; this was found to be a meningioma, and was totally removed. Dural defect was covered with fat and fascia, and postoperative cerebrospinal fluid(CSF) leakage through the frontal sinus was noted. Lumbar drainage was initiated, and about 36 hours later, the patient complained of bouts of headache, nausea and vomiting. Her mental state then gradually deteriorated, and she became stuporous. Brain CT was performed immediately and revealed bifrontal subdural fluid collection and signs of severe brain edema including obliteration of ventricles and basal cisterns. The lumbar drain was then clamped and she regained consciousness 12 hours later. This case clearly demonstrates that to avoid complications such as severe intracranial hypotension syndrome in a patient who has undergone lumbar drainage, the rate and amount of CSF drainage should be closely monitored.

Keyword

Intracranial hypotension syndrome; Lumbar drainage; Meningioma

MeSH Terms

Brain
Brain Edema
Consciousness
Drainage*
Fascia
Female
Frontal Lobe
Frontal Sinus
Headache
Humans
Intracranial Hypotension*
Magnetic Resonance Imaging
Meningioma
Middle Aged
Nausea
Stupor
Vertigo
Vomiting