J Neurointensive Care.  2018 Oct;1(1):3-6. 10.32587/jnic.2018.00017.

Postoperative Cerebrospinal Fluid Hypovolemia in Neurosurgery

• Park CW

• KMID: 2555411
• DOI: http://doi.org/10.32587/jnic.2018.00017

Abstract

Almost all neurosurgeons have concerned with postoperative uneventful recovery of their patients. However, although rare but endlessly, unexpected postoperative adverse events have occurred. Neurosurgeons, then are embarrassed and they search the causes and/or pathogenesis of such problems. Also rare, a few neurosurgeons may have been forced to litigate because of such unexpected and thus uninformed postoperative events. As many postoperative complications, postoperative adverse events from cerebrospinal fluid (CSF) hypovolemia may have led to tough circumstances. Although the exact pathomechanisms have not been fully cleared, a CSF hypovolemia can be spontaneous or postoperative, clinically. And both the cranial and spinal surgeries can cause CSF hypovolemia. It usually have taken benign courses, and some cases may have exhibited serious outcomes. We, neurosurgeons, then have considered the possibility of CSF hypovolemia in differential diagnosis for unanticipated postoperative neurologic deterioration. Since only the early recognition and prompt treatment may reverse those situations, the author try to settle and summarize comprehensively the postoperative adverse events due to CSF hypovolemia through the review of recently published or frequently cited reports on the postoperative CSF hypovolemia.

Keyword

Postoperative complications; Intracranial hypotension; Brain sag; Pseudohypoxic brain swelling; Remote site intracranial hemorrhage; Cerebrospinal fluid