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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Delayed Iatrogenic Intracranial Hypotension Following Thoracotomy

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We report a case of intracranial hypotension (IH) following thoracotomy. A 56-year-old woman presented ten days after left upper lobectomy with severe headache due to pneumocephalus and pneumorrhachis, which resolved on conservative treatment. Two months later, the patient was readmitted in an unconscious state with characteristics of IH and "sagging brain". Subsequent MRI revealed a fistula at the level of the left Th5 pedicle. The patient underwent operation with closure of the fistula and recovered without complications. Presence of pneumocephalus and pneumorrhachis following thoracotomy should raise the suspicion of a persistent subarachnoid-pleural fistula to prevent IH and "sagging brain".

Original languageEnglish
JournalThe Annals of thoracic surgery
ISSN0003-4975
DOIs
Publication statusE-pub ahead of print - 2 Jan 2020

ID: 58981333