Abstract | BACKGROUND CONTEXT: PURPOSE: STUDY DESIGN: This study is a case report. METHODS: A 23-year-old woman suffered of a Grade 3 open pelvic fracture after a motor vehicle accident. After a VAC therapy, the patient became nonresponsive. A cranial computer tomography (CCT) showed signs of intracranial hypotension with narrowing of the basal cisterns and sagging of the cerebellar tonsils. The VAC was removed. Further neuroradiological diagnostic showed a tear in the dural sac at the L5-S1 level. The patient consequently underwent neurosurgery. After a dural patch, she was oriented postoperatively and the CCT improved to a normal state. RESULTS: Fifteen days after admission, the patient was discharged without neurologic sequelae. CONCLUSIONS: Severely injured patients undergoing VAC therapy with secondary neurologic deterioration not because of head injury should be appropriately diagnosed to rule out dural laceration and cranial hypotension.
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Authors | Peter Bernhard Sporns, Sebastian Zimmer, Uta Hanning, Tarek Zoubi, Johannes Wölfer, Mirco Herbort, Wolfram Schwindt, Thomas Niederstadt |
Journal | The spine journal : official journal of the North American Spine Society
(Spine J)
Vol. 15
Issue 7
Pg. e13-6
(Jul 01 2015)
ISSN: 1878-1632 [Electronic] United States |
PMID | 25912500
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Topics |
- Accidents, Traffic
- Cerebrospinal Fluid Leak
(etiology, surgery)
- Encephalocele
(etiology, surgery)
- Female
- Humans
- Intracranial Hypotension
(etiology, surgery)
- Negative-Pressure Wound Therapy
(adverse effects)
- Neurosurgical Procedures
(adverse effects)
- Young Adult
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