Pneumocephalus in thoracoabdominal aortic aneurysm repair after lumbar drain removal and blood patch

• Main Authors: Jack Bontekoe, MD, Kyla Bennett, MD
• Format: Article
• Language: English
• Published: Elsevier 2021-09-01
• Series: Journal of Vascular Surgery Cases and Innovative Techniques
• Subjects: Abdominal aortic aneurysm; Cerebrospinal fluid pressure; Postdural puncture headache; Postoperative complication; Pneumocephalus; Thoracic aortic aneurysm
• Online Access: http://www.sciencedirect.com/science/article/pii/S2468428721000745

Lumbar spinal drain use during thoracic and thoracoabdominal aortic aneurysm repair has reduced the incidence of ischemic spinal cord injury with relatively low risk. We report a case of pneumocephalus in a 55-year-old woman who had undergone open repair of a 6.7-cm type IV thoracoabdominal aortic aneurysm. After lumbar spinal drain removal, she developed a postdural headache, which was subsequently treated with blood patch placement. After discharge, she had presented with transient headaches, perioral numbness, and left-hand weakness. Computed tomography revealed intraventricular gas within the lateral ventricles. Pneumocephalus is an exceedingly rare and potentially dangerous complication of lumbar spinal drains and blood patch placement.