Effects of the Location of Dural Tear and Repair in the Development of Pneumocephalus after Spinal Surgery

• Main Author: Ahmet Öğrenci
• Format: Article
• Language: English
• Published: Galenos Yayinevi 2019-06-01
• Series: Haseki Tıp Bülteni
• Subjects: Dural tear; pneumocephalus; spinal surgery
• Online Access: http://www.hasekidergisi.com/archives/archive-detail/article-preview/effects-of-the-location-of-dural-tear-and-repair-i/26211

Aim:To investigate the incidence of pneumocephalus related to location of iatrogenic dural defects and the role of dural defect repair in the development of pneumocephalus.Methods:In this prospective study, 18 patients, who underwent surgery for spinal pathologies between 2014 and 2017 and had iatrogenic dural injury, were included. The location of dural defects and whether dural repair was done were recorded. Cranial computed tomography was performed in patients having severe headache or nausea-vomiting after surgery. Asymptomatic patients underwent magnetic resonance imaging (MRI) after providing informed consent. Whether pneumocephalus was developed or not was compared.Results:Six of eight symptomatic patients had pneumocephalus on cranial CT. It was seen that five of six patients had posterior dural defect and one had lateral dural defect. Pneumocephalus was detected on the cranial MR in two of 10 asymptomatic patients. These two patients had posterior dural defect. Pneumocephalus was detected in seven of eight patients in whom primary suture repair of dural defect was performed. Only one of ten patients with posterolateral defects had pneumocephalus.Conclusion:Symptomatic patients with dural tear have a high rate of pneumocephalus. The risk of pneumocephalus in patients with posterolateral dural defect is low. Pneumocephalus is more likely to occur in patients having posterior dural defect, even if the defect is repaired.