Tags

Type your tag names separated by a space and hit enter

Coexistent Supratentorial and Infratentorial Subdural Hygromas with Hydrocephalus After Chiari Decompression Surgery: Review of Literature.
World Neurosurg. 2016 Sep; 93:208-14.WN

Abstract

BACKGROUND

Foramen magnum decompression (FMD) is the standard procedure for Chiari I malformation. Although seemingly a straightforward procedure, recent articles have reported an increase in various complications. We describe a rare complication of coexistent supratentorial and infratentorial subdural hygromas (SDHs) with hydrocephalus noted after FMD and provide a detailed review of the literature on this topic.

METHODS

A 34-year-old woman presented with strain-related suboccipital headache and myelopathy for 6 months. Imaging revealed tonsillar herniation up to C2 level and cervical syringomyelia. A standard FMD, C1 posterior arch removal, and tonsillar reduction was performed. After an initial uneventful postoperative course, she had 2 readmissions with headache, vomiting, and ataxia. Imaging showed a tense pseudomeningocele and concomitant supratentorial and infratentorial (initially right-sided, followed by left-sided) SDHs with ventriculomegaly. She was conservatively managed with antiedema measures and had excellent relief of symptoms. For the literature review, only cases with concomitant supratentorial and infratentorial SDHs with hydrocephalus were searched online and analyzed.

RESULTS

Including ours, 10 cases have been reported. Mean age was 25.3 years. The male-to-female ratio was 1:2.3. Symptoms appeared an average of 12.6 days postoperatively. Treatment was with conservative management in 3 cases, and 3 cases required permanent cerebrospinal fluid diversions. Mean follow-up duration was 9.4 months (range, 1-27 months).

CONCLUSIONS

Coexistent supratentorial and infratentorial SDHs with hydrocephalus after Chiari decompression is a very rare occurrence. Treatment needs to be individualized based on the predominant symptomatic lesion, and surgical options need to be judiciously considered. Good prognosis is the rule in most cases.

Authors+Show Affiliations

Department of Neurosurgery, Kasturba Medical College, Manipal University, Manipal, India. Electronic address: lakshmi.prasad@manipal.edu.Department of Neurosurgery, Kasturba Medical College, Manipal University, Manipal, India.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

27319314

Citation

Prasad, G Lakshmi, and Girish R. Menon. "Coexistent Supratentorial and Infratentorial Subdural Hygromas With Hydrocephalus After Chiari Decompression Surgery: Review of Literature." World Neurosurgery, vol. 93, 2016, pp. 208-14.
Prasad GL, Menon GR. Coexistent Supratentorial and Infratentorial Subdural Hygromas with Hydrocephalus After Chiari Decompression Surgery: Review of Literature. World Neurosurg. 2016;93:208-14.
Prasad, G. L., & Menon, G. R. (2016). Coexistent Supratentorial and Infratentorial Subdural Hygromas with Hydrocephalus After Chiari Decompression Surgery: Review of Literature. World Neurosurgery, 93, 208-14. https://doi.org/10.1016/j.wneu.2016.06.025
Prasad GL, Menon GR. Coexistent Supratentorial and Infratentorial Subdural Hygromas With Hydrocephalus After Chiari Decompression Surgery: Review of Literature. World Neurosurg. 2016;93:208-14. PubMed PMID: 27319314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coexistent Supratentorial and Infratentorial Subdural Hygromas with Hydrocephalus After Chiari Decompression Surgery: Review of Literature. AU - Prasad,G Lakshmi, AU - Menon,Girish R, Y1 - 2016/06/16/ PY - 2016/03/05/received PY - 2016/06/07/revised PY - 2016/06/08/accepted PY - 2016/6/21/entrez PY - 2016/6/21/pubmed PY - 2017/9/7/medline KW - Chiari I malformation KW - Foramen magnum decompression KW - Hydrocephalus KW - Infratentorial KW - Subdural hygroma KW - Supratentorial SP - 208 EP - 14 JF - World neurosurgery JO - World Neurosurg VL - 93 N2 - BACKGROUND: Foramen magnum decompression (FMD) is the standard procedure for Chiari I malformation. Although seemingly a straightforward procedure, recent articles have reported an increase in various complications. We describe a rare complication of coexistent supratentorial and infratentorial subdural hygromas (SDHs) with hydrocephalus noted after FMD and provide a detailed review of the literature on this topic. METHODS: A 34-year-old woman presented with strain-related suboccipital headache and myelopathy for 6 months. Imaging revealed tonsillar herniation up to C2 level and cervical syringomyelia. A standard FMD, C1 posterior arch removal, and tonsillar reduction was performed. After an initial uneventful postoperative course, she had 2 readmissions with headache, vomiting, and ataxia. Imaging showed a tense pseudomeningocele and concomitant supratentorial and infratentorial (initially right-sided, followed by left-sided) SDHs with ventriculomegaly. She was conservatively managed with antiedema measures and had excellent relief of symptoms. For the literature review, only cases with concomitant supratentorial and infratentorial SDHs with hydrocephalus were searched online and analyzed. RESULTS: Including ours, 10 cases have been reported. Mean age was 25.3 years. The male-to-female ratio was 1:2.3. Symptoms appeared an average of 12.6 days postoperatively. Treatment was with conservative management in 3 cases, and 3 cases required permanent cerebrospinal fluid diversions. Mean follow-up duration was 9.4 months (range, 1-27 months). CONCLUSIONS: Coexistent supratentorial and infratentorial SDHs with hydrocephalus after Chiari decompression is a very rare occurrence. Treatment needs to be individualized based on the predominant symptomatic lesion, and surgical options need to be judiciously considered. Good prognosis is the rule in most cases. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/27319314/Coexistent_Supratentorial_and_Infratentorial_Subdural_Hygromas_with_Hydrocephalus_After_Chiari_Decompression_Surgery:_Review_of_Literature_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(16)30410-7 DB - PRIME DP - Unbound Medicine ER -