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Posterior fossa epidural hematomas:a rare but serious complication of occipito-cervical fusion surgery.
World Neurosurg. 2018 Apr 17;:
Authors: Zhu CR, Wang J, Jianqiang D, Chen K, Hong X
Abstract
BACKGROUND: Posterior occipito-cervical fusion surgery is a commonly used surgical method to treat various craniovertebral junction pathologies. Though it is an effective method, there also have been some reports about complications of occipito-cervical fusion. However, there have been no reports about posterior fossa epidural hematomas after occipito-cervical fusion.
CASE DESCRIPTION: A 44-year-old female was referred to our Hospital with a 6-month history of neck pain and numbness limbs for 2 months. Based on the imaging findings of the patient, diagnosis were basilar invagination with atlantoaxial dislocation associated with Klipple-Feil syndrome and O-C1 assimilation. According to the principle of treatment, occipito-cervical fusion surgery was performed for her. The operation was completed successfully and the patient was awakened from anesthesia 10 minutes later and then back to the orthopedic intensive care ward. 20 hours after the surgery, her mental status had deteriorated to stupor, and both her pupils had dilated to 5 mm. Acute posterior fossa epidural hematomas was revealed by Emergent CT of the brain . Emergency craniectomy decompression and epidural hematoma removal surgery was performed for her timely. However, her mental status still did not improve and she fell into a deep coma and the pupillary reflex disappeared, and then she died.
CONCLUSIONS: Posterior fossa epidural hematomas is a rare complication of occipito-cervical fusion surgery. But once happened, it would be very serious and even led the patient to die. It is important for the surgeons to realize that posterior fossa epidural hematomas may occur after the occipito-cervical fusion surgery.
PMID: 29678713 [PubMed - as supplied by publisher]
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