A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke?
In the case presented, a patient has an unexplained episode of hypertension during aneurysm clipping. Following the procedure, the patient was discovered to have bilateral thalamic infarctions unrelated to the vascular location of the aneurysm. After a review of the case, it becomes apparent that in...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2019/8764706 |
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| author | Daniel N. Kianpour Thomas M. Nguyen Arthur M. Lam |
| author_facet | Daniel N. Kianpour Thomas M. Nguyen Arthur M. Lam |
| author_sort | Daniel N. Kianpour |
| collection | DOAJ |
| description | In the case presented, a patient has an unexplained episode of hypertension during aneurysm clipping. Following the procedure, the patient was discovered to have bilateral thalamic infarctions unrelated to the vascular location of the aneurysm. After a review of the case, it becomes apparent that intracranial hypotension caused by lumbar over drainage of cerebrospinal fluid (CSF) is the likely cause of both the episode of intraoperative hypertension and the thalamic infarcts. It is often presumed that having an open dura protects against intracranial hypotension and subsequent herniation. We present this case to suggest that opening the dura might not be protective in all cases and anesthesiologists must pay particular attention to the rate of CSF drainage. Lumbar CSF drainage is a technique frequently employed during neurological surgery and it is important for anesthesiologists to understand the signs, symptoms, and potential consequences of intracranial hypotension from rapid drainage. |
| format | Article |
| id | doaj-art-88ba0519b85b4523a9c0dbda960cb6e9 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-88ba0519b85b4523a9c0dbda960cb6e92025-08-20T03:38:05ZengWileyCase Reports in Anesthesiology2090-63822090-63902019-01-01201910.1155/2019/87647068764706A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke?Daniel N. Kianpour0Thomas M. Nguyen1Arthur M. Lam2Swedish Neuroscience Institute, Seattle, WA, USASwedish Neuroscience Institute, Seattle, WA, USAUniversity of California San Diego, USAIn the case presented, a patient has an unexplained episode of hypertension during aneurysm clipping. Following the procedure, the patient was discovered to have bilateral thalamic infarctions unrelated to the vascular location of the aneurysm. After a review of the case, it becomes apparent that intracranial hypotension caused by lumbar over drainage of cerebrospinal fluid (CSF) is the likely cause of both the episode of intraoperative hypertension and the thalamic infarcts. It is often presumed that having an open dura protects against intracranial hypotension and subsequent herniation. We present this case to suggest that opening the dura might not be protective in all cases and anesthesiologists must pay particular attention to the rate of CSF drainage. Lumbar CSF drainage is a technique frequently employed during neurological surgery and it is important for anesthesiologists to understand the signs, symptoms, and potential consequences of intracranial hypotension from rapid drainage.http://dx.doi.org/10.1155/2019/8764706 |
| spellingShingle | Daniel N. Kianpour Thomas M. Nguyen Arthur M. Lam A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke? Case Reports in Anesthesiology |
| title | A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke? |
| title_full | A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke? |
| title_fullStr | A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke? |
| title_full_unstemmed | A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke? |
| title_short | A Case Report of Thalamic Infarction after Lumbar Drain: A Unique Cause of Perioperative Stroke? |
| title_sort | case report of thalamic infarction after lumbar drain a unique cause of perioperative stroke |
| url | http://dx.doi.org/10.1155/2019/8764706 |
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