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Meningeal haemorrhage secondary to cerebrospinal fluid drainage during thoracic endovascular aortic repair.
- Source :
-
Oxford medical case reports [Oxf Med Case Reports] 2014 Jun 20; Vol. 2014 (3), pp. 56-9. Date of Electronic Publication: 2014 Jun 20 (Print Publication: 2014). - Publication Year :
- 2014
-
Abstract
- Thoracic endovascular aortic repair (TEVAR) has shown lower mortality compared with open surgical repair (OSR). However, the risk of spinal cord ischaemia (SCI) remains similar than OSR. As a prophylactic measure to reduce the risk of SCI, cerebrospinal fluid (CSF) drainage has been widely used in OSR. In TEVAR, the utility of this adjunct is still controversial. We report a case of a 56-year-old man referred for TEVAR for a descending thoracic aneurysm that previously underwent an abdominal aneurysmectomy with aortobifemoral bypass graft. On the day before, a lumbar cerebrospinal drain was placed prophylactically. Forty-eight hours after the procedure, meningeal symptoms without neurological deficits developed. Clinical investigation revealed meningeal haemorrhage. Therapy with nimodipine was initiated with symptomatic relief. Evidence from randomized controlled trials supporting the role of CSF drainage in TEVAR is still lacking. We discuss the current recommendations, potential benefits and risks and cautions associated with CSF drainage in TEVAR.
Details
- Language :
- English
- ISSN :
- 2053-8855
- Volume :
- 2014
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Oxford medical case reports
- Publication Type :
- Report
- Accession number :
- 25988028
- Full Text :
- https://doi.org/10.1093/omcr/omu019