scholarly journals Severe and persistent coronavirus disease 2019 cough resulting in bone flap displacement and pseudomeningocele

2021 ◽  
Vol 12 ◽  
pp. 348
Author(s):  
Juan Silvestre Grecia Pascual ◽  
Kevin Ivan Peñaverde Chan ◽  
Kathleen Joy Ong-Lopez Khu

Background: Cough is one of the most common symptoms of coronavirus disease 2019 (COVID-19) infection. This relatively benign symptom may lead to serious sequelae, especially in postoperative neurosurgical patients. Case Description: Here, we report a case of bone flap displacement, pseudomeningocele formation, and consequent cerebrospinal fluid leak in a patient with COVID-19 infection who recently underwent craniotomy for excision of cerebral metastasis. We highlight the pathophysiologic mechanisms of cough that may cause increased intracranial pressure (ICP), leading to the postoperative morbidity. Conclusion: Aside from additional risks to the patient’s health and increased treatment costs, these complications also lead to subsequent delays in the management of the underlying disease. Symptomatic treatment of cough is advised to prevent complications resulting from increased ICP.

2018 ◽  
Vol 129 (6) ◽  
pp. 1159-1162 ◽  
Author(s):  
James E. Cottrell

Abstract Intracranial and Hemodynamic Changes after Succinylcholine Administration in Cats. By Cottrell JE, Hartung J, Giffin JP, and Shwiry B. Anesthesia & Analgesia 1983; 62:1006–9. Reprinted with permission. Bolus injections of succinylcholine (1.5 mg/kg) significantly increased intracranial pressure (ICP) in cats under normal conditions from control levels of 8 +/- 1 mmHg to 16 +/- 3 mmHg (+/- SEM, P less than 0.01), and in the presence of artificially increased ICP from control levels of 27 +/- 1 mmHg to 47 +/- 4 mmHg (P less than 0.01). These approximately 100% increases in ICP were accompanied by a transitory decrease in mean arterial pressure (approximately 10 s), followed by a 15 to 20% increase (P less than 0.05). Pulmonary arterial pressure increased 20 to 30% (P less than 0.05). These results, when considered in conjunction with results previously obtained in humans, suggest that succinylcholine may be contraindicated in neurosurgical patients.


1977 ◽  
Vol 46 (4) ◽  
pp. 494-500 ◽  
Author(s):  
Frederick J. Buckwold ◽  
Roger Hand ◽  
Robert R. Hansebout

✓ The authors review 23 cases of hospital-acquired meningitis occurring over a 15-year period in neurosurgical patients. Factors associated with the development of meningitis include recent craniotomy, cerebrospinal fluid leak, the presence of ventricular or lumbar drainage tubes, and skull fracture. Four cases were caused by Staphylococcus epidermidis; one of these patients died. In 19 cases, Gram-negative enteric bacteria were the etiologic agents, most commonly members of the Klebsiella-Enterobacter-Serratia group. Eleven of these patients died. The particular antibiotic or group of antibiotics used and the route of administration made no difference in the outcome of Gram-negative bacillary meningitis.


2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Maria Koutourousiou ◽  
Esther Vivas ◽  
Srinivas Chivukula ◽  
Juan Fernandez-Miranda ◽  
Eric Wang ◽  
...  

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. E1208-E1209 ◽  
Author(s):  
Peter W.A. Willems ◽  
Robert A Willinsky ◽  
Yoram Segev ◽  
Ronit Agid

Abstract OBJECTIVE This is the first report of an aggressive dural arteriovenous fistula presenting with rhinorrhea. It demonstrates the importance of recognizing increased intracranial pressure, and its underlying cause, as the predisposing factor to a spontaneous cerebrospinal fluid leak because this carries implications for management. CLINICAL PRESENTATION Ten years after minor trauma and directly after an intercontinental flight, a 43-year-old woman presented with rhinorrhea. Right-sided pulsatile tinnitus had been present for the past 9 years. Imaging demonstrated an intracranial dural arteriovenous fistula of the right transverse sinus with cortical venous reflux. Magnetic resonance imaging findings indicated long-standing increased intracranial pressure. INTERVENTION The fistula was treated by endovascular means, using both transvenous and transarterial approaches, which led to immediate relief of the tinnitus and resolution of the rhinorrhea within 4 days. CONCLUSION A dural arteriovenous fistula should be included in the differential diagnosis of underlying causes of increased intracranial pressure when examining a patient with a cerebrospinal fluid leak. Treatment of the fistula should precede attempts to treat the rhinorrhea, especially if the fistula has cortical venous reflux.


Skull Base ◽  
2009 ◽  
Vol 19 (S 02) ◽  
Author(s):  
E. Pasquini ◽  
G. Tenti ◽  
C. Bordonaro ◽  
P. Farneti ◽  
V. Sciarretta ◽  
...  

2021 ◽  
pp. 1-9
Author(s):  
Jorge Tirado-Caballero ◽  
Jorge Herreria-Franco ◽  
Mónica Rivero-Garvía ◽  
Gloria Moreno-Madueño ◽  
Maria Jose Mayorga-Buiza ◽  
...  

<b><i>Introduction:</i></b> Posthemorrhagic hydrocephalus in preterm infants is a serious entity related to high mortality and morbidity. Neuroendoscopic lavage (NEL) is a suitable alternative for the management of this pathology. However, as with every endoscopic technique, it requires some experience and several cases to master. <b><i>Methods:</i></b> We present a descriptive study of some technical nuances, tips, and tricks that have been learned in the last 8 years with over a hundred NELs performed in preterm infants. These variations are classified into 3 categories according to their temporal relationship with the surgical procedure: preoperative stage, intraoperative stage, and postoperative stage. We include a brief description of each one and the reasons why they are included in our current clinical practice. <b><i>Results:</i></b> Twenty tips and pearls were described in detail and are reported here. Preoperative, intraoperative, and postoperative variations were exposed and related to the most frequent complications of this procedure: infection, cerebrospinal fluid leak, and rebleeding. <b><i>Conclusions:</i></b> NEL is a useful technique for the management of germinal matrix hemorrhage in preterm infants. These technical nuances have improved the results of our technique and helped us to prevent complications related to the procedure.


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