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Papers of the Week

2022 Mar 07

Rev Esp Anestesiol Reanim (Engl Ed)

Intraventricular hemorrhage as complication after spinal surgery. Case report.


Sánchez Zamora P, Gómez Del Pulgar Vázquez B, Gholamian Ovejero S
Rev Esp Anestesiol Reanim (Engl Ed). 2022 Mar 07.
PMID: 35272951.


Remote intracranial hemorrhage (ICH) is a rare but dreaded complication after spinal surgery. The physiopathology of this phenomenon is closely related to a loss of cerebrospinal fluid (CSF) after an incidental durotomy during spine surgery. The most common remote ICH location is cerebellar, but few articles report intraventricular hemorrhage. Its clinic is associated with cerebral hypotension due to decreased CSF, mainly headache, dysarthria, hemiparesis, an impaired level of awareness and seizures. The diagnosis of remote ICH after a non-cranial surgery can be a challenge to anesthesiologists, this pathology should be suspected face an immediate neurological deterioration after anesthetic awakening. Non-specific symptoms make it difficult to identify the origin of intracranial hemorrhagic from other differential diagnoses. We present a patient with an impaired level of awareness and seizures who suffered a hemorrhage in the right ventricle with cerebral and cerebellar edema in the immediate postoperative period after spinal surgery.