척추측만증 교정수술 후 발생한 경막하출혈

An 11-year-old boy underwent thoracolumbar surgery to correct a deformity caused by congenital kyphoscoliosis from the 6th thoracic vertebra to the 2nd lumbar vertebra. During a screw insertion, some tore and cerebro-spinal fluid (CSF) leaked. After CSF leakage, the amplitude of the motor evoked pot...

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Bibliographic Details
Published in:Korean journal of anesthesiology 2009, 56(1), , pp.116-119
Main Authors: 전승규, Seung Gyu Jeon, 유병훈, Byung Hoon Yoo, 임윤희, Yun Hee Lim, 이상석, Sang Seok Lee, 홍기혁, Ki Hyuk Hong
Format: Article
Language:Korean
Subjects:
Acute subdural hematoma
Delayed emergence
Spine surgery
마취과학
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Summary:An 11-year-old boy underwent thoracolumbar surgery to correct a deformity caused by congenital kyphoscoliosis from the 6th thoracic vertebra to the 2nd lumbar vertebra. During a screw insertion, some tore and cerebro-spinal fluid (CSF) leaked. After CSF leakage, the amplitude of the motor evoked potential in the left lower extremity was reduced by 90% compared to baseline value, but there was no nerve damage at the surgical site. His post-surgical mental status did not recover completely. Brain computed tomography revealed a subdural hemorrhage in the inter-hemispheric fissure, with both tentorium and right frontotemporooccipital and diffuse brain edema. On the 4th postoperative day, mental status recovered to near alertness, but upper motor strength was grade II, right lower motor strength was grade II and left lower motor strength was grade I. Right hemifacial palsy was also noted. At 2.5 months after surgery, right facial palsy remained, but motor function recovered to near normal levels with conservative care. (Korean J Anesthesiol 2009;56:116~9)
ISSN:2005-6419
2005-7563