| Epidural venous engorgement resulting in progressive cervical myelopathy from shunt-related intracranial hypotension. Case report and review of the literature. | |
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MedLine Citation:
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PMID: 17184086 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The authors report an unusual case of engorged epidural veins causing progressive cervical myelopathy after long-term cerebrospinal fluid (CSF) shunt therapy and intracranial hypotension. An 18-year-old woman, who had previously undergone shunt placement with a distal slit valve for a porencephalic cyst when 2 years of age, presented with progressive spastic quadriparesis, numbness, and gait difficulty. Postural headaches were absent and a lumbar puncture revealed low CSF pressure. Neuroimaging disclosed markedly engorged anterior epidural veins causing compression of the cervical spinal cord. The slit-valve shunt system was surgically removed and an external drain was placed. The patient's CSF pressure was gradually raised to clinically tolerable levels. Once the optimal pressure was identified, a programmable shunt was placed with the valve set at the same level. The patient's neurological status improved, and the epidural veins had returned to their normal size on follow-up imaging. The authors describe the unique treatment strategy used in this patient and review the literature on epidural venous engorgement as it relates to intracranial hypotension. |
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Authors:
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James K Liu; Oren N Gottfried; Douglas L Brockmeyer |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Journal of neurosurgery Volume: 105 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-12-22 Completed Date: 2007-01-18 Revised Date: 2007-04-02 |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 499-503 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, Utah 84113, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Central Nervous System Cysts / surgery Cerebrospinal Fluid Shunts / adverse effects* Epidural Space / blood supply*, pathology Female Humans Intracranial Hypotension / etiology*, pathology, surgery* Magnetic Resonance Imaging Reoperation Veins / pathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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