Rare combination of traumatic subarachnoid-pleural fistula and intracranial subdural hygromas:A case report  

作　　者：Po-Han Chen Chi-Ruei Li Cheat-Wei Gan Tsung-Hsi Yang Cheng-Siu Chang Fook-How Chan 

机构地区：[1]Department of Neurosurgery,School of Medicine,Chung Shan Medical University Hospital,Taichung 40201,Taiwan,China [2]Department of Neurosurgery,Neurological Institute,Taichung Veterans General Hospital,Taichung 40201,Taiwan,China

出　　处：《World Journal of Clinical Cases》2023年第21期5173-5178,共6页世界临床病例杂志

摘　　要：BACKGROUND Subarachnoid-pleural fistula(SPF)is a complex and rare condition characterized by a pathological shunt between the subarachnoid and pleural spaces.It can lead to the accumulation of cerebrospinal fluid(CSF)in the pleural space,pneumocephalus,and the development of central nervous system infection.Trauma or thoracic spinal surgery are common causes of SPF,with symptoms including postural headache,consciousness status changes,and dyspnea.The combination of SPF and subdural hygroma is a severe and rare condition,with little existing literature on its clinical correlation.CASE SUMMARY We report a case of an 83-year-old male patient with traumatic SPF and bilateral frontal subdural hygroma following a fall from height.The patient initially presented with severe lower back and buttock pain.During admission,the patient developed worsening lower limb weakness and pleural effusion.Further investigation revealed the presence of subdural hygromas with mass effect,requiring emergency bilateral subdural drainage.A multidisciplinary approach was undertaken to manage this complex condition,including intervention for hypovolemic CSF status and subdural hygroma management.The pleural effusion eventually resolved and the patient attained a higher level of con-sciousness after bilateral hygroma drainage surgery.We also reviewed the present literature relating to this rare combination of medical conditions.CONCLUSION Traumatic SPF with subsequent subdural hygroma is a rare but serious combination.Although the optimal treatment strategy for this complex condition remains uncertain,our literature review suggested that a multidisciplinary approach,including intervention for hypovolemic CSF and management of the subdural hygroma,is the most beneficial.

关 键 词：Subarachnoid-pleural fistula Subdural hygroma Trauma Hypovolemic cerebrospinal fluid Multidisciplinary approach Case report 

分 类 号：R651[医药卫生—外科学]