Work

Successful epidural fibrin glue patch to treat intracranial hypotension in a patient with bacteraemia and malignancy

Year: 2022

Type: article

Abstract: Cerebrospinal fluid leaks after diagnostic lumbar puncture are often treated using an epidural blood patch; however, there are situations in which this may not be a desirable or safe option. We describe a case of a 55-yr-old male who developed a cerebrospinal fluid leak with intracranial hypotension and subdural haematoma after multiple diagnostic lumbar punctures who also had Klebsiella bacteraemia, malignancy, and low platelets. Given concern about bacterial and malignant seeding of the epidural space, we considered several options including a patch with banked blood or neurosurgical intervention. To treat impending brain herniation, we opted to perform an epidural patch using fibrin glue. The fibrin patch is an absorbable surgical sealing patch that is placed on wound tissue. In this case, it was used to close the assumed dural tear, which resulted in a good outcome for the patient without need for neurosurgical intervention.

Source: BJA Open

DOI: 10.1016/j.bjao.2022.100091

Authors: Abhinav Gupta, Victoria C. Madriz, Ian R. Carroll, Vivianne L. Tawfik

Institutions: Stanford Medicine, Stanford University

Language: English

Topic: Neurosurgical Procedures and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,912