Intracranial pressure monitoring during adult spinal deformity correction in a patient with critical venous occlusive disease and superior vena cava syndrome: A technical note

Alp Ozpinar, Jesse J. Liu, Zachary J. Tempel, Phillip A. Choi, Robert A. Hart, D. Kojo Hamilton

Research output: Contribution to journalArticle

Abstract

Background: Intracranial pressure (ICP) monitoring is not routinely used during complex spinal deformity correction surgery. The authors report a 66-year-old male who during thoracolumbar deformity surgery required the placement of an ICP monitor due to the underlying history of a superior vena cava syndrome (e.g., s/p right jugular stent). Case Description: A 66-year-old male with multiple prior lumbar spinal procedures presented with lower back and bilateral lower extremity pain, paresthesias, and weakness. He had a history of chronic left internal jugular and brachiocephalic venous occlusion (e.g., he had a right internal jugular stent). During deformity surgery, a frontal intraparenchymal ICP monitor was placed. During the early portion of the operation, bed adjustments (increasing reverse trendelenburg position) were required to compensate for ICP elevations as high as 30 mm Hg. A subsequent inadvertent durotomy during decompression lowered the ICP to <5 mm Hg; no further ICP spikes occurred. His postoperative course was uneventful, and 14-month later, he was dramatically improved. Conclusion: ICP monitoring may be a useful adjunct for patient safety in selected patients who are at risk for developing intracranial hypertension during extensive spinal deformity surgery.

Original languageEnglish (US)
Article number22
JournalSurgical Neurology International
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Deformity correction
  • Intracranial pressure monitoring
  • Superior vena cava syndrome

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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