CLINICAL PRESENTATION: We report for the first time on 2 patients presenting with a clinical and radiological picture of pseudohypoxic brain swelling after spinal surgery. In the first patient, bilateral basal ganglia damage occurred after thoracic spondylodiscitis surgery, manifested by epileptic seizures and coma lasting 1 week selleck products postoperatively with subsequent recovery. The

second patient suffered basal ganglia and cerebellar and brainstem infarction after lumbar spondylodiscitis surgery, resulting in death. Because intraoperative cerebrospinal fluid leakage and use of postoperative epidural suction drainage with cerebrospinal fluid loss occurred in both cases, they are highly suspected

to have potentially caused the complications.

CONCLUSION: Pseudohypoxic brain swelling should be considered in patients with unexpected neurological deterioration after spinal surgery. It might be a form of postoperative intracranial hypotension-associated venous congestion, which should be distinguished from common postoperative cerebral ischemic events caused by arterial or venous occlusions.”
“BACKGROUND AND IMPORTANCE: Subgaleal drains are commonly used in neurosurgery. Rare complications attributed to these drains have been described. Obeticholic mouse We present a rare complication of hemodynamic collapse and multiple epidural hematomas attributed to intracranial hypotension induced by a subgaleal drain connected to suction during wound closure.

CLINICAL PRESENTATION: A 3.5-year-old boy underwent an uneventful occipital lobectomy and titanium mesh cranioplasty for resection of a recurrent choroid plexus carcinoma. The child had undergone 2 uneventful previous resections and cranial irradiation. During skin closure, a subgaleal drain was connected to suction to keep the surgical bed dry. Immediately after completion of the subgaleal layer closure, there was an acute hemodynamic collapse, accompanied by bradycardia and a drop in the hematocrit.

After successful resuscitation, the child underwent a brain computed tomography scan that showed a large bifrontal epidural hematoma and multiple additional small epidural hematomas. The large hematoma was surgically evacuated, and the child had an uneventful recovery.

CONCLUSION: MEK162 chemical structure Acute negative intracranial hypotension may cause bradycardia, epidural hematomas, and hemodynamic collapse. Subgaleal drains should not be connected to suction systems, and care should be taken when these drains are connected to vacuum bulbs in high-risk cases such as after cranial irradiation, large resections, and mesh cranioplasties.”
“Background Control of blood pressure is a key component of cardiovascular disease prevention, but is difficult to achieve and until recently has been the sole preserve of health professionals.