Intracranial Hypotension Following Lumbar Drainage

Abstract

Lumbar drainage (LD) is a technique that is widely used to prevent cerebrospinal fluid (CSF) leakage following cranial base surgery. Intracranial hypotension (ICH) syndrome with severe neurological symptoms, which is a complication of LD, is a rarely observed entity. In this paper, we present the case of a 51-year-old woman with pituitary macroadenoma, who developed severe ICH after LD and required lumbar intrathecal saline infusion (LISI) in order to reverse the acute obtundation immediately. LISI may be a life-saving intervention in patients with cerebral herniation and coma resulting from CSF depletion secondary to LD that is refractory to conventional treatment modalities.