Management of Intractable Cerebrospinal Fluid Collection after Cerebellar Tumor Resection: A Case Report

소뇌 종양 적출 후 두개강 내 발생한 난치성 뇌척수액 고임의 치험례

  • Rha, Eun Young (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Oh, Deuk Young (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hye Young (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jung Ho (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Moon, Suk Ho (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Seo, Je Won (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Rhie, Jong Won (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea) ;
  • Ahn, Sang Tae (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
  • 라은영 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 오득영 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 김혜영 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 이중호 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 문석호 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 서제원 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 이종원 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 안상태 (가톨릭대학교 의과대학 성형외과학교실)
  • Received : 2010.06.28
  • Accepted : 2010.09.14
  • Published : 2010.11.10

Abstract

Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.

Keywords

References

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