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Muruato-Araiza F, Oekenpöhler S, Wagner NM, Förster P, Warneke N, Holling M, Mannil M, Grauer OM, Stummer W, Brokinkel B. Iatrogenic lumbosacral infiltration with petroleum (hydrodesulfurized heavy) with secondary intrathecal distribution-a case report. Acta Neurochir (Wien) 2023; 165:1141-1144. [PMID: 36735094 PMCID: PMC10140093 DOI: 10.1007/s00701-023-05505-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/18/2023] [Indexed: 02/04/2023]
Abstract
Petroleum is commonly used as a solvent, and primary intrathecal administration or secondary diffusion and subsequent clinical management has not been reported. We report the case of a male patient with intrathecal petroleum diffusion following accidental lumbar infiltration. After the onset of secondary myeloencephalopathy with coma and tetraparesis, continuous cranio-lumbar irrigation using an external ventricular and a lumbar drain was established. Cranial imaging revealed distinct supra- and infratentorial alterations. The patient improved slowly and was referred to rehabilitation. Intrathecal petroleum leads to myeloencephalopathy and continuous cranio-lumbar irrigation might be a safe treatment option.
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Affiliation(s)
- Fernando Muruato-Araiza
- Department of Neurosurgery, University Hospital Münster, North Rhine-Westphalia, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany
| | - Simon Oekenpöhler
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Münster, North Rhine-Westphalia, Münster, Germany
| | - Nana-Maria Wagner
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, North Rhine-Westphalia, Münster, Germany
| | - Petra Förster
- Poison Center Bonn, Children's University Hospital, North Rhine-Westphalia, Bonn, Germany
| | - Nils Warneke
- Department of Neurosurgery, University Hospital Münster, North Rhine-Westphalia, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany
| | - Markus Holling
- Department of Neurosurgery, University Hospital Münster, North Rhine-Westphalia, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany
| | - Manoj Mannil
- Institute for Clinical Radiology, University Hospital Münster, North Rhine-Westphalia, Münster, Germany
| | - Oliver Martin Grauer
- Department of Neurology, University of Münster, North Rhine-Westphalia, Münster, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Münster, North Rhine-Westphalia, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany
| | - Benjamin Brokinkel
- Department of Neurosurgery, University Hospital Münster, North Rhine-Westphalia, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany.
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Torres-Corzo J, Sánchez-Rodríguez J, Cervantes D, Rodríguez-Della Vecchia R, Muruato-Araiza F, Hwang SW, Rangel-Castilla L. Endoscopic Transventricular Transaqueductal Magendie and Luschka Foraminoplasty for Hydrocephalus. Neurosurgery 2013; 74:426-35; discussion 436. [DOI: 10.1227/neu.0000000000000283] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
ABSTRACT
BACKGROUND:
Routinely, hydrocephalus related to fourth ventricular outlet obstruction (FVOO) has been managed with ventriculoperitoneal (VP) shunting or endoscopic third ventriculostomy (ETV). Few reports on Magendie foraminoplasty exist, and Luschka foraminoplasty has not been described.
OBJECTIVE:
To present an alternative technique in the management of FVOO via an endoscopic transventricular transaqueductal Magendie and Luschka foraminoplasty and to discuss the indications, technique, findings, and outcomes.
METHODS:
Between 1994 and 2011, all patients who underwent endoscopic Magendie and Luschka foraminoplasty were analyzed.
RESULTS:
A total of 33 Magendie (28) and/or Luschka (5) foraminoplasties were performed in 30 patients. Twenty-three were adult and 7 were pediatric patients. The etiology of the FVOO was divided into primary etiologies (congenital membrane in 5 and atresia in 2) and secondary causes (neurocysticercosis in 14 patients, bacterial meningitis in 9). Fifteen (50%) had previously failed procedures. Intraoperative findings that led to Magendie/Luschka foraminoplasty were ETV not feasible to perform, nonpatent basal subarachnoid space, or primary FVOO. Minor postoperative complications were seen in 3 patients. Only 26 patients had long-term follow-up; 17 (65.3%) of these had clinical improvement and did not require further procedures. Nine (34.7%) did not improve. Eight required another procedure (7 shunts, and 1 endoscopic procedure). One patient died.
CONCLUSION:
Flexible neuroendoscopic transventricular transforaminal Magendie and Luschka foraminoplasty is feasible and safe. These procedures may prove to be viable alternatives to standard ETV and VP shunt in appropriate patients. Adequate intraoperative assessment of ETV success is necessary to identify patients who will benefit.
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Affiliation(s)
- Jaime Torres-Corzo
- Department of Neurosurgery, Hospital Central, University of San Luis Potosi and School of Medicine, San Luis Potosi, Mexico
| | - Juan Sánchez-Rodríguez
- Department of Neurosurgery, Hospital Central, University of San Luis Potosi and School of Medicine, San Luis Potosi, Mexico
| | - Dominic Cervantes
- Department of Neurosurgery, Hospital Central, University of San Luis Potosi and School of Medicine, San Luis Potosi, Mexico
| | | | - Fernando Muruato-Araiza
- Department of Neurosurgery, Hospital Central, University of San Luis Potosi and School of Medicine, San Luis Potosi, Mexico
| | - Steven W. Hwang
- Department of Neurosurgery, Tufts Medical Center and Floating Hospital for Children, Boston, Massachusetts
| | - Leonardo Rangel-Castilla
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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