Spontaneous spinal cerebrospinal fluid leak as a cause of @entity772 after craniotomy for clipping of an unruptured XXXX .

@entity1 @entity8 @entity16 @entity772 @entity2895 @entity439 @entity1410 @entity10 @entity551 @entity438
Spontaneous spinal CSF leaks are best known as a cause of @entity10 , but may also be the cause of @entity772 . The authors encountered a unique case of a spontaneous spinal CSF leak causing @entity772 2 days after craniotomy for clipping of an unruptured @entity439 . This 44-year-old @entity1 with @entity8 underwent an uneventful craniotomy for an @entity438 . No intraoperative spinal CSF drainage was used. Two days after surgery the @entity1 became @entity772 with a left @entity2895 . Computed tomography scanning revealed a right extraceberal @entity1410 and loss of gray-white matter differentiation. The @entity1410 was evacuated and a diagnosis of hemodialysis disequilibrium syndrome was made. Continuous hemodialysis and hyperosmolar therapy were instituted without any improvement. The CT scans were then reinterpreted as showing sagging of the brain, and the @entity1 was placed in the Trendelenburg position which resulted in prompt improvement in her level of consciousness. A CT myelogram demonstrated an upper thoracic CSF leak that eventually required surgical correction. The @entity1 made a complete neurological recovery. @entity16 after craniotomy may be caused by brain sagging caused by a spontaneous spinal CSF leak, similar to @entity551 due to intraoperative lumbar CSF drainage.
