Upward transtentorial herniation: A complication of postoperative edema at the cervicomedullary junction

R. Spiegelmann, M. Hadani, Z. Ram, M. Faibel, I. Shacked

Research output: Contribution to journalArticlepeer-review

Abstract

Local edema at the operative bed developed a few hours after uneventful subtotal removal of a lesion occupying the lower medulla and upper cervical cord. The patient experienced apnea, quadriplegia, and circulatory collapse followed by acute respiratory insufficiency. Hydrocephalus secondary to aqueductal occlusion occurred on the 3rd postoperative day. A computerized tomographic scan was compatible with upward transtentorial herniation. The association of this phenomenon with an intra-axial lesion at the cervicomedullary junction has not been previously documented. The pathophysiologial mechanisms implicated in this complication are discussed.

Original languageEnglish
Pages (from-to)284-288
Number of pages5
JournalNeurosurgery
Volume24
Issue number2
DOIs
StatePublished - 1989
Externally publishedYes

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