gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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Transient intradural catheter lysis in a patient with diffuse elongated traumatic subdural hematoma of the spine

Intradurale Katheter-Lyse in einer Patientin mit einem langstreckigen traumatischen subduralen spinalen Hämatom

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  • corresponding author M.H. Deininger - Klinik für Allgemeine Neurochirurgie, Universitätsklinikum Freiburg
  • U. Hubbe - Klinik für Allgemeine Neurochirurgie, Universitätsklinikum Freiburg
  • O. Moske-Eick - Klinik für Neuroradiologie, Universitätsklinikum Freiburg
  • A. Schoder - Klinik für Neurologie, Elzach
  • V. I. Vougioukas - Klinik für Allgemeine Neurochirurgie, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 040

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc295.shtml

Published: April 11, 2007

© 2007 Deininger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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The often extended and elongated configuration of diffuse subdural hematoma of the spine is impossible to completely evacuate with common neurosurgical approaches.

We now describe complete evacuation of a diffuse traumatic subdural hematoma of the entire spine, with consecutive myelopathy using transient subdural catheter lysis.

After partial hemilaminectomy T7/8 and L2/3 using a lateral transmuscular approach, a 15 cm long Holter Salmon Rickham intraventricular catheter was inserted each in an overall one-hour procedure and connected to an external ventricular drainage system. Then, 5000 IE urokinase was applied four times daily for 30 minutes each over the next five days. Two months later, the patient presented with spastic paraparesis grade 4/5. MR tomography revealed no catheterrelated complications.

We conclude from this case that transient catheter lysis is an effective and gentle way to treat diffuse elongated traumatic subdural hematoma of the spine.