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Journal of Korean Neurosurgical Society > Volume 45(6); 2009 > Article
Journal of Korean Neurosurgical Society 2009;45(6): 386-389.
doi: https://doi.org/10.3340/jkns.2009.45.6.386
Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty.
Jae Bum Lim, Joung Soo Park, Ealmaan Kim
Skull Base Surgery Division, Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. bach1158@dsmc.or.kr
ABSTRACT
On rare occasions, percutaneous vertebroplasty (PV) may be associated with adverse spinal and extraspinal events. Subarachnoid hemorrhage (SAH) has not been reported complication following a PV. This is a report of two elderly women with spine compressions who developed idiopathic SAH after injecting polymethylmethacrylate into the thoracolumbar region transcutaneously. PV was performed as an usual manner on prone position under local anesthesia for these patients. During the interventions, two patients complained of a bursting nature of headache and their arterial blood pressure was jumped up. Computed tomography scans revealed symmetric SAH on the both hemispheres and moderate degree of hydrocephalus. Any intracranial vascular abnormalities for their SAH were not evident on modern neuroangiography modalities. One patient received a ventricular shunt surgery, but both fully recovered from the procedure-related SAH. The pathophysiologic mechanism that induce SAH will be discussed, with suggesting the manner that prevent and minimize this rare intracranial complication after PV.
Key Words: Vertebroplasty; Complication; Nonaneurysmal subarachnoid hemorrhage; Valsalva maneuver
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