Cervical spine disease may result in a negative lumbar spinal drainage trial in normal pressure hydrocephalus

Case report

Ricardo J. Komotar, Brad Zacharia, J. Mocco, Michael G. Kaiser, Stephen J. Frucht, Guy M. McKhann

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: In this case report, we present a patient with normal pressure hydrocephalus in whom a lumbar drainage trial yielded a false-negative result secondary to cervical spondylosis. CLINICAL PRESENTATION: An 80-year-old woman presented with classic symptoms of normal pressure hydrocephalus as well as evidence of cervical myelopathy. Magnetic resonance imaging of the brain and spine showed enlarged ventricles and single-level cervical canal narrowing. INTERVENTION: An initial lumbar drainage trial was performed, which revealed negative results. The patient then underwent cervical decompression and fusion. Despite this procedure, the patient's symptoms continued to worsen. A repeat lumbar drainage trial was performed with positive results. Subsequently, a ventriculoperitoneal shunt was placed, resulting in significant improvement of her symptoms. CONCLUSION: This case report illustrates how altered cerebrospinal fluid flow dynamics may impact the accuracy ofthe lumbar spinal drainage trial in patients with normal pressure hydrocephalus.

Original languageEnglish (US)
JournalNeurosurgery
Volume63
Issue number4 SUPPL.
DOIs
StatePublished - Oct 1 2008

Fingerprint

Normal Pressure Hydrocephalus
Drainage
Spine
Spondylosis
Ventriculoperitoneal Shunt
Spinal Cord Diseases
Hydrodynamics
Decompression
Cerebrospinal Fluid
Magnetic Resonance Imaging
Brain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Komotar, Ricardo J. ; Zacharia, Brad ; Mocco, J. ; Kaiser, Michael G. ; Frucht, Stephen J. ; McKhann, Guy M. / Cervical spine disease may result in a negative lumbar spinal drainage trial in normal pressure hydrocephalus : Case report. In: Neurosurgery. 2008 ; Vol. 63, No. 4 SUPPL.
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Cervical spine disease may result in a negative lumbar spinal drainage trial in normal pressure hydrocephalus : Case report. / Komotar, Ricardo J.; Zacharia, Brad; Mocco, J.; Kaiser, Michael G.; Frucht, Stephen J.; McKhann, Guy M.

In: Neurosurgery, Vol. 63, No. 4 SUPPL., 01.10.2008.

Research output: Contribution to journalArticle

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AB - OBJECTIVE: In this case report, we present a patient with normal pressure hydrocephalus in whom a lumbar drainage trial yielded a false-negative result secondary to cervical spondylosis. CLINICAL PRESENTATION: An 80-year-old woman presented with classic symptoms of normal pressure hydrocephalus as well as evidence of cervical myelopathy. Magnetic resonance imaging of the brain and spine showed enlarged ventricles and single-level cervical canal narrowing. INTERVENTION: An initial lumbar drainage trial was performed, which revealed negative results. The patient then underwent cervical decompression and fusion. Despite this procedure, the patient's symptoms continued to worsen. A repeat lumbar drainage trial was performed with positive results. Subsequently, a ventriculoperitoneal shunt was placed, resulting in significant improvement of her symptoms. CONCLUSION: This case report illustrates how altered cerebrospinal fluid flow dynamics may impact the accuracy ofthe lumbar spinal drainage trial in patients with normal pressure hydrocephalus.

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