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Multigen RF lesion generator .

 

09-SEPTEMBER-2009  RABAB KHALED MAHAMEED   38 YEARS  CSF LEAK AFTER REMOVAL OF EWING'S SARCOMA 4 DAYS AGO.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Anamnesis:

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The patient was operated for Ewing sarcoma 05-September-2009 and was ready for discharge 08-September-2009, before what she progressed CSF leak. Mannitol was started and three dressings done and the CSF continued

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The wound was opened and the CSF leak was coming from the axilla of the right C3 root , where meticulous cleaning of the tumor was performed during the first operation.

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Nylon 6 zero was used to stitch the healthy dura in water-tight fashion and surgicel was applied superior, inferior and over the axilla.

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The patient was put in several positions and Valsalva maneuver  was applied to seek for other CSF leak points. It was negative. A piece of muscle was crushed and covered over the repaired area for further assurance and Gentamicine washing of the wound was done.

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Routine closure of the wound and smooth postoperative recovery and the patient sent to the ward.


Comments

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Surgical intervention in this case was mandatory, not only to prevent CSF leak, but also to prevent seed of the tumor intradurally.  It could possibly invaded it as the left C3 root was tumorous, but the defect could accelerated the CSF seed of the tumor cells.


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