Abstract
BackgroundPleural-subarachnoid fistula (PSF) is a rare disease that is difficult to diagnose and treat. Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF.Case presentationA 1-year-old boy diagnosed PSF developed into secondary intracranial hypertension after conservative treatment. He was finally cured by down-step treatment of mannitol, avoiding form ventricle-peritoneal shunt. Then, we reviewed the literature of pleural-subarachnoid fistula. Fifty-six cases have been reported so far. Most of the cases (51.8%) were caused by surgery; only 17.9% were caused by car accidents. Regarding the treatment, half of the cases cured by surgery and the other by conservative measures. Our case is the first one involving secondary intracranial hypertension and cured by down-step treatment of mannitol.ConclusionsA comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies. Secondary acute intracranial hypertension may be cured by down step treatment of mannitol, evading from the long-term ventriculoperitoneal shunt.
Highlights
Pleural-subarachnoid fistula (PSF) is a rare disease that is difficult to diagnose and treat
Not all imaging examinations of pleural-subarachnoid fistula (PSF) showed pleural effusion; some only showed no significant changes in the pleural cavity or dilatation of the upper mediastinum [1, 2]
We described a 1-year-old boy with persistent pleural effusion caused by a car accident who was confirmed to be PSF by myelography
Summary
A comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies.
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