Postoperative intrakranielle unterdruckassoziierte venöse Kongestion: das "lentiform rim sign"

Abstract

Postoperative intracranial hypotension-associated venous congestion (PIHV) or pseudohypoxic brain swelling (PHBS), first described in 2003, is a rare but potentially fatal acute complication following otherwise uneventful intracranial or spinal surgery mainly with liquor leakage or use of suction drainage [Van Roost D et al. Neurosurgery 2003; 53: 1315–1322]. The patients suffer from an unexpected impairment of consciousness, seizures, and brainstem dysfunction. It is supposed that a rapid loss of cerebrospinal fluid (CSF) causes brain sagging which may compromise the main intracranial deep venous structures through shear forces. Therefore, venous ischemia, infarction, and bleeding due to venous congestion are likely consequences [Van Roost D et al. Neurosurgery 2003; 53: 1315–1322].