Abstract
Elevated cerebrospinal fluid (CSF) protein concentration usually occurs in CSF of patients with meningitis and leptomeningeal carcinomatosis. We identify patients at risk of prolonged illness and those with a benign course. However, sudden death has been rarely reported. We report a case of sudden death presented as elevated CSF protein. Magnetic resonance imaging of the 61-year-old man spine revealed that L4, L5, and S1 of the spinal cord were compressed by the cystic space-occupying lesions. On admission day 2, the examination of CSF showed severe elevated CSF protein. Known causes of elevated CSF protein were carefully excluded before the planned operation. During the diagnostic period for elevated CSF protein, multiple organ dysfunction syndrome suddenly occurred and caused death on admission day 8. Acute pandysautonomia, which is not familiar to neurosurgeons, might explain the pathogenesis of this unusual evolution.
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