Chiravuri S, Wasserman R, Chawla A and Haider N.
This case report describes the case of a patient who while undergoing an implantation of a spinal cord stimulator (SCS). The patient had suffered from chest pain for approximately 5 years when the decision to implant a SCS in an attempt to control the patients pain was made.
Following an uneventful surgery the patient returned home before starting to complain of a positional headache accompanied with nausea and vomiting. This progressively worsened throughout the day until the positional component ceased and the patient reported to the Emergency Room.
The patient was assessed to have mental changes present and a urgent contrast enhanced CT head showed a right sided sub-dural hematoma with ventricular compression and left-sided mid-line shift. The patient underwent an emergency craniotomy and recovered well.
While subdural hematomas are rare following this surgery this case report emphases the importance of monitoring headaches and other symptoms after spinal surgery.
This report also shows the inherent risks of any kind of spinal surgery which shows the importance of physiotherapy (especially in the management of chronic pain)as a way of avoiding invasive techniques if possible.
Pain Physician 2008;11:97-101
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