Drawbacks to nTMS the researchers pointed out include the observation that "the precision of motor mapping by nTMS can be impaired by various confounding factors, such as the definition of resting motor threshold, registration errors, navigation errors, and brain shift after durotomy
Incidental durotomy during spine surgery reportedly occurs at a rate of 3% to 14%.
At the conclusion of the procedure, no durotomy or CSF leakage was noted.
At the conclusion of the procedure, no durotomy or leakage of CSF was noted, and a Valsalva maneuver as well as watertight fascial closure was performed.
Incidental durotomy is not uncommon during surgery of the lumbar spine.
demonstrated a 1 x 3 cm mass occupying the spinal canal with peripheral displacement of the nerve roots.
A small dural and arachnoidal incision was made and a 2 to 3 mm segment of polyethylene tubing connected to a micropipette was inserted caudally through the durotomy
Decompressive hemicraniectomy for severe ischemic stroke currently is being investigated in major clinical trials, such as the Hemicraniectomy after MCA Infarction with Life-threatening Edema Trial (HAMLET), Hemicraniectomy and Durotomy
for Deterioration from Infarction Related Swelling Trial (HeaDDFIRST), Hemicraniectomy and Moderate Hypothermia in Patients with Severe Ischemic Stroke and Hemicraniectomy for Malignant Cerebral Artery Infarcts (HeMMI) (Internet Stroke Center, 2004).
Unintentional durotomy is a frequent complication of spinal surgical procedures, with a rate as high as 17% (1).
The purpose of this report is to describe a case in which new-onset tonic-clonic seizures occurred following an unintentional durotomy during lumbar discectomy and to discuss the importance of our findings in relation to the possible pathophysiological mechanisms.
Here we are attempting to make an association between the CSF hypotension caused by an unintentional durotomy at lumbar surgery and the new onset of epilepsy which might have been propagated by the patients' pre-operative anti-psychiatric medication.
New onset epilepsy following unintentional durotomy in a patient on anti-psychiatric medication.