rare case of acute hydrocephalus following unilateral radical neck dissection

ABSTRACT

Radical neck dissection remains a well established surgical option in the management of head and neck malignancy. It is also the gold standard in managing occult neck disease, of which the primary is unknown. We report a case of 66-years old lady, a diagnosed case of nasopharyngeal carcinoma who completed radiotherapy 9 years ago, presenting with a left neck node. Fine needle aspiration cytology [FNAC] confirmed a metastatic undifferentiated carcinoma. Except for the obvious lymph node, subsequent panendoscopy and magnetic resonance imaging [MRI] were unremarkable. Left radical neck dissection was performed. Postoperatively, she developed drowsiness secondary to acute hydrocephalus. An emergent ventriculoperitoneal shunt was inserted and she showed marked improvement following that. Magnetic resonance venogram [MRV] demonstrated left dural venous drainage predominance. Clinical presentation and pathophysiology of hydrocephalus following radical neck dissection are discussed here