ABSTRACT
The aims of the current study were 1) to establish an adult rat model of intraventricular hemorrhage (IVH) and post-hemorrhagic ventricular dilatation, and 2) to examine the role of alterations in cerebrospinal fluid (CSF) drainage and parenchymal injury in that dilatation. Rats underwent infusion of 200 microl of autologous blood over 15 minutes. The rats were used to measure hematoma mass, ventricular dilatation, and cortical mantle volume (with T2 imaging), resistance to CSF absorption, and brain edema (as a marker of brain injury). IVH resulted in ventricular dilatation peaking at day 2 but persisting for at least 8 weeks. Although there was an increased resistance to CSF absorption at 3 days, it returned to normal at day 7. Long-term ventricular dilatation was not associated with an alteration in cortical mantle volume, although there was evidence of cortical damage (edema). It is possible that initial ventricular distension (due to the hematoma and the impaired CSF drainage) in combination with periventricular white matter damage results in structural changes that prevent total recoil once the hematoma has resolved and CSF drainage is normalized, leading to long-term hydrocephalus.
Subject(s)
Cerebral Hemorrhage/cerebrospinal fluid , Cerebral Hemorrhage/pathology , Cerebral Ventricles/metabolism , Cerebral Ventricles/pathology , Disease Models, Animal , Hydrocephalus/cerebrospinal fluid , Hydrocephalus/pathology , Animals , Cerebral Hemorrhage/complications , Dilatation, Pathologic , Hydrocephalus/complications , Male , Rats , Rats, Sprague-DawleyABSTRACT
STUDY DESIGN: Case report. OBJECTIVE: To report a rare complication following halo placement for cervical fracture. SETTING: United States University Teaching Hospital. CASE REPORT: A 39-year-old woman who sustained a spinal cord injury from a C6-7 fracture underwent halo placement. She subsequently developed an infection adjacent to the right posterior pin, which then became infected with Diptera larvae (maggots), necessitating removal of the pin and debridement of the wound site. CONCLUSION: Halo orthosis continues to be an effective means of immobilizing the cervical spine. Incidence of complications ranges from 6.4 to 36.0% of cases. Commonly reported complications include pin-site infection, pin penetration, pin loosening, pressure sores, nerve injury, bleeding, and head ring migration. Pin-site myiasis is rare, with no known reports found in the literature. Poor pin-site care by the patient and her failure to keep follow-up appointments after development of the initial infection likely contributed to the development of this complication.
