Severe hyperglycorrhachia and status epilepticus after endoscopic aqueductoplasty: illustrative case.

Autor:	Dharia AA; 1Department of Neurosurgery, The University of Kansas Medical Center, Kansas City, Kansas., Masri A; 1Department of Neurosurgery, The University of Kansas Medical Center, Kansas City, Kansas., Rilinger JF; 2University of Missouri Kansas City School of Medicine, Kansas City, Missouri; and., Kaufman CB; 1Department of Neurosurgery, The University of Kansas Medical Center, Kansas City, Kansas.; 3Division of Neurosurgery, Children's Mercy Hospital Kansas City, Kansas City, Missouri.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Jul 17; Vol. 6 (3). Date of Electronic Publication: 2023 Jul 17 (Print Publication: 2023).
DOI:	10.3171/CASE23252
Abstrakt:	Background: While hypoglycorrhachia is observed and managed frequently, there are few reports in the literature of clinically significant hyperglycorrhachia after neurosurgery. Understanding the effects and management of severe hyperglycorrhachia is important to the neurosurgeon and neurocritical care teams who care for patients in these rare scenarios. Observations: The authors present the case of a 3-month-old male with congenital hydrocephalus who faced profound hyperglycorrhachia and status epilepticus after an endoscopic aqueductoplasty using an irrigant composed of lactated Ringer's solution with dextrose 5% in water. A multidisciplinary approach was developed to monitor and treat the patient's seizures and cerebrospinal fluid (CSF) osmolytes. Lessons: This case provides several learning opportunities for understanding CSF physiology, pathogenesis of common brain injuries related to osmotic shifts and inflammatory states, as well as clinical management of hyperglycorrhachia. It also reiterates the significance of meticulous intraoperative assessment to avoid preventable medical errors.
Databáze:	MEDLINE
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