{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T14:40:52Z","timestamp":1790433652696,"version":"4.1.0"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,2,16]]},"abstract":"<jats:p>A 72-year-old woman was admitted for elective L4\/L5 laminectomy. The operative procedure was extradural, and a Jackson-Pratt (JP) drain was placed in the tissue bed and set to wall suction during skin closure. During closure, the patient developed a 15\u2005s period of asystole. The patient was haemodynamically stable, but was comatose for 3\u2005days postoperatively. Cardiac enzymes and EEG were unrevealing. Head CT showed traces of subarachnoid haemorrhage and signs suggestive of cerebral anoxia. JP drain at the incision produced 170\u2013210\u2005mL\/day of fluid, positive for \u03b2-2 transferrin, indicating cerebrospinal fluid (CSF). The patient fully returned to baseline on hospital day 10. MRI on hospital day 8 normalised. The reversible coma and radiographic findings were most consistent with acute intracranial hypotension relating to acute loss of CSF. Because radiographic findings can mimic hypoxic-ischaemic injury, acute intracranial hypotension should be considered in the differential diagnosis of postoperative coma after cranial or spinal surgery.<\/jats:p>","DOI":"10.1136\/bcr-2014-203801","type":"journal-article","created":{"date-parts":[[2014,3,12]],"date-time":"2014-03-12T11:50:54Z","timestamp":1394625054000},"page":"bcr2014203801","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Coma from wall suction-induced CSF leak complicating spinal surgery"],"prefix":"10.1136","volume":"2014","author":[{"given":"Corey R","family":"Fehnel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Razmara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K","family":"Feske","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,3,12]]},"reference":[{"key":"2025042702535735000_2014.mar12_1.bcr2014203801.1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e3181fead14"},{"key":"2025042702535735000_2014.mar12_1.bcr2014203801.2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1749"},{"key":"2025042702535735000_2014.mar12_1.bcr2014203801.3","first-page":"1312","article-title":"Cerebellar herniation and infarction as a complication of an occult postoperative lumbar dural defect","volume":"16","author":"Andrews","year":"1995","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025042702535735000_2014.mar12_1.bcr2014203801.4","doi-asserted-by":"crossref","first-page":"798.E17","DOI":"10.1016\/j.wneu.2011.04.028","article-title":"Cerebral herniation as a complication of chest tube drainage of cerebrospinal fluid after injury to the spine","volume":"79","author":"Kalani","year":"2013","journal-title":"World Neurosurg"},{"key":"2025042702535735000_2014.mar12_1.bcr2014203801.5","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2007.6.3.276"},{"key":"2025042702535735000_2014.mar12_1.bcr2014203801.6","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1227\/01.NEU.0000093498.08913.9E","article-title":"Pseudohypoxic brain swelling: a newly defined complication after uneventful brain surgery, probably related to suction drainage","volume":"53","author":"Van Roost","year":"2003","journal-title":"Neurosurgery"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-203801","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:54:03Z","timestamp":1745747643000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-203801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3,12]]},"references-count":6,"alternative-id":["10.1136\/bcr-2014-203801"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-203801","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,3,12]]}}}