traumatic dural tear

Keywords: Depressed skull fracture; Dural tear; Head injury; Trauma; Elevation of … Neurological deficits following spinal trauma may be aggravated by dural tears with entrapment of the spinal nerve roots. An anterior dural tear was identified during surgery and successfully sealed. Conclusion: In depressed skull fractures, there are high chances of associated traumatic dural tears which should be vigilantly managed. These injuries occur relatively frequently in patients with thoracolumbar fractures secondary to the high-energy forces required to create these injuries (Figs. Meier U(1), Gärtner F, Knopf W, Klötzer R, Wolf O. BPW: Nothing to disclose. FIGURE 95–1 A, Sagittal and B, axial computed tomography of T11 burst fracture associated with a posterior elements fracture. Sebastian Zimmer. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Traumatic dural tears: what do we know and are they a problem? Author disclosures: MJL: Nothing to disclose. Because the environment is controlled and the tear usually is detected intraoperatively, this is the most reported and studied cause of tear. We use cookies to help provide and enhance our service and tailor content and ads. In total, 1,615 operatively managed spine injuries over a 7-year period were reviewed to identify 187 patients with traumatic dural tears. Traumatic dural tears are not infrequent, especially with thoracolumbar burst fractures. traumatic durotomy. The sample comprises 187 patients with traumatic dural tears identified from 1,615 patients who underwent operative management of their traumatic injury. 95-1 and 95-2). lamina fracture is associated with dural tear and entrapped nerve roots; be aware when spit spinous process; chest and intra-abdominal injuries. Operative reports were reviewed to assess location and description of injury as well as type of repair, if done. Imaging findings of a dural tear have been reported in dogs ( 1 – 7 ) and, to the authors’ knowledge, this case represents the first description of the myelographic findings of a dural … Purpose: Traumatic cervical spinal cord injuries (SCIs) frequently develop dural tears and resultant cerebrospinal fluid (CSF) leaks. In one case, the thecal laceration had healed and the contrast material was confined in a post-traumatic meningocele. Translational thoracolumbar injuries have high association with spinal dural tears and traumatic aortic injuries however, associated traumatic ureteral injury is rare. Trauma. Wolfram Schwindt. However, a dural tear itself may not lead to CSF leakage if the spinal muscles and skin overlying the tear are intact and exert a sufficient tamponade effect. Dural tear was present in 28 (33.7%) patients and it was absent in 55 (66.3%) of patients. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Traumatic Dural Tear. "Tear, torn (traumatic)" References in the ICD-10-CM Index to Diseases and Injuries. During myelography, a dorsal laceration of the dura mater was detected at T 12–13.Immediate hemilaminectomy was performed at T 12–13, but neurologic status did not improve.At necropsy there was epidural and subdural hemorrhage at the T 12–13 interspace, and malacia and swelling of the … 6 In particular, faulty screw placement has been shown to cause a small number of tears. Patients with traumatically induced dural tears have a low likelihood of developing a complication attributable to the dural tear. JRC: Board of Directors: AO Spine International (C), AO Board of Trustees (C); Endowments: Hansjoerg Wyss Endowed Chair (I, Paid directly to institution/employer); Fellowship Support: AO Spine (E, Paid directly to institution/employer), OMEGA (C, Paid directly to institution/employer), OREF (D, Paid directly to institution/employer). The authors prefer 6-0 GORE-TEX simple running suture. Facultad de Medicina, Departamento de Radiología y Medicina Física, Universidad Complutense de Madrid, Madrid, Spain. A traumatic injury at times can disrupt the dural tube. Rarely, transection of the vertebral artery can be seen with extravasation of hemorrhage into the surrounding soft tissues of the neck. Wolfram Schwindt. JAA: Nothing to disclose. On the other hand, post traumatic dural sinus thrombosis is considered a rare complication which may lead to. JRC: Board of Directors: AO Spine International (C), AO Board of Trustees (C); Endowments: Hansjoerg Wyss Endowed Chair (I, Paid directly to institution/employer); Fellowship Support: AO Spine (E, Paid directly to institution/employer), OMEGA (C, Paid directly to institution/employer), OREF (D, Paid directly to institution/employer). GYB: Nothing to disclose. Primary repair should always be attempted. Dural tears are rare in the setting of trauma. He closed a traumatic dural tear over a frontal sinus fracture using muscle and fascia lata. Valid for Submission. The outcome measures consisted of a description of the location and nature of dural tears and associated fracture patterns and neurologic status as well as an assessment of complications attributable to the traumatic dural tear. origin. Postoperative records were assessed focusing on complications related to the traumatic dural tears. Associated spinal cord injuries as well as fracture level, patterns, and complications were recorded. Two patients (1%) developed a persistent cerebral spinal fluid leak that necessitated an irrigation and debridement with exploration and closure of the cerebral spinal fluid tear. They are not usually identified with advanced imaging, and there are no reports on managing CSF leaks after cervical trauma. Author information: (1)Neurotraumatological Clinic, Hospital of Friedrichshain, Berlin, Federal Republic of Germany. Copyright © 2021 Elsevier B.V. or its licensors or contributors. Search for … There is little information, however, with respect to the implications and complications of traumatic dural tears. The source of bleeding is likely from a tear of the underlying sagittal dural venous sinus. 15 The incidence of dural tear differs dep… During the next several decades, a better understanding of the natural history of traumatic and spontaneous CSF fistulas was obtained. The particular diagnosis also varies, and may include herniated disc, spinal stenosis, spondylolisthesis, and instability from previous spinal surgery. 95-1 … The characteristics of dural tears are demonstrable by metrizamide computed tomography, either in conjunction with myelography or as a separate procedure. To describe the demographics and characteristics of traumatically acquired dural tears and evaluate the complication rate associated with traumatic dural tears in patients who have undergone surgical treatment for spine injuries. Traumatic dural injuries are typically the result of a traumatic mechanism and subsequent laceration of the thecal sac. In case of head injury, a dural tear is likely in case of a depressed skull fracture. Conflicts of interest and source of funding: There is no funding associated with this study. They are not usually identified with advanced imaging, and there are no reports on managing CSF leaks after cervical trauma. Vertebral artery injuries can be seen following trauma. Excessive and traumatic nerve root traction is rare, and usually can be prevented by meticulous surgical technique. Disruption can also occur during the surgical intervention. Among the patients, 82.3% (154/187) had a formal dural repair. If a dural tear nevertheless occurs, it can be repaired by a standard dural closure technique eg, using standard stitches. It involves hemosiderin deposition in the subpial layers of the brain and spinal cord from repeated slow haemorrhage into the subarachnoid space. An SDH collects between the inner layer of the dura and the arachnoid. These spontaneous leaks are often associated with thinner dura than normal, as is seen with a number of heritable disorders of connective tissue. When diagnosed intraoperatively, they need to be promptly addressed. Traumatic Dural Injuries. Copyright © 2021 Elsevier B.V. or its licensors or contributors. The use of transpedicle screw plates and other cross-links are related to a small but nonnegligible risk of dural tear. Traumatic brain injuries are more common in young patients, and men account for the majority (75%) of cases 4. CONCLUSIONS: In depressed skull fractures, there are high chances of associated traumatic dural tears which should be vigilantly managed. Figure 6: Traumatic depressed skull fractures or the footplate of the drill can cause inadvertent interruptions or sizable tears along the superior wall of the sinus that are not amenable to primary closure. articular (current) - S83.3 Tear of articular cartilage of knee, current; old - See: Derangement, knee, meniscus, due to old tear; ligament - See: Sprain; Post injury, the patient had symptoms of severe positional headaches that were treated/resolved w/ an IR lumbar epidural blood patch (3E0S3GC) nontraumatic - G96.11 Dural tear; internal organ - See: Injury, by site; knee cartilage. Iatrogenic dural tears are common complications encountered in spine surgery with known ramifications. Traumatic dural tears were identified in 9.1% (67/739) of cervical, 9.9% (45/452) of thoracic, and 17.6% (75/424) of lumbosacral spine fractures. Acute tonsillar cerebellar herniation in a patient with traumatic dural tear and VAC therapy after complex trauma. No funding was received or used in this study. Traumatic dural tears occurred in 11.6% of patients with operatively managed traumatic spine injuries at a regional Level 1 trauma center. Traumatic – caused as a result of an injury. The operator may misjudge the lateral extension of the variable venous sinus (venous lake) and as he or she attempts to complete the most medial dural incision to expose the interhemispheric space. Traumatic Brain Injury (TBI) is a disruption in the normal function of the brain that can be caused by a blow, bump or jolt to the head, the head suddenly and violently hitting an object or when an object pierces the skull and enters brain tissue. IMAGING DIAGNOSIS: TRAUMATIC DURAL TEAR DIAGNOSED USING INTRATHECAL GADOPENTATE DIMEGLUMINE IMAGING DIAGNOSIS: TRAUMATIC DURAL TEAR DIAGNOSED USING INTRATHECAL GADOPENTATE DIMEGLUMINE MUÑOZ, ALBERTO; MATEO, ISIDRO; LORENZO, VALENTINA; MARTÍNEZ, JERÓNIMO 2009-09-01 00:00:00 History and Physical Findings A 2‐ year ‐ old , Jack Russell terrier had … Dural tears with contrast material escaping outside the subarachnoid space were documented in five cases. Dural tear following traumatic spinal cord injury. G96.11 is a billable diagnosis code used to specify a medical diagnosis of dural tear. Traumatic cervical vertebral artery transection associated with a dural tear leading to subarachnoid extravasation Mark O. Baerlocher, Tanya L. Zakrison , Homer Tien, Richard I. Aviv, Sean P. Symons Research output : Contribution to journal › Article › peer-review Download with Google Download with Facebook. Traumatic dural tears occurred in 11.6% of patients with operatively managed traumatic spine injuries at a regional Level 1 trauma center. 1: Department of Orthopedic surgery Mongi Slim Hospital Tunis, Tunisia. In a period of 13 years 978 cases of severe head injuries were operated on in … The outcome measures consisted of a description of the location and nature of dural tears and associated fracture patterns and neurologic status as well as an assessment of complications attributable to the traumatic dural tear. Among the patients, 82.3% (154/187) had a formal dural repair. Two patients (1%) developed a persistent cerebral spinal fluid leak that necessitated an irrigation and debridement with exploration and closure of the cerebral spinal fluid tear. Traumatic dural tears occurred in 11.6% of patients with operatively managed traumatic spine injuries at a regional Level 1 trauma center. Copyright © 2014 Elsevier Inc. All rights reserved. Dural defects can be patched using autografts like fascia lata, or a collagen matrix graft. Among the patients, 82.3% (154/187) had a formal dural repair. Hence, the authors evaluated the incidence of CSF leaks after cervical SCIs and described how to predict and manage CSF leaks. Two patients (1%) developed a pseudomeningocele; one required a return to the operating room for irrigation and debridement, and the other suspected of having developed meningitis was treated with intravenous antibiotics. 1: Department of Orthopedic surgery Mongi Slim Hospital Tunis, Tunisia 2: College of medicine Tunis Tunisia * Corresponding author Correspondence to: hich.abid2112@gmail.com Publication Data: Submitted: April 28,2020 Accepted: May30,2020 Online: June 30,2020 JAA: Nothing to disclose. 2. This case report describes 2 unusual features in feline medicine: a traumatic dural rupture and a bilateral Horner’s syndrome. CB: Fellowship Support: AO Spine (E, Paid directly to institution/employer), OMEGA (C, Paid directly to institution/employer), OREF (D, Paid directly to institution/employer). There are only single case reports about major complications after vacuum extraction delivery in the literature available. Wolfram Schwindt. The authors prefer 6-0 GORE-TEX simple running suture. It is usually caused as a result of trauma or as a complication following surgery. Traumatic dural tear - ICD-10 code I am trying to locate an ICD-10 code for traumatic dural tear (unknown level) sustained during a snowboarding fall onto the buttocks. Author disclosures: MJL: Nothing to disclose. IMAGING DIAGNOSIS: TRAUMATIC DURAL TEAR DIAGNOSED USING INTRATHECAL GADOPENTATE DIMEGLUMINE IMAGING DIAGNOSIS: TRAUMATIC DURAL TEAR DIAGNOSED USING INTRATHECAL GADOPENTATE DIMEGLUMINE MUÑOZ, ALBERTO; MATEO, ISIDRO; LORENZO, VALENTINA; MARTÍNEZ, JERÓNIMO 2009-09-01 00:00:00 History and Physical Findings A 2‐ year ‐ old … Among the patients, 2.1% (4/187) were noted to have a complication directly related to a traumatic dural tear. Most traumatic vertebral artery injuries are limited to an intimal dissection. 1 The cardinal clinical features include sensorineural hearing loss, cerebellar ataxia, pyramidal signs and cognitive impairment. Figure 2: The most common form of injury to the sinus is a small tear along the lateral edge of the sinus during paramedian dural opening. The disclosure key can be found on the Table of Contents and at www.TheSpineJournalOnline.com. A traumatic injury at times can disrupt the dural tube. References in the ICD-10-CM Index to Diseases and Injuries applicable to the clinical term "tear, torn (traumatic)" Tear, torn (traumatic) - See Also: Laceration; annular fibrosis - M51.35 Other intervertebral disc degeneration, thoracolumbar region It most commonly occurs in the lumbar region. ALBERTO MUÑOZ. Copyright © 2014 Elsevier Inc. All rights reserved. or. Traumatic dural tears were identified in 9.1% (67/739) of cervical, 9.9% (45/452) of thoracic, and 17.6% (75/424) of lumbosacral spine fractures. Fracture patterns included burst (AO Type A3) 26.2% (49/187), flexion distraction (AO Type B) 16% (30/187), and fracture dislocations (AO Type C) 36.4% (68/187). To describe the demographics and characteristics of traumatically acquired dural tears and evaluate the complication rate associated with traumatic dural tears in patients who have undergone surgical treatment for spine injuries. Create a free account to download. Traumatic cervical spinal cord injuries (SCIs) frequently develop dural tears and resultant cerebrospinal fluid (CSF) leaks. As with most maxillofacial trauma, traumatic CSF leaks occur most commonlyinyoungmalesandcomplicate2%ofallheadtraumas,and12%to30%of all basilar skull fractures.5 Anterior skull base leaks are more common than middle or posterior leaks, due to the firm adherence of the dura to the anterior basilar skull. Among the patients, 2.1% (4/187) were noted to have a complication directly related to a traumatic dural tear. Sebastian Zimmer. Superficial siderosis is a relatively rare neurodegenerative disorder with approximately 300 cases reported worldwide. common; thoracic spine fractures with neurologic deficit 1/3 associated with hemopneumothorax, major vessel … Dural tear is associated with an increased rate of other perioperative complications in primary lumbar spine surgery for degenerative diseases S. Takenaka , Takahiro Makino , +4 authors T. Kaito Medicine Patients with traumatically induced dural tears have a low likelihood of develop … The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Dural tear was present in 28 (33.7%) patients and it was absent in 55 (66.3%) of patients. The frequency of seizure development in patients with dural penetration ranged from 36% to 50%, while for patients without dural penetration the rates of seizure ranged from 6% to 23% (Hughes, 1986). GYB: Nothing to disclose. Traumatic Fractures Involving Major Dural Venous Sinuses: A Reappraisal Study from the Tertiary Trauma Care Center in Nepal A B S T R A C T. Objective: The surgical management of compound depressed fractures overlying dural venous sinuses confers major challenges for the neurosurgeons.On one hand, the depressed fracture and associated compound wound herald the risk of venous … Retrospective review of a single Level I trauma center to identify patients with traumatic dural tears between January 1, 2003 and December 31, 2009. Dural defects can be patched using autografts like fascia lata, or a collagen matrix graft. Diagnosis. Dural tear is a known complication of spinal surgeries, such as laminectomies, spinal fusions, and disc excisions. Dural tears with leakage of cerebral spinal fluid into surrounding soft tissues can occur after traumatic spinal cord injury. Associated spinal cord injuries as well as fracture level, patterns, and complications were recorded. This is a typical setup for traumatic dural injuries. The characteristics of dural tears are demonstrable by metrizamide computed tomography, either in conjunction with myelography or as a separate procedure. Cord, Dura, and Vessels. CONCLUSIONS: Traumatic dural tears occurred in 11.6% of patients with operatively managed traumatic spine injuries at a regional Level 1 trauma center. Traumatic brain lesions after vacuum extraction delivery are rare. Dural tear, nontraumatic; Nontraumatic dural tear; intracranial hypotension, if applicable (G96.81-); accidental puncture or laceration of dura during a procedure (G97.41) ICD-10-CM Diagnosis Code G96.11 Conflicts of interest and source of funding: There is no funding associated with this study. 1: Department of Orthopedic surgery Mongi Slim Hospital Tunis, Tunisia 2: College of medicine Tunis Tunisia * Corresponding author Correspondence to: hich.abid2112@gmail.com Publication Data: Submitted: April 28,2020 Accepted: May30,2020 Online: June 30,2020 We use cookies to help provide and enhance our service and tailor content and ads. The traumatic dural sinus injury--a clinical study. There is little information, however, with respect to the implications and complications of traumatic dural tears. Primary repair should always be attempted. common; thoracic spine fractures with neurologic deficit 1/3 associated with hemopneumothorax, major vessel … Bookmarks (0) Spine. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Traumatic dural tears: what do we know and are they a problem? A calcified intervertebral disc or bone spur may also be the cause of a dural tear. Diagnosis. Alternatively, repair can be performed by patching or sealing the dura. Fracture patterns included burst (AO Type A3) 26.2% (49/187), flexion distraction (AO Type B) 16% (30/187), and fracture dislocations (AO Type C) 36.4% (68/187). lamina fracture is associated with dural tear and entrapped nerve roots; be aware when spit spinous process; chest and intra-abdominal injuries. Wolfram Schwindt. Traumatic dural injuries are typically the result of a traumatic mechanism and subsequent laceration of the thecal sac. The disclosure key can be found on the Table of Contents and at www.TheSpineJournalOnline.com. https://doi.org/10.1016/j.spinee.2013.03.049. Dural tears may occur inadvertently at the time of epidural injections (epidural refers to the space in the spinal canal outside of dura and spinal cord). Traumatic dural tears were identified in 9.1% (67/739) of cervical, 9.9% (45/452) of thoracic, and 17.6% (75/424) of lumbosacral spine fractures. The earliest efforts to identify the site of … A delayed complication. Observing one of the following clinical signs constitutes alteration in the normal brain function: Colachis SC 3rd(1), Rea GL. Giant dorsolumbar pseudomeningocele: Unusual evolution of traumatic dural tiny tear. By continuing you agree to the use of cookies. Traumatic dural tears occurred in 11.6% of patients with operatively managed traumatic spine injuries at a regional Level 1 trauma center. A complete neurologic injury was noted in 48.7% (91/187) of the patient population, whereas no neurologic injury was noted in 17.1% (32/187). dural - G97.41 Accidental puncture or laceration of dura during a procedure. During myelography, a dorsal laceration of the dura mater was detected at T 12–13.Immediate hemilaminectomy was performed at T 12–13, but neurologic status did not improve.At necropsy there was epidural and subdural hemorrhage at the T 12–13 interspace, and malacia and swelling of the … Disruption can also occur during the surgical intervention. From Wikipedia, the free encyclopedia Dural tear is a tear occurring in the dura mater of the brain. 3. Abid Hichem 1,2,*, Nefiss Mouadh 1,2, Ben Maatoug Aymen 1,2, Bouzidi Ramzi 1,2. In total, 1,615 operatively managed spine injuries over a 7-year period were reviewed to identify 187 patients with traumatic dural tears. Traumatic cervical spinal cord injuries (SCIs) frequently develop dural tears and resultant cerebrospinal fluid (CSF) leaks. These injuries occur relatively frequently in patients with thoracolumbar fractures secondary to the high-energy forces required to create these injuries (Figs. The Spine Journal, 2015. When diagnosed intraoperatively, they need to be promptly addressed. They are usually the result of penetrating trauma or severe blunt trauma. ... Repair of dural laceration. Frequently, these injuries are the result of a traumatic mechanism or an iatrogenic opening during surgical dissection.… Dynamic instability-induced repetitive traction and compression of the dural sac by the tissues at the level of the post-traumatic CSA might have progressively weakened and torn the dural sac. The code G96.11 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions. RJB: Speaking/Teaching Arrangements: AO Spine NA (C); Grants: Synthes (C, Paid directly to institution/employer); Fellowship Support: AO Spine (E, Paid directly to institution/employer), OMEGA (C, Paid directly to institution/employer), OREF (D, Paid directly to institution/employer). Traumatic causes can be further subclassified into surgical and nonsurgical, with surgical causes divided into planned (as in failure of reconstruction of a planned dural resection) or unplanned (as a complication following an ethmoidectomy).2 Non-traumatic CSF leaks may be subclassified into high or normal pressure leaks, with the Imaging findings of a dural tear have been reported in dogs (1-7) and, to the authors' knowledge, this case represents the first description of the myelographic findings of a dural rupture in a cat. CB: Fellowship Support: AO Spine (E, Paid directly to institution/employer), OMEGA (C, Paid directly to institution/employer), OREF (D, Paid directly to institution/employer). Patients with traumatically induced dural tears have a low likelihood of developing a complication attributable to the dural tear. Neurological deficits following spinal trauma may be aggravated by dural tears with entrapment of the spinal nerve roots. CHAPTER 95 Spinal Dural Injuries Peter G. Campbell, MD, Amgad Hanna, MD, James S. Harrop, MD Spinal thecal sac or dural disruption may result in subsequent cerebrospinal fluid (CSF) drainage and can be the result of various mechanisms. Subdural hematomas. Computed tomography of the spine using intrathecal metrizamide was performed on six patients with spinal trauma. In these situations, I remove additional bone over the sinus expeditiously and investigate the morphology and extent of the tear. https://doi.org/10.1016/j.spinee.2013.03.049. dural tear/penetration are at higher risk for seizure than patients with closed head injuries. The purpose of this study was to determine the reliable MR imaging findings suggesting dural tears in spinal burst fractures. fixation from T9 to L2. They may also occur at the time of surgery. There are no conflict of interest–associated biases or applicable financial relationships related to this manuscript. The liquid was apparently clear and colourless. A complete neurologic injury was noted in 48.7% (91/187) of the patient population, whereas no neurologic injury was noted in 17.1% (32/187). Retrospective review of a single Level I trauma center to identify patients with traumatic dural tears between January 1, 2003 and December 31, 2009. IMAGING DIAGNOSIS: TRAUMATIC DURAL TEAR DIAGNOSED USING INTRATHECAL GADOPENTATE DIMEGLUMINE. link. traumatic durotomy. Dural tear. In general, the tear is noted at the time of operation when leakage of cerebrospinal fluid (CSF) is noted by the surgeon. 2016 2017 2018 2019 2020 2021 Billable/Specific Code. In total, 83% had a neurologic injury and 49% had complete spinal cord injuries. Although sport is a common cause of relatively mild repeated head injury potentially eventually leading to chronic traumatic encephalopathy, more severe injuries are most often due to motor vehicle accidents and assault. It is usually caused as a result of trauma or as a complication following surgery. By continuing you agree to the use of cookies. Sebastian Zimmer. No funding was received or used in this study. To prevent dural tears, a surgeon must carefully protect … BPW: Nothing to disclose. BACKGROUND AND PURPOSE: The diagnosis of traumatic spinal dural tears is difficult to establish. Most frequently, during spinal surgery, direct trauma or laceration causes dural tear. hemorrhagic infarction with its serious consequences including epilepsy, neurological deficits, or death. An intra-operative post-traumatic dural tear was suspected, because of a small leak of CSF, but no repair was attempted because of the impossibility to clearly identify the site of leakage. Operative reports were reviewed to assess location and description of injury as well as type of repair, if done. There are no conflict of interest–associated biases or applicable financial relationships related to this manuscript. Traumatic cervical vertebral artery transection associated with a dural tear leading to subarachnoid extravasation Mark O. Baerlocher, Tanya L. Zakrison , Homer Tien, Richard I. Aviv, Sean P. Symons Research output : Contribution to journal › Article › peer-review RJB: Speaking/Teaching Arrangements: AO Spine NA (C); Grants: Synthes (C, Paid directly to institution/employer); Fellowship Support: AO Spine (E, Paid directly to institution/employer), OMEGA (C, Paid directly to institution/employer), OREF (D, Paid directly to institution/employer). or. Acute pelvic limb paralysis occurred in a racing Greyhound after a traumatic incident. In total, 83% had a neurologic injury and 49% had complete spinal cord injuries. Post injury, the patient had symptoms of severe positional headaches that were treated/resolved w/ an IR lumbar epidural blood patch (3E0S3GC)
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