Complications in neurosurgery can occur during diagnostic procedures, such
as lumbar puncture, lumbar drainage, suboccipital cisternal tap or cerebral/spinal
angiography, or during neurosurgical procedures. Severe complications during or
subsequent to lumbar puncture are extremely rare and include brainstem herniation,
infection, subdural hematoma and subarachnoid hemorrhage. Insertion of a catheter
into the lumbar subarachnoid space to drain the cerebrospinal fluid (CSF) can also be
followed by infection or overdrainage. The complications of cisternal tap include
hemorrhage in the cisterna magna and piercing of the medulla oblongata that can cause
cardiac or respiratory arrest. The iodine-based contrast agents used for cerebral
angiography can cause allergic reactions and epileptic seizures. Iatrogenic
complications during surgical procedures can occur at any stage pre-, intra- or
immediately postoperative. Complications occur during patient positioning, rendering
this step of paramount importance to the success of surgery. Infectious and cosmetic
complications can occur during skin disinfection, incision of the skin of the scalp and
surgical incision of the skull. Dural lesions can lead to cerebrospinal fluid leak or
fistulae. Corticotomy or corticectomy should be realized cautiously and external to
functional areas. Ligation or coagulation of brain vessels can lead to cerebral infarction
(arterial or venous) with loss of cerebral function. Iatrogenic lesions in different regions
of the brain lead to specific neurological manifestations. Lesions in the anterior fossa
can lead to anosmia, abulia or behavioral alterations. Lesions in the middle fossa can
lead to aphasia and motor deficits, while lesion in the posterior fossa can lead to cranial
nerve deficits or coma.
Keywords: Anosmia, Aphasia, Brachial Paresis, Brain swelling, Brainstem
herniation, Cerebrospinal fluid fistula, Chemical external otitis, Corticotomy,
Duraplasty, Hearing loss, Ischemic stroke, Lumbar puncture, Meningitis,
Osteonecrosis, Skull deformities, Thalamic infarction, Tonsillar herniation,
Venous air embolism, Venous infarction, Ventriculitis.
