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Case 94 - Rhabdomyolysis

from Section II - Neurocritical care

Published online by Cambridge University Press:  03 May 2011

By
Mauricio Perilla  and
Jerome O’Hara
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
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Summary

Rhabdomyolysis is a potentially life-threatening clinical syndrome caused by damage of the muscle fibers, which results in necrosis and disintegration of the striated muscle. Early diagnosis and aggressive management are key to avoiding major adverse events such as renal failure. This chapter presents a case study of a 53-year-old patient who was scheduled for L2-1 spine revision and new instrumentation. The patient had a history of seizure disorder, postlaminectomy syndrome, diabetes, morbid obesity, and drug abuse. Ethanol, cocaine, and other illicit drug utilization have been associated with this syndrome, and a toxicology screen is recommended with the initial assessment. The treatment of this condition should be to (1) rapidly recognize the initial trigger, (2) restore intravascular volume, (3) prevent acute renal failure, and (4) monitor the development of common complications. Rapid diagnosis, aggressive hydration, and correction of electrolyte abnormalities are key features of management.

Keywords

neurocritical care patientsurface-cooling techniquestherapeutic hypothermiamechanical ventilationendovascular approachcardiopulmonary resuscitation
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 317 - 320
Publisher: Cambridge University Press
Print publication year: 2011

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