Intracranial Embolism After a Dural Tear in Endoscopic Spine Surgery

Case: An 87-year-old female patient with a history of lumbar fusion at L4-S1 presented with progressive stenosis at L2-3 and L3-4 and underwent biportal endoscopic decompression. Intraoperatively, a 0.7-cm dural tear was noted at L3-4. Postoperatively, the patient developed agitation, tachypnea, tachycardia, and seizure-like activity, necessitating reintubation and admission to the intensive care unit. Immediate brain magnetic resonance imaging revealed intracranial embolism. Conclusion: In endoscopic spine surgery, preventing and managing complications from dural tear–related intracranial embolisms is vital.