Traumatic subarachnoid-pleural fistula.

Traumatic subarachnoid-pleural fistula, a rare entity in civilian life, was recently diagnosed in a seven-year-old boy after blunt trauma. This case, and the four previously reported in the literature, share certain diagnostic and therapeutic features. The diagnosis is suggested by the association of a pleural effusion and signs of spinal cord injury at the thoracic level and can be confirmed by myelography. Although an initial period of conservative treatment with supine bed rest and daily lumbar punctures in order to promote closure of the fistula is recommended, our case and three of the four previously reported cases required operation for closure of the fistula.