Traumatic subarachnoid-pleural fistula.

Traumatic subarachnoid pleural fistulas are uncommon. A recent review of the English language literature reveals only 2 cases of this condition demonstrated by myelography. Wilson and Jumer (1) reported a case, due to a bullet wound, in which free contrast material was demonstrated within the right pleural space after cisternal myelography. There was a block to the caudad flow of contrast material at T8. Contrast medium was noted in the pleural space, apparently as a result of a fistula at this level. Overton, Hood and Farris (2) reported a case, involving an automobile accident, in which lumbar myelography showed a fistula between the pleural cavity and subarachnoid space in the region of T7. A healthy 42-year-old woman was shot in the left side of the back on Dec. 30, 1966. She fell to the ground, was unable to stand, and was promptly taken to the hospital. On admission the patient was in moderate distress because of pain in the back and right lateral chest wall and inability to move the legs. There was...