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Cerebrospinal fluid fistula

Tao Xie, Wei Sun, Xiaobiao Zhang, Tengfei Liu, Hailing Ding, Fan Hu, Yong Yu, Ye Gu
BACKGROUND: In this study, we investigated the value of three-dimensional (3D) fast-imaging employing steady-state acquisition (FIESTA) magnetic resonance imaging (MRI) in detecting non-iatrogenic cerebrospinal fluid (CSF) rhinorrhoea and compared it with regular MRI and 3D magnetisation prepared rapid acquisition gradient echo (MPRAGE) MRI sequences, as well as high-resolution computed tomography (HRCT) imaging. We also present the endoscopic experiences of such cases. METHOD: From June 2011 to Feb 2016, 17 patients with non-iatrogenic cerebrospinal fluid rhinorrhoea were included...
October 13, 2016: Acta Neurochirurgica
C Garcia-Cabo, E S Morales-Deza, L Martinez-Rodriguez, E Murias-Quintana, A Perez-Alvarez, J Martinez-Ramos, P Vega-Valdes, P Suarez-Santos, A Garcia-Rua, G Moris
INTRODUCTION: Although spinal fistulas account for 70% of all spinal arteriovenous malformations, they are an underdiagnosed condition. The arteriovenous shunt produces vascular congestion that gives rise to a progressive myelopathy, sometimes irreversible if it is not treated in the early stages. AIM: To describe the clinicoradiological characteristics of a series of patients with spinal fistulas. PATIENTS AND METHODS: A retrospective search was conducted for patients diagnosed with a spinal fistula who were hospitalised in the neuroscience area of a tertiary care hospital...
October 1, 2016: Revista de Neurologia
Alberto Pasqualin, Pietro Meneghelli, Francesco Cozzi, Franco Chioffi
Surgery on paraclinoid carotid aneurysms is technically demanding and entails considerable risks, especially to visual function. The aim of this study was to evaluate the clinical and visual outcome after surgery in 66 patients with paraclinoid carotid aneurysms (30 ruptured and 36 unruptured) treated between 1990 and 2014. Thirty-six aneurysms were of standard size, and 30 were large (16-20 mm) or giant (>20 mm); the Barami classification was used in every case. During surgery, multiple clips were needed in 25 % of patients with standard, and in 80 % of patients with large-giant aneurysms; temporary carotid occlusion was performed on 11 % of patients with standard and 63 % with large-giant aneurysms...
2016: Acta Neurochirurgica. Supplement
Daniel Morell-Garcia, Josep Miquel Bauça, M Pilar Sastre, Aina Yañez, Isabel Llompart
BACKGROUND: Prostaglandin D2 synthase, commonly known as β-trace protein (βTP), is an excellent biomarker for the assessment of cerebrospinal fluid (CSF) leaks. Despite being widely used, the limits for the diagnostic values of βTP are not well established to date, and currently suggested cut-off values in literature range from 0.25 to 6.0mg/L. Sample-specific and more accurate thresholds are a current need. METHODS: A retrospective observational study, performed in a tertiary-care hospital, between January 2006 and January 2014...
September 7, 2016: Clinical Biochemistry
Lütfi Postalci, İbrahim Erdim, Bülent Demirgil, Ömür Günaldi, Murad Asiltürk, Hakan Demirci, Hakan Kina, Uzay Erdoğan, Mine Yazici, Erhan Emel
AIM: Major complications from microscopic transnasal hypophyseal surgery (MTHS), such as cerebrospinal fluid rhinorrhea, carotid injury, and optic nerve injury, are very rare. However, late rhinological complications can be ignored because they are a minor cause of morbidity compared with major complications. In this study, we extensively examined postoperative rhinological complications in patients who underwent MTHS for pituitary adenoma. MATERIAL AND METHODS: Thirty-one patients diagnosed with pituitary adenoma, who underwent MTHS and whose preoperative nasal examinations were recorded between January 2007 and January 2014, were included in the study...
October 2, 2015: Turkish Neurosurgery
Mark J Lenart, Jeffrey M Carness
A 23-year-old woman at 41 weeks and 6 days estimated gestational age underwent continuous spinal analgesia for labor after a recognized, unintended dural puncture. Excellent analgesia was maintained throughout labor and vaginal delivery, the intrathecal catheter was left in situ for 24 hours postpartum, and the catheter was subsequently removed without apparent complication. On physical examination during her anesthesia postoperative visit, clear fluid was noted to be slowly draining from the catheter insertion site...
September 1, 2016: A & A Case Reports
Akin Akakin, Baran Yilmaz, Murat Şakir Ekşi, Emel Ece Özcan-Ekşi, Mustafa Kemal Demir, Zafer Orkun Toktaş, Deniz Konya
Cranial chronic subdural hematoma (CSH) occurs secondary to trauma or just spontaneously. In this clinical report, the authors presented a 39-year-old male patient who was admitted with cranial CSH. In further assessment of the patient, the authors found an underlying cerebrospinal fluid (CSF) leak at the level of cervical spine. Following evacuation of the CSH, it recurred. In the second session, the hematoma was re-evacuated and the CSF fistula repaired. The CSH did not recur again. In young adult patients with recurrent CSH and prior presence of bilateral CSH, a survey for an underlying spinal CSF leak should be considered in the differential, especially in the background of trauma...
September 2016: Journal of Craniofacial Surgery
Hambra Di Vitantonio, Danilo De Paulis, Mattia Del Maestro, Alessandro Ricci, Soheila Raysi Dechordi, Sara Marzi, Daniele F Millimaggi, Renato J Galzio
BACKGROUND: Various materials have been proposed to obliterate dead spaces and to reconstruct dural defects during a neurosurgical approach. This study describes our technique of using the abdominal autologous fat graft and evaluates the complications and characteristics related to the use of this tissue during cranial procedures. METHODS: Autologous fat grafts were used in 296 patients with basicranial and convexity extraaxial tumors from April 2005 to January 2015...
2016: Surgical Neurology International
Zalán Piski, András Büki, Nelli Nepp, Andráas Burián, Péter Révész, Imre Gerlinger
BACKGROUND AND PURPOSE: In case of dehiscenses developing on the anterior scull base, complete closure resulting in the cessation of the communication between the nasal cavity and the intracranial space is mandatory as soon as possible, in order to prevent serious complications. With the development of the endoscopic techniques, the endonasal management for the reconstruction has become available in recent decades. METHODS: We aim to present the reconstruction techniques applied in our department in the cases of two patients recently operated at our institute...
March 30, 2016: Ideggyógyászati Szemle
Ramón Moreno-Luna, Eugenio Cárdenas Ruiz-Valdepeñas, José Ignacio Tato, Monica Rivero-Garvia, Javier Márquez-Rivas, Antonio Mochón Martín
BACKGROUND: Adenoidectomy is one of the most common procedures in the field of pediatric otolaryngology. Postoperative bleeding is one of the most frequent complications (0.4%). In turn, cerebrospinal fluid fistula is a very uncommon but critical complication in this type of surgery. METHODS: We report the case of a 3-year-old patient who underwent adenoidectomy and presented a cerebrospinal fluid leak associated with pneumocephalus and meningitis. RESULTS: The solution provided was a suture in layers of the fistula tract, reinforced with basipharyngeal vascularized and rotation random flap of mucosa, and a free graft of muscle, through a transoral endoscopic approach...
September 2016: World Neurosurgery
Angel Horcajadas Almansa, Ana Román Cutillas, Ana Jorques Infante, José Ruiz Gómez, Heriberto Busquier
Spontaneous cerebrospinal fluid (CSF) fistulas are rather common in daily practice. The aim of the surgical treatment is closure of the leak, but recurrences are quite frequent. The association between spontaneous CSF fistulas and idiopathic intracranial hypertension (IIH) is not uncommon, and this is probably the cause of the low rate of success of the surgical treatment. Symptoms of IIH associated with spontaneous CSF fistula are atypical, and diagnosis is often missed. Continuous intracranial pressure monitoring is very useful in the diagnosis of chronic IIH and in patients with spontaneous CSF fistula, as it helps in making decisions on the treatment of these patients...
July 18, 2016: Neurocirugía
Matthew R Naunheim, Neerav Goyal, Matthew M Dedmon, Kyle J Chambers, Ahmad R Sedaghat, Benjamin S Bleier, Eric H Holbrook, William T Curry, Stacey T Gray, Derrick T Lin
OBJECTIVE: To characterize our experience with the surgical management of anterior skull base malignancy, and to propose an algorithm for surgical approach to anterior skull base malignancies. DESIGN: Retrospective review. SETTING: Academic cranial base center. PARTICIPANTS: Sixty-seven patients who underwent resection of paranasal sinus or anterior skull base malignancy with an endoscopic, cranioendoscopic, or traditional anterior craniofacial approach...
August 2016: Journal of Neurological Surgery. Part B, Skull Base
Veysel Burulday, Nuray Bayar Muluk, Mehmet H Akgül, Ahmet Kaya, Mustafa Öğden
PURPOSE: The types and ratio of anterior clinoid process (ACP) pneumatization in paranasal sinus Multidetector Computerized Tomography (MDCT) were investigated the importance of ACP in neurosurgical approaches discussed. METHODS: Paranasal MDCT images of 499 subjects (259 male, 240 female), between 17 and 65 years of age, were included in the study. Presence and types of pneumatization of the ACP and pneumatization types (I, II or III) were evaluated. RESULTS: ACP pneumatization was detected in 37...
2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Swati Tandon, Satinder Singh, Shalabh Sharma, Asish K Lahiri
INTRODUCTION: Congenital anomalies of the cochlea and labyrinth can be associated with meningitis and varying degrees of hearing loss or deafness. Despite antibiotics, meningitis remains a life threatening complication. CASE REPORT: We report a case of recurrent meningitis following episodes of otitis media in a cochlear implantee child with bilateral vestibulocochlear malformation, due to fistula in the stapes footplate. Intrathecal fluorescin was used to identify the leak site...
May 2016: Iranian Journal of Otorhinolaryngology
Richard D Murray, Rachel Friedlander, Samuel Hanz, Harminder Singh, Vijay K Anand, Theodore H Schwartz
OBJECTIVE The anterior skull base is a common site for the spontaneous development of meningoceles, encephaloceles, and meningoencephaloceles that can lead to cerebrospinal fluid (CSF) fistula formation, particularly in association with idiopathic intracranial hypertension. In some circumstances the lesions are difficult to localize. Whether all sites in the anterior skull base are equally prone to fistula formation or whether they are distributed randomly throughout the anterior skull base is unknown, although the anterior cribriform plate has been proposed as the most frequent location...
July 1, 2016: Journal of Neurosurgery
Erhan Çelikoğlu, Jülide Hazneci, Ali Fatih Ramazanoğlu
Endoscopic sinus surgery (ESS) may rarely be complicated by intracranial complications; the most common of them is a cerebrospinal fluid fistula. Pneumocephalus as a complication of ESS is quite rare. Here, we presented a unique case of tension pneumocephalus causing brain herniation as a complication of ESS, to whom emergent craniotomy was performed.
July 2016: Asian Journal of Neurosurgery
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan Deshpande
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurologic complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: Cerebrospinal fluid (CSF) leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
June 28, 2016: Clinical Spine Surgery
Archil Eristavi, Ian Sabin
We describe an unusual and rarely documented site of SIH supported by clear radiological evidence: a case of spontaneous cerebrospinal fluid (CSF) fistulae involving the C7 and C8 nerve root sheaths, presenting with sudden onset headache and requiring surgical intervention to seal the leaks. Investigations confirmed the leaks and the typical MRI findings of meningeal enhancement, which were resolved after surgery.
June 24, 2016: British Journal of Neurosurgery
Gabrielle A White-Dzuro, Pouya Entezami, George Wanna, Paul Russell, Lola B Chambless
Introduction Traumatic cerebrospinal fluid (CSF) fistulae can be a challenging neurosurgical disease, often requiring complicated surgical intervention. Case Presentation A 54-year-old man presented with a gunshot wound to the head with complex injury to the skull base and significant CSF leakage from multiple sites. A single surgery was performed using a combined Neurosurgery, Neurotology, and Rhinology team, which was successful in repairing the multiple skull base defects and preventing further CSF leak...
June 2016: Journal of Neurological Surgery Reports
Vladimir Kljajić, Petar Vuleković, Ljiljana Vlaški, Slobodan Savović, Danijela Dragičević, Vladimir Papić
INTRODUCTION: Nasal liquorrhea indicates a cerebrospinal fluid fistula, an open communication between the intracranial cerebrospinal fluid and the nasal cavity. It can be traumatic and spontaneous. OBJECTIVE: The aim of this study was to assess the outcome of endoscopic repair of cerebrospinal fluid fistula using fluorescein. METHODS: This retrospective study included 30 patients of both sexes, with a mean age of 48.7 years, treated in the period from 2007 to 2015...
June 4, 2016: Brazilian Journal of Otorhinolaryngology
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