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Cerebrospinal fluid fistula

O I Sharipov, M A Kutin, A V Bayuklin, A A Imaev, A A Abdilatipov, A B Kurnosov, D V Fomichev, N I Mikhaylov, P L Kalinin
Nasal liquorrhea is a serious problem in surgery of skull base tumors, which is associated with a high risk of purulent-septic complications. This paper presents a case of successful repair of a cerebrospinal fluid fistula with an autologous platelet gel in the postoperative period after removal of meningioma of the anterior cranial fossa base, which was accompanied by a purulent-inflammatory complication in the surgical wound area.
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Vaibhav Kumar Jain, Vikas Kanaujia, Priyadarshini Mishra, Kumudini Sharma
Encephalocele is a rare congenital abnormality characterized by abnormal protrusion of brain and meninges through an opening in the skull. We report an 8-year-old girl who presented with a swelling in the right lower lid for the last 6 years. In her infancy, she had undergone surgery for a very small swelling located in the right nasolacrimal area. On further clinicoradiological evaluation, anterior encephalocele was diagnosed. This case highlights the uncommon site of anterior encephalocele; misdiagnosis and mismanagement of which could result in dreaded complications such as meningitis and cerebrospinal fluid leaking fistula formation...
March 2018: Indian Journal of Ophthalmology
Souha S Elabd, Maswood M Ahmad, Sameer Q Qetab, Mussa Hussain Almalki
Cerebrospinal fluid (CSF) rhinorrhea is rarely reported as the first presenting feature of giant invasive macroprolactinomas. Cerebrospinal fluid rhinorrhea is usually reported as a complication of trauma, neurosurgical, and skull-based procedures (such as pituitary surgery or radiations), and less frequently after medical treatment with dopamine agonists (DAs) for macroprolactinomas. This phenomenon results from fistula creation that communicates between the subarachnoid space and the nasal cavity. Meanwhile, pneumocephalus is another well-recognized complication after transsphenoidal surgery for pituitary macroadenomas...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
Michiari Umakoshi, Takao Yasuhara, Atsuhiko Toyoshima, Susumu Sasada, Akira Kusumegi, Jun Morimoto, Kyohei Kin, Yousuke Tomita, Isao Date
The spinal extradural arachnoid cyst is a rare entity. Obtaining the correct diagnosis and detecting the fistula location are critical for providing effective treatment. A 41-year-old man had numbness in the soles of his feet for 2 years with accompanying gait disturbance, and a defecation disorder. Computed tomography myelography performed at another hospital revealed an epidural arachnoid cyst from Th11 to L2. He received a subarachnoid-cyst shunt at the rostral part of the cyst. However, his symptoms worsened and he was admitted to our hospital...
February 2018: Acta Medica Okayama
Michael S Clark, Felix E Diehn, Jared T Verdoorn, Vance T Lehman, Greta B Liebo, Jonathan M Morris, Kent R Thielen, John T Wald, Neeraj Kumar, Patrick H Luetmer
PURPOSE: A recently identified and treatable cause of spontaneous intracranial hypotension (SIH) is cerebrospinal fluid (CSF)-venous fistula, and a recently described computed tomography myelogram (CTM) finding highly compatible with but not diagnostic of this entity is the hyperdense paraspinal vein sign. We aimed to retrospectively measure the prevalence of the hyperdense paraspinal vein sign on CTMs in SIH patients without dural CSF leak, in comparison with control groups. METHODS: Three CTM groups were identified: 1) SIH study group, which included dural CSF leak-negative standard CTMs performed for SIH, with early and delayed imaging; 2) Early control CTMs, which were performed for indications other than SIH, with imaging shortly after intrathecal contrast administration; 3) Delayed control CTMs, which included delayed imaging...
January 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Evangelos Kogias, Jan-Helge Klingler, Pamela Franco Jimenez, Ioannis Vasilikos, Ronen Sircar, Christoph Scholz, Ulrich Hubbe
STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To compare the incidence, management, and outcome of incidental durotomy in revision microdiscectomy with open and minimal-access surgery. SUMMARY OF BACKGROUND DATA: Incidental durotomy occurs with a variable incidence of 3%-27% in spine surgery. The highest rate occurs in revision microdiscectomy. The intraoperative and postoperative management of dural tears varies in the literature and the definite impact on clinical outcome has to be clarified...
December 2017: Clinical Spine Surgery
Asli Cakir Cetin, Nuri Karabay, Enis Alpin Guneri
In this report, we present two cases of patients with cerebrospinal fluid (CSF) otorrhea who underwent surgical repair through either a transmastoid or middle cranial fossa approach. In our first case, a 34-year-old male after head trauma with conductive hearing loss and a House-Brackmann grade 2 facial palsy was found to have a soft tissue mass protruding through his right tympanic membrane. Radiological examination revealed a wide tegmen tympani defect. He underwent surgery via a transmastoid approach with repair of the defect and blind sac closure of the external auditory canal after middle ear cavity obliteration...
November 1, 2017: Turkish Neurosurgery
Neeraja Konuthula, Mohemmed N Khan, Anthony Del Signore, Satish Govindaraj, Raj Shrivastava, Alfred M Iloreta
BACKGROUND: Secondary cerebrospinal leaks (CSF) are leaks that recur after an initial endoscopic repair of CSF leaks. Identification of characteristics that could predict secondary leaks may allow surgeons to plan repairs with the knowledge that these defects are more likely to fail. OBJECTIVE: To identify characteristics that could predict secondary CSF leaks. METHODS: A search of all studies that reported outcomes after endoscopic repair of CSF leaks was conducted by using medical literature data bases...
November 1, 2017: American Journal of Rhinology & Allergy
Erwin M J Cornips
BACKGROUND: Anterior transthoracic approaches including thoracoscopic microdiscectomy (TMD) are the preferred technique for central, broad-based, calcified thoracic disc herniations (TDHs). Dural defects due to manipulation or transdural extension may create a potentially life-threatening subarachnoid-pleural fistula. We evaluate a fast, sutureless technique to reconstruct the dura. METHODS: We analyzed 476 anterior transthoracic approaches for TDHs (437 TMDs, 31 mini-thoracotomies, 7 transaxillary approaches, one sternotomy)...
October 20, 2017: World Neurosurgery
S Das, P A Rea
No abstract text is available yet for this article.
October 5, 2017: Clinical Otolaryngology
Gonçalo Novais, Bernardo Ratilal, Lia Pappamikail, Pedro Branco, Nuno Reis
BACKGROUND: Pseudomeningocele, an extradural collection of cerebrospinal fluid (CSF), has only been rarely reported to occur spontaneously in conjunction with isthmic spondylolisthesis (with lysis) in the lumbar spine. CASE DESCRIPTION: A 68-year-old male presented with low back pain and neurogenic claudication of several years duration without any history of trauma, epidural spine injections, or spine surgery. Lumbosacral magnetic resonance imaging (MRI) revealed a grade-I L4-L5 isthmic spondylolisthesis with spinal canal narrowing and a posterior paravertebral collection consistent with CSF...
2017: Surgical Neurology International
Ben A Strickland, Joshua Lucas, Brianna Harris, Edwin Kulubya, Joshua Bakhsheshian, Charles Liu, Bozena Wrobel, John D Carmichael, Martin Weiss, Gabriel Zada
OBJECTIVE Cerebrospinal fluid (CSF) rhinorrhea is among the most common complications following transsphenoidal surgery for sellar region lesions. The aim of this study was to review the authors' institutional experience in identifying, repairing, and treating CSF leaks associated with direct endonasal transsphenoidal operations. METHODS The authors performed a retrospective review of cases involving surgical treatment of pituitary adenomas and other sellar lesions at the University of Southern California between December 1995 and March 2016...
September 29, 2017: Journal of Neurosurgery
J Čmelo, R Illéš, J Šteňo
The value of ICT is important in diagnosis of the diseases of the eye and orbit Methods for direct measurement of intracranial pressure (ICT) are exact, but they are invasive and there is some risk of infection and damage of the tissue. Currently there are 2 valid indirect methods of mesurement of IKT. Digital Ophthalmodynamometry (D-ODM) and Transcranial Doppler ultrasonography (TDU). D-ODM is a non-invasive method for measuring of the Pulsating Venous Pressure (VPT). We can measure VPT by the pulse phenomena...
2017: Ceská a Slovenská Oftalmologie
Julie Richter Hansen, Lars Poulsgaard, Markus Holtmannspötter, Joan Højgaard, Peer Tfeldt-Hansen
This is a case report of a 60-year-old male admitted on suspicion of relapse of idiopathic transverse myelitis (TM), who after further diagnostic workup underwent successful closure of a dural arteriovenous fistula (DAVF). Magnetic resonance imaging in DAVF usually shows longitudinal TM, which, unlike DAVF, is also seen with the more common inflammatory or infectious causes usually showing inflammation in the cerebrospinal fluid. The natural history of DAVF is progressive. Since curable options exist, timely diagnosis is most important...
September 18, 2017: Ugeskrift for Laeger
Sanjith Aaron, Anupriya Arthur, A T Prabakhar, Pavitra Mannam, N K Shyamkumar, Sunithi Mani, Vivek Mathew, Jeyanthi Peter, Ajith Sivadasan, Anika Alexander, M Karthik, Rohith Ninan Benjamin, Mathew Alexander
Visual impairment can complicate cerebral venous thrombosis (CVT). Here, we describe the various pathophysiological mechanisms and treatments available. A retrospective chart review of all patients treated for CVT in a large quaternary teaching hospital was done, and cases with visual impairment due to CVT were identified. The various mechanisms causing visual impairment in CVT were (1) raised intracranial pressure (ICP) caused by venous thrombosis without venous infarcts resulting in a benign intracranial hypertension-like presentation of CVT, (2) venous infarcts involving the occipital cortex, (3) raised ICP following the development of a secondary dural arteriovenous (AV) fistula, and (4) arterial occipital infarcts due to posterior cerebral artery compression secondary to herniation in large venous infarcts...
July 2017: Annals of Indian Academy of Neurology
Jean-Baptiste Oudart, Laure Zucchini, François-Xavier Maquart, Xavier Dubernard, Marc Labrousse, Géraldine Fiabane, Alexandra Quedreux, Fabien Litre, Laurent Ramont
INTRODUCTION: The management of posttraumatic cerebrospinal fluid (CSF) rhinorrhoea remains a clinical challenge. Cerebrospinal fistula is a dural defect responsible for possible CSF leakage into the contiguous air-filled cavities located at the skull base. The risk of central nervous system infection in these conditions is severe and can be life threatening. Consequently, a specific CSF biomarker might be used in case of difficult diagnosis of CSF rhinorrhoea. CSF Tau protein is a neuronal protein, commonly assessed for diagnosis of Alzheimer Disease (AD)...
October 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
Xiliang Dang, Liping Lian, Dongsheng Wu
BACKGROUND: We aimed to explore the prognosis and risk factors influencing tumor recurrence in surgery-treated patients with primary sacral tumors. METHODS: Fifty-six patients between February 2011 and December 2016 in Yishui Central Hospital with primary sacral tumors were selected and treated with radical surgeries. The perioperative outcomes and postoperative neurological functions were observed. After postoperative follow-up, the overall survival time (OS), disease-free survival time (DFS), and recurrence were recorded to analyze the potential risk factors influencing tumor recurrence...
August 2017: Iranian Journal of Public Health
Gabriel Mulinari-Santos, João Paulo Bonardi, Willian Ricardo Pires, Ricardo Garcia Mureb Jacob, Fábio Roberto de Souza Batista, Leonardo Perez Faverani, Francisley Ávila Souza, Idelmo Rangel Garcia Júnior
Cerebrospinal fluid fistula caused by head trauma is a potentially dangerous problem and precise localization and radical treatment are necessary. We present a case of a patient with Panfacial fracture caused by a motorcycle accident, resulting in a cerebrospinal fluid leakage. The correct diagnosis was realized by computed tomography and auxiliary tests. The successful treatment can be confirmed with the support of radionuclide cisternography examination.
October 2017: Journal of Craniofacial Surgery
Frederik Enders, Amelie Ackemann, Simon Müller, Karl Kiening, Berk Orakcioglu
STUDY DESIGN: This is a retrospective study analysis. OBJECTIVE: In this retrospective study we evaluated risk factors for incidental durotomy and its impact on the postoperative course. SUMMARY OF BACKGROUND DATA: Lumbar interbody fusion (LIF) is increasingly applied for the treatment of degenerative instability. A known complication is incidental durotomy. MATERIALS AND METHODS: A cohort of 541 patients who underwent primary LIF surgery between 2005 and 2015 was analyzed...
August 28, 2017: Clinical Spine Surgery
Peter G Kranz, Michael D Malinzak, Timothy J Amrhein, Linda Gray
PURPOSE OF REVIEW: The purpose of this study is to provide an update on recent developments in the understanding, diagnosis, and treatment of spontaneous intracranial hypotension (SIH). RECENT FINDINGS: SIH is an important cause of headaches caused by spinal cerebrospinal fluid (CSF) leaks, with an increasingly broad spectrum of clinical presentations and diagnostic findings. A simple conception of the condition as being defined by the presence of low CSF pressure is no longer sufficient or accurate...
August 2017: Current Pain and Headache Reports
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