keyword
https://read.qxmd.com/read/38152778/an-uncommon-case-of-multiple-recurrent-cerebrospinal-fluid-venous-fistulas
#21
May Ameri, Andrew Whyte, Stephen Chen, Andrew G Lee, Nagham Al Zubidi
We present a clinical case to discuss the use of computed tomography (CT) spine myelograms alongside a complete history to diagnose multiple cerebrospinal fluid (CSF) venous fistulas (CVFs). The goal of this study is to familiarize clinicians with this challenging diagnosis and the utility of these studies in localizing leaks. A 63-year-old male patient with a history of cervical spinal stenosis, intermittent double vision, and sinus pressure managed with intermittent steroids presented to the clinic. He provided a detailed timeline of his previous symptoms and previous workups leading to the suspicion of intracranial hypotension due to CSF leak vs...
November 2023: Curēus
https://read.qxmd.com/read/38146166/fluctuating-hearing-loss-secondary-to-spontaneous-intracranial-hypotension-a-case-report-and-review-of-the-literature
#22
JOURNAL ARTICLE
Michal Cahal, Jonathan Roth, Omer J Ungar, Waleed Brinjikji
OBJECTIVE: Fluctuating sensorineural hearing loss (SNHL) has multiple etiologies, most commonly Ménière's disease (MD), recurrent sudden SNHL, and autoimmune inner ear disorders. Fluctuating SNHL has rarely been described as a symptom of spontaneous intracranial hypotension (SIH). PATIENT: A 39-year-old previously healthy female presented with "Ménière's like" symptoms responsive to steroid treatment, which worsened during the day and improved in the supine position...
December 25, 2023: Interventional Neuroradiology
https://read.qxmd.com/read/38130106/efficacy-of-transvenous-embolization-of-csf-venous-fistula-in-spontaneous-intracranial-hypotension-case-series
#23
JOURNAL ARTICLE
Nathaniel R Ellens, Derrek Schartz, Rahim Ismail, Alex Kessler, Shehenaz Ellika, Sajal Medha K Akkipeddi, Redi Rahmani, Matthew T Bender
BACKGROUND: Spontaneous intracranial hypotension is a debilitating neurological condition which can be caused by a cerebrospinal fluid-venous fistula. Transvenous embolization is a promising technique to provide minimally invasive yet durable treatment. METHODS: A retrospective single-center case series was performed on all patients who underwent transvenous embolization of a cerebrospinal fluid (CSF)-venous fistula. Clinical and radiographic parameters, including Bern score, were reported preoperatively and at 3-month follow-up...
December 21, 2023: Interventional Neuroradiology
https://read.qxmd.com/read/38111582/autoimmune-glial-fibrillary-acidic-protein-astrocytopathy-complicated-with-low-flow-perimedullary-arteriovenous-fistula-a-case-report
#24
Ting Xu, Jingyun Chen, Tingting Xuan, Jiang Cheng, Haining Li
Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy and low-flow perimedullary arteriovenous fistulas (PMAVFs) may cause longitudinal widespread myelopathy. We report a middle-aged male patient with autoimmune GFAP astrocytopathy complicated with low flow PMAVFs disease, presenting with lower extremity weakness and dysuria. Magnetic resonance imaging (MRI) of the spinal cord revealed a significant longitudinal extent of T2 high signal from T11 to L1, with the lesion located proximal to the vascular territory supplied by the anterior spinal artery...
2023: Frontiers in Immunology
https://read.qxmd.com/read/38022263/fluid-leak-from-the-spinal-epidural-puncture-site-is-that-cerebrospinal-fluid
#25
Rui Torres, Rita P Sa, Ana S Cruz, Juliana L Cruz, Lúcia V Maria
We present the case of a 30-year-old parturient who underwent a combined spinal-epidural for an elective cesarean section and subsequently experienced fluid leakage at the puncture site. The fluid analysis indicated a glucose level of 57 mg/dL, which initially raised suspicion of a cerebrospinal fluid fistula. However, an MRI revealed no significant abnormalities, and the patient remained asymptomatic. We aim to highlight that various fluids can emerge from a neuraxial puncture site, including cerebrospinal fluid, interstitial fluid due to edema, or residual local anesthetic...
October 2023: Curēus
https://read.qxmd.com/read/38021026/small-spheno-ethmoidal-meningoencephalocele-versus-ethmoidal-mucocele-in-spontaneous-intracranial-hypotension
#26
Giulio Bonomo, Gennaro Bussone, Alessandro Gans, Guglielmo Iess, Roberta Bonomo, Francesco Restelli, Jacopo Falco, Elio Mazzapicchi, Mario Stanziano, Alessia Amato, Morgan Broggi, Francesco Acerbi, Paolo Ferroli, Marco Schiariti
BACKGROUND: Meningoencephalocele is defined as an abnormal sac of brain tissue and meninges extending beyond natural skull margins, often leading to cerebrospinal fluid (CSF) leakage. When this condition arises in the spheno-ethmoidal region, the diagnosis becomes more challenging as it can be mistaken for other nasal pathologies, such as mucocele. RESEARCH QUESTION: We show in this case report a non-congenital sphenoethmoidal meningoencephalocele causing rhinoliquoral fistula and spontaneous intracranial hypotension...
2023: Brain Spine
https://read.qxmd.com/read/38020184/kocuria-kristinae-neuroinfection-in-an-immunocompetent-patient-a-case-report-and-review-of-the-literature
#27
Mauricio Alejandro Saldaña-Ruiz, José Marcelino Chávez-García, Federico Ortiz-Alonso, Cindy Sharon Ortiz-Arce, Jaime Eugenio Espinosa-Mora, José Remedios Cortés-Cárdenas
Few cases of disease by Kocuria kristinae have been reported, some in immunocompetent patients but mainly in immunocompromised. The current case report describes a 28-year-old female with an initial diagnosis of pituitary macroadenoma. After the initial surgery, the patient was readmitted due to tension pneumocephalus and cerebrospinal fluid (CSF) fistula. Cultures showed K. kristinae in the CSF and Candida albicans in the urine. The patient died after multiple complications. This is the first case of neuroinfection by K...
December 2023: IJID Reg
https://read.qxmd.com/read/37992305/preoperative-examination-and-intraoperative-cerebrospinal-fluid-leakage-test-for-minimally-invasive-surgery-of-spinal-extradural-arachnoid-cysts-illustrative-case
#28
JOURNAL ARTICLE
Yoshihiro Sunada, Kenji Yagi, Yoshifumi Tao, Hirotake Nishimura, Tomohito Hishikawa
BACKGROUND: Spinal extradural arachnoid cysts (SEACs) are rare and can cause spinal dysfunction. Total cyst removal and duraplasty via multiple laminectomies are commonly performed. However, to avoid postoperative spinal deformity and axial pain, a minimally invasive surgery via selective laminectomy may be optimal. Therefore, preoperative detection of the dural fistula site is required. OBSERVATIONS: A 25-year-old male presented with a 2-month history of progressive gait disturbance and back pain...
November 20, 2023: J Neurosurg Case Lessons
https://read.qxmd.com/read/37989285/-the-differential-diagnosis-of-inflammatory-and-non-inflammatory-myelopathy
#29
JOURNAL ARTICLE
Tetsuo Ando
The differential diagnosis of inflammatory and non-inflammatory myelopathy can be challenging. Clinical information such as age, gender, speed of onset and progression, systemic symptoms, spinal cord and brain MRI, autoantibodies, and cerebrospinal fluid findings are necessary. The speed of onset is particularly important for differentiation. Inflammatory myelopathy typically follows an acute/subacute course, while spinal cord infarction presents with a hyperacute course, and intramedullary tumors often have a chronic progressive course...
November 22, 2023: Rinshō Shinkeigaku, Clinical Neurology
https://read.qxmd.com/read/37982787/ventriculoperitoneal-shunt-alone-for-spontaneous-cerebrospinal-fluid-rhinorrhea-as-a-presenting-symptom-of-hemi-hydranencephaly
#30
JOURNAL ARTICLE
Meng Zhu, Wujun Chen, Yan Zheng, Dongming Xing, Jiahui Zhang
A 27-year-old female patient presented with chronic spontaneous cerebrospinal fluid (CSF) rhinorrhea. She had deformity and weakness on the left side since childhood. Imaging examinations demonstrated hemi-hydranencephaly with a nearly complete absence of the right cerebral hemisphere, which was replaced with a membranous sac filled with CSF. She was accompanied with a frontal midline tumor containing lipids. After ventriculoperitoneal shunt, the CSF rhinorrhea completely ceased and no direct repair of the CSF fistula was necessary...
November 20, 2023: Journal of Craniofacial Surgery
https://read.qxmd.com/read/37970777/-endonasal-repair-of-spontaneous-csf-fistulas-of-the-lateral-recess-of-the-sphenoid-sinus
#31
JOURNAL ARTICLE
D V Roschina, I M Godkov, A A Grin, A S Tovmasyan, E V Garov
CSF fistulas of the lateral recess of the sphenoid sinus are a rare surgical pathology. Cerebrospinal fluid leak from lateral recess of the sphenoid sinus is observed with a frequency of 7.7% among all leakafe of the skull base. The article presents 3 clinical cases of patients with spontaneous cerebrospinal fluid leak from lateral recess of the sphenoid sinus and surgical treatments by transsphenoidal and transpterygoid (transpterygoid) endoscopic approaches with various postoperative results. The plastic surgery success of CSF fistulas from lateral recess of the sphenoid sinus doesn`t depend on the type of endonasal surgical approach, but on the plastic quality and the preoperative level of CSF pressure...
2023: Vestnik Otorinolaringologii
https://read.qxmd.com/read/37938060/cranial-nerve-fourth-palsy-due-to-cerebrospinal-fluid-venous-fistula
#32
JOURNAL ARTICLE
Atish S Amin, Pamela A Davila, Noor A Laylani, Peter W Mortensen, Andrew G Lee
No abstract text is available yet for this article.
November 6, 2023: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://read.qxmd.com/read/37918908/direct-comparison-of-digital-subtraction-myelography-versus-ct-myelography-in-lateral-decubitus-position-evaluation-of-diagnostic-yield-for-cerebrospinal-fluid-venous-fistulas
#33
JOURNAL ARTICLE
Niklas Lützen, Theo Demerath, Urs Würtemberger, Nebiyat Filate Belachew, Enrique Barvulsky Aleman, Katharina Wolf, Amir El Rahal, Florian Volz, Christian Fung, Jürgen Beck, Horst Urbach
BACKGROUND: Cerebrospinal fluid (CSF)-venous fistulas (CVFs) are increasingly identified as a cause of spontaneous intracranial hypotension (SIH). Lateral decubitus digital subtraction myelography (LD-DSM) and CT myelography (LD-CTM) are mainly used for detection, but the most sensitive method is yet unknown. OBJECTIVE: To compare LD-DSM with LD-CTM for diagnostic yield of CVFs. METHODS: Patients with SIH diagnosed with a CVF between January 2021 and December 2022 in which the area of CVF(s) was covered by both diagnostic modalities were included...
November 2, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/37910308/intraoperative-application-of-triamcinolone-a-risk-factor-for-delayed-csf-fistula-formation
#34
JOURNAL ARTICLE
Nikolaus Kögl, Konstantin Brawanski, Claudius Thomé, Ondra Petr
PURPOSE: Cerebrospinal fluid (CSF) leaks are a well-known complication in spinal surgery, caused mostly by incidental durotomy (ID). However, delayed pseudomeningocele formation has been described in patients following an unremarkable surgery - without ID. Intraoperative and epidural triamcinolone application has been suspected to be a potential risk factor. This study was conducted to evaluate the management of ID and identify further risk factors for secondary CSF fistula formation...
November 1, 2023: Acta Neurochirurgica
https://read.qxmd.com/read/37898553/clinical-and-imaging-outcomes-of-100-patients-with-cerebrospinal-fluid-venous-fistulas-treated-by-transvenous-embolization
#35
JOURNAL ARTICLE
Waleed Brinjikji, Ajay Madhavan, Ivan Garza, Mark Whealy, Narayan Kissoon, Ian Mark, Pearse P Morris, Jared Verdoorn, John Benson, John L D Atkinson, Hassan Kobeissi, Jeremy K Cutsforth-Gregory
BACKGROUND: Cerebrospinal fluid-venous fistulas (CSFVF) are a common cause of spontaneous intracranial hypotension (SIH). Transvenous embolization has emerged as a reliable treatment option. We review the clinical presentation, imaging, and clinical outcomes of 100 consecutive CSFVF patients who underwent embolization over 2 years. METHODS: Baseline clinical characteristics, imaging findings (including Bern SIH score), technical outcomes, and long-term imaging and clinical outcomes were collected...
October 28, 2023: Journal of Neurointerventional Surgery
https://read.qxmd.com/read/37846141/endoscopic-endonasal-approach-for-tuberculum-sellae-meningioma-2-dimensional-operative-video
#36
JOURNAL ARTICLE
Luigi Maria Cavallo, Domenico Solari, Elena d'Avella, Manuel Colangelo, Paolo Cappabianca
INDICATIONS CORRIDOR AND LIMITS OF EXPOSURE: Ideal indications for tuberculum sellae meningiomas (TSM) removal through endoscopic endonasal approach (EEA) are midline tumors (<3.5 cm), possibly with no optic canal invasion and no vessels encasement. The EEA is favored by a wide tuberculm sellae (TS) angle and a deep sella at the sphenoid sinus (SS).1 Adequate removal of paranasal structures provides a wider surgical corridor ensuring exposure at the suprasellar area and safe instruments manuevrability...
November 1, 2023: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/37817851/safety-of-cerebrospinal-%C3%AF-uid-drainage-in-descending-and-thoracoabdominal-aortic-replacement-surgery
#37
JOURNAL ARTICLE
Afsheen Nasir, Mohammad A Zafar, Mohamed Abdelbaky, Dimitra Papanikolaou, Hesham Ellauzi, Maryam Shaikh, Bulat A Ziganshin, John A Elefteriades
BACKGROUND: Spinal cord injury (SCI) remains a significant morbidity of surgical repair of descending thoracic aortic aneurysms (DTAA) and thoracoabdominal aortic aneurysms (TAAA). We present our 17-year experience with cerebrospinal fluid drainage (CSFD) as a protective strategy during open surgical repair of descending and thoracoabdominal aortic disease. METHODS: We conducted a retrospective chart review of 132 patients who underwent open surgical repair of DTAA and TAAA and dissections with concurrent use of CSFD for spinal cord protection...
September 28, 2023: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/37804453/treatment-of-a-symptomatic-cervical-cerebrospinal-fluid-fistula-after-full-endoscopic-cervical-foraminotomy-with-ct-guided-epidural-fibrin-patch
#38
JOURNAL ARTICLE
Stefan Motov, B Stemmer, P Krauss, C Maurer, E Shiban
BACKGROUND: There is only limited data on the management of cerebrospinal fluid (CSF) fistulas after cervical endoscopic spine surgery. We investigated the current literature for treatment options and present a case of a patient who was treated with CT-guided epidural fibrin patch. METHODS: We present the case of a 47-year-old female patient with a suspected CSF fistula after endoscopic decompression for C7 foraminal stenosis. She was readmitted 8 days after surgery with dysesthesia in both upper extremities, orthostatic headache and neck pain, which worsened during mobilization...
October 7, 2023: European Spine Journal
https://read.qxmd.com/read/37800900/necrosectomy-versus-stand-alone-suboccipital-decompressive-craniectomy-for-the-management-of-space-occupying-cerebellar-infarctions-a-retrospective-multicenter-study
#39
JOURNAL ARTICLE
Silvia Hernandez-Duran, Johannes Walter, Bedjan Behmanesh, Joshua D Bernstock, Marcus Czabanka, Nazife Dinc, Daniel Dubinski, Thomas M Freiman, Albrecht Günther, Kara Hellmuth, Eva Herrmann, Juergen Konczalla, Ilko Maier, Ruzanna Melkonian, Dorothee Mielke, Sebastian Johannes Müller, Paul Naser, Veit Rohde, Jan Hendrik Schaefer, Christian Senft, Alexander Storch, Andreas Unterberg, Uwe Walter, Matthias Wittstock, Florian Gessler, Sae-Yeon Won
BACKGROUND AND OBJECTIVES: Space-occupying cerebellar stroke (SOCS) when coupled with neurological deterioration represents a neurosurgical emergency. Although current evidence supports surgical intervention in such patients with SOCS and rapid neurological deterioration, the optimal surgical methods/techniques to be applied remain a matter of debate. METHODS: We conducted a retrospective, multicenter study of patients undergoing surgery for SOCS. Patients were stratified according to the type of surgery as (1) suboccipital decompressive craniectomy (SDC) or (2) suboccipital craniotomy with concurrent necrosectomy...
October 6, 2023: Neurosurgery
https://read.qxmd.com/read/37782313/-spontaneous-intracranial-hypotension
#40
JOURNAL ARTICLE
Roberto Doria-Medina, Florian Volz, Niklas Lützen, Jürgen Beck
Spontaneous intracranial hypotension (SIH) is a disease presenting mostly with orthostatic head and neck pain due to a spontaneous cerebrospinal fluid (CSF) leak or a CSF-venous fistula in the spinal region. It demonstrates typical MRI findings with sagging of the brain causing tension of the meninges and sometimes the cranial nerves. It shares some clinical similarities with post puncture headache but differs in its pathophysiological cause, diagnosis, and treatment. Many patients remain misdiagnosed or wait too long for the correct diagnosis...
October 2, 2023: Läkartidningen
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