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Cerebrospinal fluid spinal fistula

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https://www.readbyqxmd.com/read/27861828/postural-headaches-due-to-cerebrospinal-fluid-leakage-through-subarachnoid-pleural-fistula-a-case-report
#1
Sheng-Feng Lin, Hsing-Yu Weng
BACKGROUND: Postural headaches are commonly associated with spontaneous intracranial hypotension and cerebrospinal fluid (CSF) leakage from the spine. A subarachnoid-pleural fistula (SPF) is a very rare and serious type of CSF fistula that has mostly been reported following traumatic causes. CASE REPORT: Here, the case of a 36-year-old woman who suffered from postural headaches after chiropractic manipulation of her neck was reported. Brain and spinal magnetic resonance (MR) imaging showed brain sagging, a C7-T1 dural defect, and overt CSF leakage...
November 10, 2016: Headache
https://www.readbyqxmd.com/read/27853662/postoperative-cerebrospinal-fluid-leak-rates-with-subfascial-epidural-drain-placement-after-intentional-durotomy-in-spine-surgery
#2
Tianyi Niu, Derek S Lu, Andrew Yew, Darryl Lau, Haydn Hoffman, David McArthur, Dean Chou, Daniel C Lu
Study Design Retrospective chart review. Objective Postoperative cerebrospinal fluid (CSF) leak is a known complication of intraoperative durotomy. Intraoperative placement of subfascial epidural drains following primary dural repair has been proposed as a potential management strategy to prevent formation of CSF cutaneous fistula and symptomatic pseudomeningocele. Here we describe our experience with subfascial drain after intentional durotomy. Methods Medical records of patients who underwent placement of subfascial epidural drains during spinal procedures with intentional intraoperative durotomies over a 4-year period at two institutions were retrospectively reviewed...
December 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27799999/pneumocephalus-and-pneumorrhachis-due-to-a-subarachnoid-pleural-fistula-that-developed-after-thoracic-spine-surgery
#3
Gun-Sang Lee, Myung-Ki Lee, Woo-Jae Kim, Ho-Sang Kim, Jeong-Ho Kim, Yun-Suk Kim
Development of a communication between the spinal subarachnoid space and the pleural space after thoracic spine surgery is uncommon. Subarachnoid pleural fistula (SAPF), a distressing condition, involves cerebrospinal fluid leakage. Here we report an unusual case of SAPF, occurring after thoracic spine surgery, that was further complicated by pneumocephalus and pneumorrhachis postthoracentesis, which was performed for unilateral pleural effusion.
September 2016: Korean Journal of Spine
https://www.readbyqxmd.com/read/27658361/-description-of-a-series-of-hospital-patients-with-a-spinal-fistula
#4
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
https://www.readbyqxmd.com/read/27614217/sample-dependent-diagnostic-accuracy-of-prostaglandin-d-synthase-in-cerebrospinal-fluid-leak
#5
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
https://www.readbyqxmd.com/read/27580408/cerebrospinal-fluid-cutaneous-fistula-after-continuous-spinal-catheter-in-an-obstetric-patient
#6
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
https://www.readbyqxmd.com/read/27526247/recurrent-cranial-chronic-subdural-hematoma-due-to-cervical-cerebrospinal-fluid-fistula-repair-of-both-entities-in-the-same-session
#7
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
https://www.readbyqxmd.com/read/27355740/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#8
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
https://www.readbyqxmd.com/read/27213110/firearm-bullet-settling-into-the-lumbar-spinal-canal-without-causing-neurological-deficit-a-report-of-two-cases
#9
Tayfun Hakan, Ajlan Çerçi, Serkan Gürcan, Serkan Akçay
BACKGROUND: Uncertainty still exists regarding the treatment of the patients presenting with gunshot wounds to the spine. Neurological insults, cerebrospinal fluid fistula, infection, lead or copper toxicity, migration of bullets, and spinal instability are included among the common challenging issues. CASE DESCRIPTION: An 18-year-old woman was admitted with low back pain following a gunshot injury five days ago. She was neurologically intact. Radiological examinations showed that a bullet was settled in L4-5 disc space...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/26921138/migrating-bullet-in-the-thecal-sac-at-the-level-of-the-conus-medullaris-without-neurological-deficit
#10
Orkun Koban, Hasan Çal, Murat Şakir Ekşi, Emel Ece Özcan-Ekşi, Ahmet Öğrenci
Bullets can lodge in the organs, blood vessels or thecal sac. To our knowledge, a migrating bullet at the level of the conus medullaris without neurological deficit has never been reported. We present our patient along with a discussion of bullet migration in the spinal canal and its mechanisms, diagnosis and treatment. A 29-year-old man was admitted to the emergency department due to a gunshot wound in the right upper quadrant of his abdomen. He had no neurological deficit. Spinal CT scan and plain radiography showed the bullet had passed through the L2 vertebral body and had migrated downwards until it had lost its energy and come to rest in the spinal canal at the L3 vertebra level...
July 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/26904371/aulogous-fibrin-sealant-vivostat-%C3%A2-in-the-neurosurgical-practice-part-ii-vertebro-spinal-procedures
#11
Francesca Graziano, Rosario Maugeri, Luigi Basile, Favia Meccio, Domenico Gerardo Iacopino
BACKGROUND: Epidural hematomas, cerebrospinal fluid fistula, and spinal infections are challenging postoperative complications following vertebro-spinal procedures. We report our preliminary results using autologous fibrin sealant as both fibrin glue and a hemostatic during these operations. METHODS: Prospectively, between January 2013 and March 2015, 68 patients received an autologous fibrin sealant prepared with the Vivostat(®) system applied epidurally to provide hemostasis and to seal the dura...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/26889271/endoscopic-inter-laminar-management-of-lumbar-disease
#12
REVIEW
Yad Ram Yadav, Vijay Parihar, Yatin Kher, Pushp Raj Bhatele
Discectomy for lumbar disc provides faster relief in acute attack than does conservative management. Long-term results of open, microscopy-, and endoscopy-assisted discectomy are same. Early results of endoscopy-assisted surgery are better as compared to that of open surgery in terms of better visualization, smaller incision, reduced hospital stay, better education, lower cost, less pain, early return to work, and rehabilitation. Although microscopic discectomy also has comparable advantages, endoscopic-assisted technique better addresses opposite side pathology...
January 2016: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/26802871/balloon-assisted-fistula-sealing-procedure-for-symptomatic-tarlov-cysts
#13
Xuesheng Zheng, Shiting Li, Hansong Sheng, Baohui Feng, Nu Zhang, Chaoran Xie
OBJECTIVE: Tarlov cyst is an abnormal expansion of the spinal nerve sleeve, and it communicates with the subarachnoid cavity via a perineural fistula. This study presents our experience of a balloon-assisted fistula sealing procedure in treating Tarlov cyst. METHODS: Twenty-two patients with symptomatic Tarlov cysts were surgically treated. An emulsion balloon was placed into the lumbar subarachnoid cistern through a trocar, so as to temporarily block cerebrospinal fluid flow, then the thecal sac was opened and the inlet of the fistula was sealed by suture of a muscular patch and reinforced by fibrin glue...
April 2016: World Neurosurgery
https://www.readbyqxmd.com/read/26605107/incidence-and-management-of-cerebrospinal-fluid-fistulas-in-336-multilevel-laminectomies-with-noninstrumented-fusions
#14
Nancy E Epstein
BACKGROUND: The incidence (e.g., 3-27%) and the types of cerebrospinal fluid (CSF) fistulas occurring during multilevel lumbar laminectomy with noninstrumented spinal fusions varies. METHODS: From 2000 to 2015, we retrospectively evaluated the incidence/etiologies of CSF fistulas occurring for 336 patients undergoing average 4.7 laminectomies with average 1.4 level noninstrumented fusions over a 15 year period. The varied etiologies of CSF leaks included; ossification of the yellow ligament (OYL) extending through the dura, postoperative surgical scar, iatrogenic traumatic leak, epidural steroid injections (ESI), resection of synovial cysts, and the removal of intradural tumors...
2015: Surgical Neurology International
https://www.readbyqxmd.com/read/26587299/disabling-orthostatic-headache-after-penetrating-stonemason-pencil-injury-to-the-sacral-region
#15
Carlo Brembilla, Luigi Andrea Lanterna, Paolo Gritti, Emanuele Costi, Gianluigi Dorelli, Elena Moretti, Claudio Bernucci
Penetrating injuries to the spine, although less common than motor vehicle accidents and falls, are important causes of injury to the spinal cord. They are essentially of two varieties: gunshot or stab wounds. Gunshot injuries to the spine are more commonly described. Stab wounds are usually inflicted by knife or other sharp objects. Rarer objects causing incidental spinal injuries include glass fragments, wood pieces, chopsticks, nailguns, and injection needles. Just few cases of penetrating vertebral injuries caused by pencil are described...
2015: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/26240724/a-lethal-sequelae-of-spinal-infection-complicating-surgery-and-radiotherapy-for-head-and-neck-cancer
#16
Jason Pui Yin Cheung, Kin Cheung Mak, Helen Hoi Lun Tsang, Keith Dip Kei Luk
Patients who have undergone neck dissection and radiotherapy are at risk of cervical spine infections. Furthermore, previous radiotherapy and cervical spine infections can lead to fistula formation to the subarachnoid space and intracranial infection. This report discusses the serious consequences of a missed cervical spine infection including cerebrospinal fluid fistula formation and persistent central nervous system infection, and serves as a reminder to clinicians of the possible association between cervical spine infections and prior head and neck surgery and radiotherapy...
August 2015: Asian Spine Journal
https://www.readbyqxmd.com/read/25986178/transient-monoplegia-and-paraesthesia-after-an-epidural-blood-patch-for-a-spinal-cerebrospinal-fluid-leak
#17
Alvin Ho-Kwan Cheung, Lai-Fung Li, Vincent Ching So, May Ka-Mei Leung, Wai-Man Lui
We describe the very rare complication of new onset complete paralysis and numbness of one limb after an epidural blood patch in a 36-year-old woman. Intracranial hypotension resulting from a spinal cerebrospinal fluid fistula may be treated by epidural injection of autologous blood that is, a blood patch. This is usually a safe and effective procedure. The woman's muscle strength of hip flexion, extension, ankle dorsiflexion and plantarflexion decreased from 5/5 to 0/5 following the procedure. After symptom onset, an MRI of her spine showed no compressive or ischaemic lesions amenable to urgent intervention...
September 2015: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/25982607/-acetazolamide-in-the-resolution-of-cerebrospinal-fluid-cutaneous-fistula-after-peridural-analgesia-case-report
#18
Félix Manuel Juárez-Adame, Yolanda Ruiz-Rubio, Ana Bertha Zavalza-Gómez
BACKGROUND: Cerebrospinal fluid cutaneous fistula following spinal anesthesia is a serious and rare complication which mandates prompt diagnosis, although the treatment modalities are not well codified. CLINICAL CASE: Female aged 50 with a stage IIB cervical carcinoma; a peridural catheter was passed at lumbar level; three days after surgery, refers severe headache and to corroborate leakage cerebrospinal fluid through the puncture. The prescription was antibiotics and acetazolamide 250mg every 8hours for five days with favorable evolution...
January 2015: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/25705346/combat-related-intradural-gunshot-wound-to-the-thoracic-spine-significant-improvement-and-neurologic-recovery-following-bullet-removal
#19
Thijs M Louwes, William H Ward, Kendall H Lee, Brett A Freedman
The vast majority of combat-related penetrating spinal injuries from gunshot wounds result in severe or complete neurological deficit. Treatment is based on neurological status, the presence of cerebrospinal fluid (CSF) fistulas, and local effects of any retained fragment(s). We present a case of a 46-year-old male who sustained a spinal gunshot injury from a 7.62-mm AK-47 round that became lodged within the subarachnoid space at T9-T10. He immediately suffered complete motor and sensory loss. By 24-48 hours post-injury, he had recovered lower extremity motor function fully but continued to have severe sensory loss (posterior cord syndrome)...
February 2015: Asian Spine Journal
https://www.readbyqxmd.com/read/25701541/a-late-and-extreme-complication-of-lumboperitoneal-shunt
#20
Murat Vural, Emre Özkara, Baki Adapinar, Emine Dündar, Ali Arslantaş
BACKGROUND CONTEXT: Lumboperitoneal (LP) shunting is an effective treatment modality for commmunicating hydrocephalus, pseudotumor cerebri, postoperative pseudomeningoceles, and cerebrospinal fluid fistulas. However, LP shunts are associated with some complications. Here, we report an extreme complication resulting in the formation of granulation tissue. PURPOSE: To report a late extreme complication of LP shunt. STUDY DESIGN: A case report...
May 1, 2015: Spine Journal: Official Journal of the North American Spine Society
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