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Cerebrospinal fluid leaks by traumatic

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https://www.readbyqxmd.com/read/27846635/multilayered-closure-of-cerebrospinal-fluid-rhinorrhea-with-inlay-fascia-lata-autologous-fat-and-outlay-fascia-lata-our-experience
#1
Mehmet Akif Eryılmaz, Mitat Arıcıgil, Mehmet Akif Alan
BACKGROUND/AIMS: Since the initial use in 1981 by Wigand, different endoscopic endonasal surgery techniques have been proposed to close ventral skull base defects, all of which include multilayer closure involving vascularized mucoseptal flaps, autologous grafts, and synthetic materials. These methods are used individually or in combination, as required by the operative condition. METHODS: In this study we aimed to describe our endoscopic technique using inlay-outlay fascia lata and autologous fat with fibrin sealant to close spontaneous and traumatic cerebrospinal fluid (CSF) rhinorrhea...
November 16, 2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/27648399/treatment-of-temporal-bone-fractures
#2
REVIEW
Rodney C Diaz, Brian Cervenka, Hilary A Brodie
Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications...
October 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27351232/spontaneous-intracranial-hypotension-associated-with-kinetic-tremor-and-ataxia
#3
Richard Salazar
BACKGROUND: Spontaneous intracranial hypotension (SIH) is a clinically variable syndrome caused by low cerebrospinal fluid (CSF) pressure due to a non-traumatic CSF leak. PHENOMENOLOGY SHOWN: This case describes a 68-year-old gentleman who presents with chronic and slightly progressive kinetic tremor of bilateral hands associated with gait ataxia and gait start hesitation. EDUCATIONAL VALUE: This case underscores the importance of having a high index of suspicion for the diagnosis of SIH when encountering a patient presenting with late-onset progressive kinetic tremor and gait ataxia syndrome...
2016: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/27126910/syringomyelia-caused-by-traumatic-intracranial-hypotension-case-report-and-literature-review
#4
Sébastien Richard, Lisa Humbertjean, Gioia Mione, Marc Braun, Emmanuelle Schmitt, Sophie Colnat-Coulbois
BACKGROUND: Syringomyelia due to intracranial hypotension is rarely described. As a consequence, intracranial hypotension is less recognized as a potential cause of syringomyelia or mistaken with Chiari type 1 malformation. The pathogeny is poorly understood, and we lack diagnostic and therapeutic strategies for this particular setting. CASE DESCRIPTION: We describe a 45-year-old patient who developed syringomyelia after about 10 years of undiagnosed intracranial hypotension caused by traumatic C6 cerebrospinal fluid (CSF) leak...
July 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27114672/purely-endoscopic-pterional-extradural-approach-a-novel-technique-for-repair-of-cerebrospinal-fluid-rhinorrhea
#5
Ajit Kumar Sinha, Sumit Goyal
STUDY DESIGN: Retrospective descriptive study of an innovative surgical technique. OBJECTIVE: To assess the feasibility and success of repair of transfrontal sinus cerebrospinal fluid (CSF) rhinorrhea through pterional transcranial extradural approach using endoscope. SUMMARY OF BACKGROUND DATA: Repair of CSF rhinorrhea has seen advancement with the evolution of endoscopic transnasal techniques. However, leaks from defect in the posterior wall of frontal sinus still remain a challenge for the skull base surgeons and requires conventional craniotomy more often...
April 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/26878002/endoscopic-repair-of-csf-rhinorrhea-an-institutional-experience
#6
Sarita Kumari Mishra, George Ani Mathew, Roshna Rose Paul, Syed Kamran Asif, Mary John, Ajoy Mathew Varghese, Mary Kurien
INTRODUCTION: Endoscopic repair is considered the treatment of choice in cerebrospinal fluid (CSF) rhinorrhea. The aim of our study was to analyze the etiopathogenesis of CSF rhinorrhea, the outcome of treatment and the causes of failure in a developing-country setting. MATERIALS AND METHODS: A retrospective review of patients treated with endoscopic repair for CSF rhinorrhea at a tertiary care hospital in southern India from January 2002 to December 2009 identified 36 patients, the majority of them being women...
January 2016: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/26778810/pneumocephalus-leading-to-the-diagnosis-of-cerebrospinal-fluid-leak-and-esophageal-perforation-after-cervical-spine-surgery
#7
C Rory Goodwin, Christine E Boone, James Pendleton, Benjamin D Elder, Zhikui Wei, Wesley Hsu, Daniel M Sciubba, Timothy F Witham
Pneumocephalus is a collection of air within in the intracranial cavity, most commonly seen following traumatic injury or cranial surgeries. Esophageal injury and cerebrospinal fluid (CSF) leak are rare complications that may occur following anterior cervical discectomy and fusion (ACDF). We present a novel case of pneumocephalus arising from unrestricted leakage of CSF via coincident esophageal injury and durotomy in a patient who underwent an ACDF after trauma. A 21-year-old man presented to an outside hospital with C5/C6 subluxation, complete spinal cord injury, and quadriplegia from a motor vehicle accident...
April 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/26776882/endoscopic-repair-of-cerebrospinal-fluid-rhinorrhoea
#8
S D Sharma, G Kumar, J Bal, A Eweiss
GOAL: The purpose of this review was to look at the success rate of transnasal endoscopic repair of CSF rhinorrhoea and the impact of patient factors, repair techniques and adjuvant treatment. MATERIAL AND METHODS: A literature search was performed on PubMed, Medline and Cochrane Central databases, independently by two of the authors, of all studies reporting the outcomes of CSF rhinorrhoea repair, published until the 1st June 2014, using keywords Cerebrospinal fluid leak, CSF leak, CSF fistula, CSF leak or fistula repair, endoscopic sinus surgery or ESS complications...
June 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/26563603/transorbital-neuroendoscopic-surgery-for-the-treatment-of-skull-base-lesions
#9
Rohan Ramakrishna, Louis J Kim, Randall A Bly, Kris Moe, Manuel Ferreira
Transorbital neuroendoscopic surgery (TONES) is a relatively new technique that not only allows access to the contents of the orbit but also the intracranial compartment, including the anterior cranial fossa, middle fossa and lateral cavernous sinus. In this study, we aimed to retrospectively review the largest experience to our knowledge with regards to surgical outcomes of skull base pathologies treated with a TONES procedure. Forty patients (aged 3-89 years) underwent 45 TONES procedures between the years of 2006-2013...
February 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/26370047/-the-clinical-features-of-cerebrospinal-fluid-leaks-based-on-our-experiences
#10
Tatsuya Ohtonari, Shinzo Ota, Yoshinobu Sekihara, Nobuharu Nishihara, Taisei Ota, Michiyoshi Sato, Akio Tanaka
Cerebrospinal fluid (CSF) leak, which usually occurs idiopathically or traumatically as a rare situation, is a rare disease that causes orthostatic headache or idiopathic chronic subdural hematoma (CSDH). We report our therapeutic experience of consecutive 20 cases for this disease, and review the current status and problems. Consecutive 20 patients (11 women; age 44.7±12.1 years) between April, 2006 and March, 2014, who were diagnosed by MRI and/or CT myelography (CTM), were evaluated retrospectively about clinical features...
September 1, 2015: Journal of UOEH
https://www.readbyqxmd.com/read/26305350/-endoscopic-endonasal-treatment-of-cerebrospinal-fluid-leak-caused-by-clival-fracture-a-case-report
#11
M Májovský, D Netuka, V Masopust, V Beneš
INTRODUCTION: Clivus is a central structure of the skull base located in the vicinity of the brainstem and vital brain vessels. Clival fractures are usually caused by a high-energy trauma. Cerebrospinal fluid leak is one of the most common complications. CASE REPORT: A middle-aged male sustained a mild head trauma, followed by a nasal cerebrospinal fluid leak. CT scan revealed the massive pneumocephalus and the fracture of the clivus in the posterior wall of the sphenoidal sinus...
July 2015: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/26151517/basal-skull-fractures-are-associated-with-mortality-in-pediatric-severe-traumatic-brain-injury
#12
Ibrahim Alhelali, Tanya Charyk Stewart, Jennifer Foster, Ibrahim M Alharfi, Adrianna Ranger, Hani Daoud, Douglas D Fraser
BACKGROUND: Basal skull fractures (BSFs) are caused by blunt force trauma, occurring in the temporal, occipital, sphenoid, and/or ethmoid bones. In pediatric severe traumatic brain injury (sTBI), there is a paucity of data on BSFs. Our goal was to investigate the BSF prevalence, anatomy, and association with short-term outcomes in pediatric sTBI. METHODS: We retrospectively reviewed all severely injured (Injury Severity Score ≥12) pediatric patients (aged <18 years) admitted to our hospital after experiencing an sTBI (Glasgow Coma Scale score ≤8 and head Abbreviated Injury Scale score ≥4)...
June 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26028845/a-7-year-study-of-1-278-patients-with-maxillofacial-trauma-and-cerebrospinal-fluid-leak
#13
Dariush Hasheminia, Mahmood Reza Kalantar Motamedi, Hadi Hashemzehi, Rahman Nazeri, Bijan Movahedian
BACKGROUND: A number of patients with facial fractures have cerebrospinal fluid (CSF) leak that may result in meningitis and other central nervous system complications. Commonly, CSF leak occurs following trauma, but the etiology and pattern of this disorder are different from region to region. This study aims to evaluate the distribution of CSF leak in patients with maxillofacial fractures in Isfahan province, Iran. PATIENTS AND METHODS: In this retrospective cross-sectional study, 1,287 medical files of patients admitted to a medical center with head and face injuries were evaluated during a 7-year period (2004-2010)...
June 2015: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/25947983/is-acetazolamide-really-useful-in-the-management-of-traumatic-cerebrospinal-fluid-rhinorrhea
#14
Jaskaran S Gosal, Tenzin Gurmey, Gopi K Kursa, Pravin Salunke, Sunil K Gupta
BACKGROUND: Traumatic cerebrospinal fluid (CSF) rhinorrhea is a serious and potentially fatal condition as it may lead to meningitis. As acetazolamide decreases CSF production and hence CSF pressure, it has been proposed that the medication may help in curing CSF rhinorrhea. There is no definitive evidence, however, that acetazolamide is actually beneficial in treating traumatic CSF rhinorrhea. The aim of this study was to determine if the administration of acetazolamide in patients of head trauma with CSF rhinorrhea was beneficial in decreasing the duration of CSF rhinorrhea...
March 2015: Neurology India
https://www.readbyqxmd.com/read/25912500/acute-tonsillar-cerebellar-herniation-in-a-patient-with-traumatic-dural-tear-and-vac-therapy-after-complex-trauma
#15
Peter Bernhard Sporns, Sebastian Zimmer, Uta Hanning, Tarek Zoubi, Johannes Wölfer, Mirco Herbort, Wolfram Schwindt, Thomas Niederstadt
BACKGROUND CONTEXT: Cases of cerebral hypotension and tonsillar herniation after accidental lumbar cerebrospinal fluid (CSF) drainage or chest tube drainage with intrathoracic CSF leaks have been reported. To the authors' knowledge, this case presents the first report of severe intracranial hypotension because of suction of CSF by a Vacuum-Assisted Closure (VAC) device. PURPOSE: The purpose of this study was to report a life-threatening intracranial hypotension in a polytraumatized patient after VAC therapy...
July 1, 2015: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/25750839/preservation-of-frontal-sinus-anatomy-and-outflow-tract-following-frontal-trauma-with-dural-defect
#16
James Wei Ming Kwek, David Chao Wu Chin, Ian Chi Yuan Loh
Our case report describes a young male mechanic who was hit in his face by a spring while repairing a car, resulting in traumatic injury to the frontal sinus, with fractures of both the anterior and the posterior tables with dural defect and cerebrospinal fluid leak. Current guidelines recommend that comminuted and/or displaced fractures of the posterior table of the frontal sinus with dural defects should be either cranialized or obliterated. In this patient, instead of cranializing or obliterating the frontal sinus, we managed to preserve the frontal sinus anatomy and its outflow tract using a combined open bicoronal and nasoendoscopic approach...
February 2015: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/25746317/the-endoscopic-endonasal-approach-for-cerebrospinal-fluid-leak-repair-in-the-elderly
#17
Enzo Emanuelli, Laura Milanese, Marta Rossetto, Diego Cazzador, Elena d'Avella, Tiziana Volo, Valentina Baro, Luca Denaro, Giorgio Gioffrè, Daniele Borsetto, Alessandro Martini
INTRODUCTION: Cerebrospinal fluid (CSF) rhinorrhea can lead to CNS infections, carrying significant morbidity and mortality, especially in the elderly. Endoscopic endonasal surgery is a validated technique in the repair of anterior skull base CSF leaks. The aim of this study is to assess diagnostic management, surgical technique and clinical outcome in a consecutive series of elderly patients. METHODS: Patients older than 65 years treated for anterior skull base CSF leaks through endoscopic endonasal surgery between 2003 and 2014 were retrospectively reviewed...
May 2015: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/25705346/combat-related-intradural-gunshot-wound-to-the-thoracic-spine-significant-improvement-and-neurologic-recovery-following-bullet-removal
#18
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/25569422/computed-tomography-image-guidance-for-more-accurate-repair-of-anterior-table-frontal-sinus-fractures
#19
Justine C Lee, Brian T Andrews, Hamid Abdollahi, Alex G Lambi, Clifford T Pereira, James P Bradley
BACKGROUND: Anterior table frontal sinus fractures accompanied by nasofrontal duct injury require surgical correction. Extracranial approaches for anterior table osteotomies have traditionally used plain radiograph templates or a "cut-as-you-go" technique. We compared these methods with a newer technique utilizing computed tomography (CT)-guided imaging. METHODS: Data of patients with acute, traumatic anterior table frontal sinus fractures and nasofrontal duct injury between 2009 and 2013 were reviewed (n = 29)...
January 2015: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/25374381/posterior-cervicothoracic-instrumentation-testing-the-clinical-efficacy-of-tapered-rods-dual-diameter-rods
#20
Arvind G Kulkarni, Abhilash N Dhruv, Anupreet J Bassi
STUDY DESIGN: Prospective study. OBJECTIVE: To study the clinical efficacy of tapered rods in posterior cervicothoracic instrumentation. SUMMARY OF BACKGROUND DATA: The cervicothoracic spine is a junctional area with complex biomechanics. A variety of disorders affect this region, rendering it unstable. Numerous posterior constructs have been evaluated by in vitro biomechanical studies. There are no data available on the clinical efficacy of a screw-rod system utilizing tapered (dual-diameter) rods...
December 2015: Journal of Spinal Disorders & Techniques
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