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Cerebrospinal fluid leaks by traumatic

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https://www.readbyqxmd.com/read/29777885/posttraumatic-cerebrospinal-fluid-leak-associated-with-an-upper-cervical-meningeal-diverticulum
#1
Noriya Enomoto, Hideo Mure, Toshiyuki Okazaki, Mai Azumi, Shinya Okita, Shinji Nagahiro, Yasushi Takagi
Spontaneous intracranial hypotension (SIH) has been increasingly recognized as a phenomenon caused by cerebrospinal fluid (CSF) leaks; however, its pathogenesis is still unclear. Here, we report two cases of SIH as a result of CSF leak from a meningeal diverticulum at the C2 nerve root sleeve. The first case is that of a 46-year-old man who had suffered from orthostatic headache after a bicycle accident at age 45. Computed tomography (CT) myelography revealed CSF leaks at the C1/2 level. He underwent epidural blood patch (EBP) therapy, but it was unsuccessful...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29554345/the-role-of-the-visor-flap-in-scalp-reconstruction-a-case-series-of-21-patients
#2
Marco Ellis, Lisa Hwang, Ni-Ka Ford, Konstantin Slavin
BACKGROUND: Full-thickness scalp defects pose a reconstructive problem, especially in the setting of infection, chemotherapy/radiation, and underlying cranial defects. Current options include dermal matrices, skin grafts, and local flaps. Local flaps often fail, requiring subsequent microvascular free flap reconstruction. OBJECTIVE: To describe the visor flap, a novel bipedicled advancement flap design, and its role in reconstruction of scalp defects. METHODS: A retrospective review of 21 adult patients who developed scalp defects reconstructed using the visor flap from 2013 to 2017...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29510289/-ethmoid-meningoencephalocele-in-a-patient-with-cerebrofacial-arteriovenous-metameric-syndrome-a-case-report
#3
Rodrigo Fernandez-Gajardo, Joao Paulo Almeida, Suganth Suppiah, Ian Witterick, Gelareh Zadeh
BACKGROUND: Skull base meningoencephaloceles are a rare condition, frequently secondary to traumatic or iatrogenic causes. Cerebrofacial arteriovenous metameric syndrome (CAMS) is characterized by the presence of retinal, facial and cerebral arteriovenous malformations (AVMs) with metameric distribution. To the best of our knowledge, this is the first reported case associating these two conditions. CASE DESCRIPTION: A 45 years old female previously diagnosed with CAMS type 2 presented with a long history of cerebrospinal fluid (CSF) rhinorrhea...
March 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29286998/endoscopic-repairs-of-sinonasal-cerebrospinal-leaks-outcome-and-prognostic-factors
#4
Xiaole Song, Dehui Wang, Xicai Sun, Quan Liu, Li Hu, Yurong Gu, Huankang Zhang
OBJECTIVE: The aim of this study was to review the management of sinonasal cerebrospinal fluid (CSF) leaks and outcome of endoscopic repairs and to provide experience regarding leaks at the lateral wall of sphenoid sinus and the posterior wall of frontal sinus. METHODS: Patients who underwent endoscopic repairs of CSF leaks were reviewed. Characteristics of different etiologies were compared, and prognostic factors were analyzed. RESULTS: The study included 144 patients with 150 CSF leaks, in which spontaneous leaks account for 55%...
January 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29283022/cns-injury-posttranslational-modification-of-the-tau-protein-as-a-biomarker
#5
Mitchell T Caprelli, Andrea J Mothe, Charles H Tator
The ideal biomarker for central nervous system (CNS) trauma in patients would be a molecular marker specific for injured nervous tissue that would provide a consistent and reliable assessment of the presence and severity of injury and the prognosis for recovery. One candidate biomarker is the protein tau, a microtubule-associated protein abundant in the axonal compartment of CNS neurons. Following axonal injury, tau becomes modified primarily by hyperphosphorylation of its various amino acid residues and cleavage into smaller fragments...
November 1, 2017: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
https://www.readbyqxmd.com/read/29234230/traumatic-eye-ball-luxation-a-stepwise-approach-to-globe-salvage
#6
Himika Gupta, Srivalli Natarajan, Sushrut Vaidya, Shipra Gupta, Dinesh Shah, Raj Merchant, Shrikant Deshpande
Craniofacial trauma is often associated with orbital and ocular injuries. We report a case of a 21-year-old male with motor vehicular accident, orbital roof blow-in fracture, cerebrospinal fluid (CSF) leak, and left sided globe luxation with corneal abrasion and complete conjunctival denuding. The patient was managed by a multispeciality team and the eyeball was protected by amniotic membrane graft (AMG) biological dressing with novel use of inverted sterile metallic bowl as mechanical protection till the patient stabilized...
October 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28866068/treating-cerebrospinal-fluid-rhinorrhea-without-dura-repair-a-case-report-of-posterior-fossa-choroid-plexus-papilloma-and-review-of-the-literature
#7
REVIEW
François Lechanoine, Ilyess Zemmoura, Stéphane Velut
BACKGROUND: Choroid plexus papilloma revealed by nontraumatic cerebrospinal fluid (CSF) rhinorrhea has only been described 5 times, to our knowledge, in the literature. The challenges in this situation are to recognize CSF leak, to rapidly understand the pathophysiology of the leak, and to choose the best treatment strategy in emergency. We report an original case of posterior fossa choroid plexus papilloma revealed by CSF leak. We then discuss the surgical strategy and the pathophysiology of CSF leak, which is explained, in this case, by both hyperproduction of CSF and local skull base erosion...
December 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28744321/an-18-f-positron-emitting-fluorescent-cerebrospinal-fluid-probe-for-imaging-damage-to-the-brain-and-spine
#8
Harikrishna Kommidi, Hua Guo, Nandi Chen, Dohyun Kim, Bin He, Amy P Wu, Omer Aras, Richard Ting
Fluorescein is modified to bear 18 F so that it can act as both a positron emitter, and a fluorophore, allowing detection by positron emission tomography (PET), scintillation, and fluorescent imaging (FL). [18 F]- 2 is injected into the intrathecal space of rats and used to observe the cerebrospinal fluid (CSF) that bathes the brain and spine. Injury in three different applications is visualized with [18 F]- 2 : 1) detection of a 0.7 mm paranasal-sinus CSF leak (CSFL); 2) detection of 0.5 mm puncture damage to the thoracic spine (acute spinal cord injury); and 3) detection of intracerebral hemorrhage/edema because of traumatic brain injury...
2017: Theranostics
https://www.readbyqxmd.com/read/28481397/endoscopic-endonasal-cerebrospinal-fluid-leak-repair-on-the-ventral-midline-skull-base-a-single-neurosurgical-center-experience
#9
Cihan Isler, Merdin Lyutviev Ahmedov, Mehmet Yigit Akgun, Baris Kucukyuruk, Nurperi Gazioglu, Galip Zihni Sanus, Necmettin Tanriover
AIM: To present the results of endoscopic endonasal repair of ventral midline skull base cerebrospinal fluid (CSF) leak (VMSBL) at our institution and to discuss the technique and results from a neurosurgical perspective. MATERIAL AND METHODS: A retrospective analysis of all VMSBL cases that underwent endoscopic endonasal skull base approach (EESBA) for CSF leak repair at a single tertiary neurosurgical center was performed. Twenty six patients with an average age of 44...
2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28331772/an-automated-gravity-driven-csf-drainage-system-decreases-complications-and-lowers-costs
#10
Robert E Lieberson, Jan Eckermann, William Meyer, Tung Trang
BACKGROUND: FlowSafe(TM) (BeckerSmith Medical, Irvine, CA, USA) is a novel, robotic, external lumbar drainage (ELD) system, which was designed to control cerebrospinal fluid (CSF) drainage, reduce complications, and decrease treatment costs. METHODS:  Forty-seven consecutive neurosurgical patients requiring ELD were treated using the FlowSafe system. RESULTS: In 39 of 40 patients with traumatic and surgical dural openings, potential CSF leaks were avoided...
February 3, 2017: Curēus
https://www.readbyqxmd.com/read/28152490/traumatic-tension-pneumocephalus-two-case-reports
#11
Abubaker Al-Aieb, Ruben Peralta, Mohammad Ellabib, Ayman El-Menyar, Hassan Al-Thani
INTRODUCTION: Traumatic pneumocephalus rarely evolves into tension pneumocephalus. It can be devastating if not recognized and treated promptly. CASE PRESENTATION: We presented two cases of post-traumatic tension pneumocephalus. A 30- year old male pedestrian hit by a car presented with right frontal bone fracture extending to right frontal sinuses. He developed pneumocephalus involving all ventricles and subdural space and extending down to foramen magnum with tight basal cistern...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28124655/role-of-lumbar-drains-in-contemporary-endonasal-skull-base-surgery-meta-analysis-and-systematic-review
#12
REVIEW
Brian D'Anza, Duc Tien, Janalee K Stokken, Pablo F Recinos, Troy R Woodard, Raj Sindwani
BACKGROUND: Historically, lumbar drains (LD) have played a prominent role in endonasal skull base surgery. Over the past few decades, advancements in techniques have augmented our ability to successfully reconstruct complex skull base defects and often obviates the need for cerebrospinal fluid (CSF) diversion. Clarity on the appropriate use of LDs is needed. OBJECTIVE: To examine the literature for the need for LDs in contemporary skull base reconstruction after resection of skull base tumors...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28124654/outcomes-of-endoscopic-repair-of-cerebrospinal-fluid-rhinorrhea-without-lumbar-drains
#13
COMPARATIVE STUDY
Austin S Adams, Paul T Russell, James A Duncavage, Rakesh K Chandra, Justin H Turner
OBJECTIVE: Lumbar drains (LD) are commonly used during endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea, either to facilitate graft healing or to monitor CSF fluid dynamics. However, the indications and necessity of LD placement remains controversial. The current study sought to evaluate endoscopic CSF leak repair outcomes in the setting of limited LD use. METHODS: Patients who underwent endoscopic repair of CSF rhinorrhea between 2004 and 2014 were identified by a review of medical records...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/27989981/heterotopic-intracranial-skin-presenting-as-chronic-draining-sinus-after-remote-craniotomy
#14
Husain Al-Qattan, Joanna E Gernsback, Ajani G Nugent, Kirill A Lyapichev, Ricardo J Komotar, Harvey Chim
BACKGROUND: Craniotomies for trauma are associated with a significant risk of wound complications. We report a case in which a chronic nonhealing draining sinus was caused by an ectopic epidermal lining deep to the craniotomy bone flap, adherent to the underlying dura. CASE DESCRIPTION: A 61-year-old man was examined for a 3-year-old, nonhealing scalp wound resulting after a traumatic brain injury. His initial surgery consisted of an intracranial hematoma evacuation through a temporoparietal craniotomy; this was complicated by wound dehiscence and a chronic sinus draining clear fluid that did not resolve with antimicrobial therapy...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27846635/multilayered-closure-of-cerebrospinal-fluid-rhinorrhea-with-inlay-fascia-lata-autologous-fat-and-outlay-fascia-lata-our-experience
#15
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...
2016: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/27648399/treatment-of-temporal-bone-fractures
#16
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
#17
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
#18
REVIEW
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
#19
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
#20
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
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