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Cerebrospinal fluid leak

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https://www.readbyqxmd.com/read/28445308/clinical-value-of-radionuclide-shuntography-by-qualitative-methods-in-hydrocephalic-adult-patients-with-suspected-ventriculoperitoneal-shunt-malfunction
#1
Szu-Ying Tsai, Shan-Ying Wang, Yu-Chien Shiau, Lin-Hsue Yang, Yen-Wen Wu
To determine the clinical value of radionuclide shuntography in the evaluation of adult hydrocephalic patients with suspected ventriculoperitoneal (V-P) shunt malfunction. All adult patients who underwent Tc-99m diethylenetriamine pentaacetic acid shuntographic scans at Far Eastern Memorial Hospital between August 2005 and December 2015 were included. Shuntographic results were visually evaluated in a simple qualitative manner: prompt flow that reached the peritoneum on 30-minute early images and diffuse peritoneal tracer distribution on 2-hour delayed images were interpreted as nonobstructive shunt flow...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28437812/infection-rate-in-1033-elective-neurosurgical-procedures-at-a-university-hospital-in-south-china
#2
Hongwei Zhu, Xiyao Liu, Zhanxiang Wang
Objective Infection following surgery is a serious complication, especially in neurosurgery. The aim of the study is to report the change of incidence rates of infection in patients undergoing elective neurosurgical procedures at a university hospital in South China as well as the risk factors. Material and Methods The medical records and postoperative courses for patients undergoing 1,033 neurosurgical procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence of neurosurgical infection, the identity of the offending organisms, and the factors associated with infection...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28435930/spinal-subdural-hematoma-a-rare-case-of-spinal-subdural-hematoma-complicating-routine-minimally-invasive-lumbar-discectomy-and-decompression-and-relevant-literature-review
#3
Chelsea C Boe, Brett A Freedman, Ravi Kumar, Kendall Lee, Robert McDonald, John Port
We present a case of apparently uncomplicated lumbar decompression and discectomy with delayed postoperative neurological deterioration secondary to subdural hematoma at the thoracolumbar level of the spinal cord. Previously described subdural hematomas have occurred spontaneously or related to iatrogenic injury. Hitherto, no case of acute postoperative subdural hematoma has been reported in the postoperative setting in the absence of known iatrogenic dural injury. A 76-year-old male with central and lateral recess spinal stenosis underwent apparently uncomplicated bilateral L3-4 and left sided L4-5 decompressive partial laminectomies and discectomy...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28433849/clinical-significance-of-long-term-follow-up-of-children-with-posttraumatic-skull-base-fracture
#4
Sharon Leibu, Guy Rosenthal, Yigal Shoshan, Mony Benifla
BACKGROUND: To assess in children with skull base fractures, incidences of cerebrospinal fluid (CSF) leak, meningitis, and the need for prophylactic antibiotics, anti-pneumococcal vaccination, and surgical interventions. METHODS: We reviewed the records of children with skull base fractures who were admitted to our tertiary care center during 2009-2014. RESULTS: 196 children (153 male) were hospitalized with skull base fractures, aged 1 month to 18 years (mean 6 ± 4 years)...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28410953/spontaneous-cerebrospinal-fluid-fistula-in-the-clivus
#5
A Codina Aroca, J R Gras Cabrerizo, M De Juan Delago, H Massegur Solench
INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) fistulas are infrequent and only 10 cases in the literature have been located in the clivus. We describe two new cases of CSF fistulas in this site and review the literature. CASE REPORT: The first patient was a 52-year-old woman referred to our centre for intermittent rhinorrhea that had been diagnosed after an episode of meningitis. The second case was a 69-year-old man who was visited for rhinorrhea of one-year duration; he also developed meningitis during the preoperative study...
April 11, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28390811/hydroxyapatite-bone-cement-for-suboccipital-retrosigmoid-cranioplasty-a-single-institution-case-series
#6
Alexander L Luryi, Ketan R Bulsara, Elias M Michaelides
OBJECTIVE: To report rates of cerebrospinal fluid leak, wound infection, and other complications after repair of retrosigmoid craniotomy with hydroxyapatite bone cement. METHODS: Retrospective case review at tertiary referral center of patients who underwent retrosigmoid craniotomy from 2013 to 2016 with hydroxyapatite cement cranioplasty. OUTCOME MEASURES: Presence of absence of cerebrospinal fluid leak, wound infection, and other complications...
March 31, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28390712/safe-intrathecal-fluorescein-use-for-identification-of-cerebrospinal-fluid-leaks-case-report-and-perioperative-algorithm-description
#7
M Á Rodríguez-Navarro, C Díaz-Alejo, M L Padilla-Del Rey, A B Alcaraz, P González-Pérez, M Benítez
Intrathecal injection of fluorescein is a method for repairing cerebrospinal fluid fistulas. The most frequent surgical procedure is endonasal endoscopy and the purpose of injecting this dye is to locate the fistula. The anaesthesiologists usually perform the puncture, therefore it is necessary to review this method and to specify some anaesthetic considerations such as correct dosing, safe management protocols and medical-legal aspects. In this case-report we describe the pre, intra and postoperative protocol of action implemented in our department that basically consists of: obtaining a specific consent, prior neurological/ophthalmologic assessment to rule out hypertension and brain damage, use of corticosteroids and previous antihistamines, choosing the correct dose and concentration of intrathecal sodium fluorescein (maximum 1ml at a concentration of 5% diluted in 9ml of cerebrospinal fluid) and close intra and postoperative monitoring...
April 5, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28385420/less-is-more-efficacy-of-rapid-3d-t2-space-in-ed-patients-with-acute-atypical-low-back-pain
#8
Nicholas A Koontz, Richard H Wiggins, Megan K Mills, Michael S McLaughlin, Elaine C Pigman, Yoshimi Anzai, Lubdha M Shah
RATIONALE AND OBJECTIVES: Emergency department (ED) patients with acute low back pain (LBP) may present with ambiguous clinical findings that pose diagnostic challenges to exclude cauda equina syndrome (CES). As a proof of concept, we aimed to determine the efficacy of a rapid lumbar spine (LS) magnetic resonance imaging (MRI) screening protocol consisting of a single 3D-T2 SPACE FS (3D-T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution fat saturated) sequence relative to conventional LS MRI to exclude emergently treatable pathologies in this complex patient population...
April 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28377801/current-best-practice-in-the-management-of-patients-after-pituitary-surgery
#9
REVIEW
Alessandro Prete, Salvatore Maria Corsello, Roberto Salvatori
Sellar and parasellar masses are a common finding, and most of them are treated surgically via transsphenoidal approach. This type of surgery has revolutionized the approach to several hypothalamic-pituitary diseases and is usually effective, and well-tolerated by the patient. However, given the complex anatomy and high density of glandular, neurological and vascular structures in a confined space, transsphenoidal surgery harbors a substantial risk of complications. Hypopituitarism is one of the most frequent sequelae, with central adrenal insufficiency being the deficit that requires a timely diagnosis and treatment...
March 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28363328/cerebrospinal-fluid-cutaneous-fistula-following-obstetric-epidural-analgaesia-case-report
#10
J J Fedriani de Matos, A V Quintero Salvago, M D Gómez Cortés
Cutaneous fistula of cerebrospinal fluid is a rare complication of neuroaxial blockade. We report the case of a parturient in whom an epidural catheter was placed for labour analgesia and 12h after the catheter was removed, presented an abundant asymptomatic fluid leak from the puncture site, compatible in the cyto-chemical analysis with cerebrospinal fluid. She was treated with acetazolamide, compression of skin orifice of the fluid leakage, antibiotic prophylaxis, hydration and rest, and progressed satisfactorily without requiring blood patch...
March 28, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28357166/spontaneous-intracranial-hypotension-presenting-as-a-pseudo-chiari-1
#11
Ali S Haider, Suraj Sulhan, Ian T Watson, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Spontaneous intracranial hypotension (SIH) is classified as a decrease in cerebrospinal fluid (CSF) pressure secondary to a CSF leakage and consequent descent of the brain into the foramen magnum. Diagnosing SIH can be difficult due to its overlapping findings with Arnold-Chiari type 1 Malformation (CM1) where the cerebellar tonsils herniate into the foramen magnum. The similarity of both conditions calls for a more reliable imaging technique to localize the CSF leak which could narrow the differential diagnosis and aid in choosing the correct treatment...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28355333/intracranial-hypotension-secondary-to-spontaneous-spinal-cerebrospinal-fluid-leaks
#12
Antonio Eustáquio Silva, Patricia Pavan, Mariana Mari Oshima, Tânia Marchiori de Oliveira Cardoso, Fabiano Reis
No abstract text is available yet for this article.
March 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28349571/idiopathic-intracranial-hypertension-contemporary-review-and-implications-for-the-otolaryngologist
#13
Shawn M Stevens, Habib G Rizk, Karl Golnik, Norberto Andaluz, Ravi N Samy, Ted A Meyer, Paul R Lambert
OBJECTIVES: 1) Review controversies pertaining to the pathophysiology, diagnosis, and treatment of idiopathic intracranial hypertension. 2) Discuss the evolving role of otolaryngologists in managing this disease and related disorders. DATA SOURCES: Primary literature review, Centers for Disease Control and Prevention website, International Classification of Headache Disorders, Second Edition. METHODS: A comprehensive review of the primary literature was performed from 1990 to 2016 utilizing keywords idiopathic intracranial hypertension, pseudotumor cerebri, benign intracranial hypertension, spontaneous cerebrospinal fluid leak, and encephalocele...
March 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#14
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28336418/treatment-of-cerebrospinal-fluid-leak-after-spine-surgery
#15
REVIEW
Zhao Fang, Rong Tian, Yu-Tao Jia, Tian-Tong Xu, Yang Liu
Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid (CSF) leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows: 1) creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2) retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28331772/an-automated-gravity-driven-csf-drainage-system-decreases-complications-and-lowers-costs
#16
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/28327892/safety-and-efficacy-of-tachosil-absorbable-fibrin-sealant-patch-compared-with-current-practice-for-the-prevention-of-cerebrospinal-fluid-leaks-in-patients-undergoing-skull-base-surgery-a-randomized-controlled-trial
#17
Bernard George, Christian Matula, Lars Kihlström, Enrique Ferrer, Vilhelm Tetens
BACKGROUND: Cerebrospinal fluid (CSF) leakage associated with incomplete sealing of the dura mater is a major complication of intradural procedures. OBJECTIVE: To compare the efficacy and safety of adjunctive TachoSil (Takeda Pharma A/S, Roskilde, Denmark) with current practice for the prevention of postoperative CSF leaks in patients undergoing elective skull base surgery involving dura mater closure. METHODS: Patients were intraoperatively randomized to TachoSil or current practice immediately before primary dura closure by suturing ± duraplasty...
March 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28321383/direct-endonasal-approach-with-partial-upper-posterior-septectomy-a-rescue-flap-technique-modification
#18
Arturo Sotomayor-González, Armando José Díaz-Martínez, Ramón Radillo-Gil, Everardo García-Estrada, Jesús Alberto Morales-Gómez, Isaac Jair Palacios-Ortiz, Samuel Pérez-Cárdenas, Mauricio Arteaga-Treviño, Ángel Martínez-Ponce De León
Objective Report a modification of the "rescue flap" technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution. Design Prospective study. Setting Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León. Main Outcome Measures Since April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321377/single-layer-repair-of-large-anterior-skull-base-defects-without-vascularized-mucosal-flap
#19
Frederick Yoo, Marilene B Wang, Marvin Bergsneider, Jeffrey D Suh
Objectives Bilateral anterior skull base (ASB) defects following endoscopic endonasal tumor resection are most commonly repaired utilizing multilayered reconstruction with a vascularized mucosal flap. Single-layer closure of large ASB defects has been described in the literature but this technique has yet to gain a widespread use. We report our experience with a series of patients who underwent reconstruction of large ASB defects using a single-layer intradural graft, without nasoseptal flaps. We also compared the use of acellular dermal matrix (AlloDerm, LifeCell, Branchburg, New Jersey, United States) or collagen matrix xenograft (Duramatrix, Stryker, Kalamazoo, Michigan, United States) as the graft biomaterial...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321372/treatment-outcomes-of-rathke-s-cleft-cysts-managed-with-marsupialization
#20
Edward C Kuan, Frederick Yoo, Jennifer Chyu, Marvin Bergsneider, Marilene B Wang
Objectives Rathke's cleft cysts (RCC) are benign cystic lesions of the sella resulting from incomplete obliteration of Rathke's cleft. Symptomatic lesions often require surgical decompression, which is often amenable to a transnasal, transsphenoidal (TNTS) approach. We report our experience with marsupialization of RCC and describe a novel technique to promote re-epithelization of the cyst cavity. Design Retrospective review. Setting Tertiary academic medical center. Participants Patients who underwent TNTS for RCC between 2007 and 2015...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
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