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Cerebrospinal fluid leak

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https://www.readbyqxmd.com/read/28079571/spontaneous-intracranial-hypotension-with-site-of-leak-detected-only-after-111in-dtpa-cisternogram
#1
Sana Parsian, Manuela C Matesan, Sachin Shivaji Kumbhar, David H Lewis
A 54-year-old man with a 3-week history of orthostatic headache and acute on chronic subdural hematoma presented with imaging findings suggestive of spontaneous intracranial hypotension. Three myelograms were negative for leak, and nontargeted epidural blood patches did not result in symptom relief. A cerebrospinal fluid leak study using In-DTPA with SPECT/CT demonstrated a focal area of asymmetric activity at the left C2 nerve root. A left C2 root tie-off, targeted epidural blood patch, and Dura seal glue resulted in resolution of patient symptomatology highlighting the importance of fused SPECT/CT images in detection of an occult cerebral spinal fluid leak...
January 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28072740/keyhole-approach-in-the-neuroendoscopic-treatment-for-hydrocephalus
#2
Qiang Cai, Xiangyang Zhang, Long Wang, Shulan Huang, Zhibiao Chen, Qianxue Chen
The aim of the study was to explore keyhole approach and dura suture in the neuroendoscopic treatment for hydrocephalus.Twelve cases of hydrocephalus patients who were treated with neuroendoscope by this approach were analyzed retrospectively from April 2015 to April 2016 in our department. The basic steps of this procedure was using drill and milling cutter to form a small bone flap instead of burr hole, and then making a cruciate incision on the dura. After endoscopic third ventriculostomy or endoscopic third ventriculostomy + ventriculocystostomy finished, dura was sutured and the bone flap was reset...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072705/posterior-only-vertebral-column-resection-for-revision-surgery-in-post-laminectomy-rotokyphoscoliosis-associated-with-late-onset-paraplegia-a-case-report-and-literature-review
#3
Youping Tao, Jigong Wu, Huasong Ma
RATIONALE: Severe post-laminectomy spinal deformity associated with late-onset paraplegia is a complex and rare disorder. Little is known about revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia treated by the single stage posterior-only vertebral column resection (VCR) procedure. PATIENT CONCERNS AND DIAGNOSES: The patient was a 14-year-old male diagnosed as post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28059442/hydroxyapatite-cement-cranioplasty-following-translabyrinthine-approach-long-term-study-of-369-cases
#4
Peter G Volsky, Todd A Hillman, Kellen J Stromberg, Farrel J Buchinsky, Douglas A Chen, Neal M Jackson, Moisés A Arriaga
OBJECTIVE: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections. STUDY DESIGN: Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm)...
January 6, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28057591/surgical-management-of-spontaneous-spinal-cerebrospinal-fluid-epidural-fistula
#5
Declan G Siedler, Imogen M Ibbett, Nova B Thani
BACKGROUND: Intracranial hypotension secondary to spontaneous spinal cerebrospinal fluid (CSF) fistula is a rare condition which can have serious sequelae. Early diagnosis and treatment can be challenging. CASE DESCRIPTION: We present a case of a 17-year-old man who presented with a history of sudden onset, postural headaches, associated with upper thoracic back pain. Magnetic Resonance Imaging (MRI) demonstrated a thoracic extradural fluid collection and slumping of the brain within the posterior fossa...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28045630/outcomes-of-vestibular-schwannoma-surgery-among-the-elderly
#6
Michael J Sylvester, Darshan N Shastri, Viral M Patel, Milap D Raikundalia, Jean Anderson Eloy, Soly Baredes, Yu-Lan Mary Ying
Objective To compare comorbidities and in-hospital complications between elderly and nonelderly patients undergoing vestibular schwannoma (VS) surgery. To examine average length of stay (LOS) and hospital charges among elderly patients. Study Design Population-based inpatient registry analysis. Setting Academic medical center. Subjects and Methods Retrospective analysis of the National Inpatient Sample for patients undergoing VS surgery from 2002 to 2010: 4137 patients met inclusion criteria, with 519 (12.5%) in the elderly cohort (≥65 years)...
January 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28029524/-external-lumbar-drainage-with-volumetric-continuing-infusion-pump-in-patients-with-cerebrospinal-fluid-leak-a-case-series
#7
Ana Belén Manso Melgosa, Helena García Gutiérrez, Mónica Fernández Porras, Ana Berta Castrillo Manero, Belén Pérez Marijuán
OBJECTIVE: To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. METHODS: Retrospective descriptive case series study. POPULATION: patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP...
October 28, 2016: Enfermería Clínica
https://www.readbyqxmd.com/read/28017759/the-monro-kellie-doctrine-in-action-posterior-reversible-leukoencephalopathy-syndrome-pres-due-to-intracranial-hypotension-from-lumbo-peritoneal-shunt-placement
#8
Ioannis Karakis, Audrey H Nuccio, Jordan P Amadio, Arthur J Fountain
BACKGROUND: Posterior reversible leukoencephalopathy syndrome (PRES) is linked to various etiologies, foremost systemic hypertension. Its association with intracranial hypotension (IH), a potential sequela of various neurosurgical procedures, is under-recognized. We report a case of lumbo-peritoneal shunt induced IH resulting in PRES with the goal to increase awareness, and elaborate on the potential biological mechanism, based on the Monro-Kellie hypothesis. CASE DESCRIPTION: A 26-year-old woman with acquired immunodeficiency syndrome and epilepsy was admitted for recurrent cryptococcal meningitis and breakthrough seizures...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28008629/lower-airway-disease-and-pituitary-surgery-is-there-an-association-with-postoperative-cerebrospinal-fluid-leak
#9
Curtis Hanba, Peter F Svider, Jeffrey T Jacob, Murali Guthikonda, James K Liu, Jean Anderson Eloy, Adam J Folbe
OBJECTIVES/HYPOTHESIS: To explore the relationship between lower airway disease and postoperative cerebrospinal fluid (CSF) rhinorrhea among patients undergoing pituitary surgery STUDY DESIGN: Retrospective review. METHODS: A retrospective review of the Healthcare Cost and Utilization Project's 2013 National Inpatient Sample was conducted to characterize the hospital stay and surgical outcomes of patients undergoing pituitary surgery. Patients with lower airway disease (including chronic obstructive pulmonary disease and asthma) were compared to a disease-free population identifying demographics and complications over-represented in the lower airway group...
December 23, 2016: Laryngoscope
https://www.readbyqxmd.com/read/28005795/orbitocranial-fibrous-dysplasia-outcome-of-radical-resection-and-immediate-reconstruction-with-titanium-mesh-and-pericranial-flap
#10
Khalid Nasser Fadle, Ahmed Gaber Hassanein, Abdin K Kasim
INTRODUCTION: Fibrous dysplasia (FD) is a non-neoplastic developmental fibro-osseous disease. It represents 2.5% of all bone tumors and 5% to 7% of the benign bone tumors. Orbitocranial region is involved in about 20% of the patients. The main presentations are craniofacial deformity and headache. Loss of vision is the most devastating result of this disease. There is no medical treatment to cure or prevent FD. Radiation therapy is contraindicated. Surgery for the orbitocranial FD is often challenging because of the proximity of neurovascular and ocular structures...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27994364/idiopathic-intracranial-hypertension-with-spontaneous-cerebrospinal-fluid-leak-into-the-orbit
#11
Joe James, James Jose, V Abdul Gafoor
No abstract text is available yet for this article.
October 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27993737/bolstering-the-nasoseptal-flap-using-sphenoid-sinus-fat-packing-a-technical-case-report
#12
Hussam Abou-Al-Shaar, Hasan A Zaidi, David J Cote, Edward R Laws
BACKGROUND: Resection of extensive skull base lesions often necessitates relatively large dural openings and arachnoid, resulting in skull base defects with the potential for a post-operative cerebrospinal fluid (CSF) leak. A nasoseptal flap (NSF) is a vascularized graft which has greatly diminished the incidence of CSF leak. Annealing of flaps against the ventral skull base can be tenuous within the first few days after surgery. We report the use of sphenoid sinus fat packing as a buttress to support the nasoseptal flap during skull base reconstruction...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27989981/heterotopic-intracranial-skin-presenting-as-chronic-draining-sinus-after-remote-craniotomy
#13
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...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27965073/outcomes-of-endonasal-and-lateral-approaches-to-petroclival-meningiomas
#14
Maria Koutourousiou, Juan C Fernandez-Miranda, Francisco Vaz Guimaraes Filho, John R de Almeida, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECT: Transpetrosal approaches for the treatment of petroclival meningiomas are often associated with substantial morbidity and long recovery. With the goal of early clinical improvement, we have employed less invasive surgical approaches for petroclival meningiomas. METHODS: We retrospectively reviewed 32 patients with petroclival meningiomas. Eleven patients (34.4%) were managed with lateral approaches (retrosigmoid or far lateral approach), 17 (53.1%) with anterior midline approaches (endoscopic endonasal approach [EEA]) and 4 (12...
December 10, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27942920/traumatic-elevated-vertex-fracture-with-delayed-increase-in-intracranial-pressure-a-rare-case
#15
Uday Singh Raswan, Sarbjit Singh Chhiber, Altaf U Ramzan
INTRODUCTION: Skull fractures are traditionally classified into linear, comminuted or depressed which can either be simple or compound. A skull fracture where the bone fragment is elevated above the intact skull known as elevated skull fracture has been reported infrequently in literature. CASE PRESENTATION: We report a unique case of simple elevated vertex fracture in a 3-month-old child where the vertex had separated from the calvarium and was elevated above the level of outer table in a patient with delayed neurological deterioration...
December 9, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27935362/dramatic-radiographic-response-resulting-in-cerebrospinal-fluid-rhinorrhea-associated-with-sunitinib-therapy-in-recurrent-atypical-meningioma-case-report
#16
Amol Raheja, Howard Colman, Cheryl A Palmer, William T Couldwell
Sunitinib is a multiple tyrosine kinase inhibitor with antiangiogenic, cytostatic, and antimigratory activity for meningiomas. A recent clinical trial of sunitinib for treatment of recurrent Grade II and III meningiomas suggested potential efficacy in this population, but only 2 patients exhibited significant radiographic response with tumor volume reduction. The authors illustrate another such case and discuss a complication related to this dramatic tumor volume reduction in aggressive skull base meningiomas...
December 9, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27933634/middle-cranial-fossa-approach-to-repair-tegmen-defects-assisted-by-three-dimensionally-printed-temporal-bone-models
#17
Sameer Ahmed, Kyle K VanKoevering, Stephanie Kline, Glenn E Green, H Alexander Arts
OBJECTIVES/HYPOTHESIS: To explore the perioperative utility of three-dimensionally (3D)-printed temporal bone models of patients undergoing repair of lateral skull base defects and spontaneous cerebrospinal fluid leaks with the middle cranial fossa approach. STUDY DESIGN: Case series. METHODS: 3D-printed temporal bone models-based on patient-specific, high-resolution computed tomographic imaging-were constructed using inexpensive polymer materials...
December 9, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27932769/-correction-of-posttraumatic-thoracolumbar-kyphosis-with-modified-pedicle-subtraction-osteotomy
#18
Fei Chen, Yijun Kang, Bin Zhou, Zhehao Dai
To evaluate the efficacy and safety of modified pedicle subtraction osteotomy for treatment of thoracolumbar old fracture with kyphosis.
 Methods: From January 2003 to January 2013, 58 patients of thoracolumbar kyphosis, who underwent modified pedicle subtraction osteotomy, were reviewed. Among them, 45 cases underwent initial operation and 13 cases underwent revision surgery. Preoperative and postoperative kyphotic Cobb's angle, score of back pain, as well as the incidence of complication were accessed by using visual analogue scale (VAS) and Oswestry disability index (ODI)...
November 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/27929605/nasopharyngeal-airway-to-prevent-tension-pneumocephalus-after-open-resection-of-anterior-skull-base-tumors
#19
Matthew E Spector, Jon-Paul Pepper, Stephen Sullivan, Lawrence Marentette, Erin McKean
We conducted a retrospective study to assess the efficacy of using a nasopharyngeal airway in lieu of a tracheotomy or prolonged intubation for the diversion of airflow to prevent tension pneumocephalus after an open resection of anterior skull base tumors. Our study population was made up of 120 patients-74 males and 46 females, aged 12 to 84 years (mean: 48.7)-who had undergone an anterior skull base resection with documented nasopharyngeal airway placement from 1996 through 2009. Our main outcome measure was the presence of tension pneumocephalus while controlling for the placement of a lumbar drain, the development of a cerebrospinal fluid (CSF) leak, and the type of reconstruction...
December 2016: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/27918153/enlargement-of-meckel-s-cave-in-patients-with-spontaneous-cerebrospinal-fluid-leaks
#20
Geoffrey P Aaron, Elisa Illing, Zachary Lambertsen, Miles Ritter, Erik H Middlebrooks, Joel Cure, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks have imaging findings consistent with chronically elevated intracranial pressure, such as empty sella. Meckel's cave is a CSF-filled space that houses the trigeminal ganglion at the cranial base. Our objective in this study was to evaluate "dilated" Meckel's cave as a radiologic sign in patients with elevated intracranial pressure spontaneous CSF leaks and compare the dimensions with those from a control cohort. METHODS: Meckel's cave dimensions were measured in patients with spontaneous CSF leaks and documented elevated intracranial pressure...
December 5, 2016: International Forum of Allergy & Rhinology
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