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CSF leak

S Sellari-Franceschini, I Dallan, A Bajraktari, G Fiacchini, M Nardi, R Rocchi, C Marcocci, M Marinò, A P Casani
The objective of this study is to analyse the complications of orbital decompression in Graves' orbitopathy. The clinical records of 946 patients who had been operated on with orbital decompression for Graves' orbitopathy were reviewed and the intra- and post-operative complications with minimum follow-up of six months were analysed. An extensive review of the literature was carried out to compare results. In the case-series reported here the most frequent complications were: wasting of the temporal region (100%) in patients operated on using a coronal approach; permanent hypoesthesia of V2 (13%) and V1 (8%) in patients operated on with an upper eyelid incision...
August 2016: Acta Otorhinolaryngologica Italica
Jenny X Chen, Blake C Alkire, Allen C Lam, William T Curry, Eric H Holbrook
Objectives While bacterial meningitis is a concerning complication after endoscopic skull base surgery, the diagnosis can be made without consideration for aseptic meningitis. This article aims to (1) present a patient with recurrent craniopharyngioma and multiple postoperative episodes of aseptic meningitis and (2) discuss the diagnosis and management of aseptic meningitis. Design Case report and literature review. Results A 65-year-old female patient with a symptomatic craniopharyngioma underwent transsphenoidal resection...
October 2016: Journal of Neurological Surgery Reports
V Gellner, W Koele, A Wolf, C Gerstenberger, M Mokry, H Stammberger, P V Tomazic
No abstract text is available yet for this article.
October 3, 2016: Clinical Otolaryngology
Ayman A El Shazly, Mohammed A El Wardany, Tamer A Abo El Ezz
CONTEXT: Many reconstructive techniques have been proposed to prevent postoperative cerebrospinal fluid (CSF) leakage after trans-sphenoidal pituitary surgery. However, no total agreement has been reached to the best technique. AIM: Assessment of the efficacy of sellar repair with autologous muscle and composite septal cartilage grafts for treatment of intraoperative and delayed postoperative CSF leakage following trans-sphenoidal pituitary surgery without the use of postoperative external lumbar CSF drain...
October 2016: Asian Journal of Neurosurgery
Leigh A Rettenmaier, Brian J Park, Marshall T Holland, Youssef J Hamade, Shuchita Garg, Rahul Rastogi, Chandan G Reddy
Spontaneous intracranial hypotension (SIH) is a more common than previously noted condition (1-2.5 per 50,000) typically caused by cerebrospinal fluid (CSF) leakage. Initial treatment involves conservative therapies, but the mainstay of treatment for patients who fail conservative management is the epidural blood patch (EBP). Subdural hematoma (SDH) is a common complication occurring with SIH, but its management remains controversial. In this report, we discuss a 62-year-old female who presented with a 5-week history of orthostatic headaches associated with nausea, emesis, and neck pain...
September 27, 2016: World Neurosurgery
Kevin Phan, Ya Ruth Huo, Jarred A Hogan, Joshua Xu, Alexander Dunn, Samuel K Cho, Ralph J Mobbs, Patrick McKenna, Trichy Rajagopal, Farhaan Altaf
BACKGROUND: Minimally invasive approaches for the treatment of adult degenerative scoliosis have been increasingly implemented. However, little data exists regarding the safety and complication profiles of minimally invasive lumbar interbody fusion (LIF) for adult degenerative scoliosis. This study aimed to greater understand different minimally invasive surgical approaches for adult degenerative scoliosis with respect to clinical outcomes, changes in radiographic measurements, and complication profiles via meta-analytical techniques...
June 2016: J Spine Surg
Omar H Ahmed, Sonya Marcus, Jenna R Tauber, Binhuan Wang, Yixin Fang, Richard A Lebowitz
OBJECTIVE: Perioperative lumbar drain (LD) use in the setting of endoscopic cerebrospinal fluid (CSF) leak repair is a well-established practice. However, recent data suggest that LDs may not provide significant benefit and may thus confer unnecessary risk. To examine this, we conducted a meta-analysis to investigate the effect of LDs on postoperative CSF leak recurrence following endoscopic repair of CSF rhinorrhea. DATA SOURCES: A comprehensive search was performed with the following databases: Ovid MEDLINE (1947 to November 2015), EMBASE (1974 to November 2015), Cochrane Review, and PubMed (1990 to November 2015)...
September 27, 2016: Otolaryngology—Head and Neck Surgery
See Yung Phang, Kathrin Whitehouse, Lucy Lee, Hisham Khalil, Paul McArdle, Peter C Whitfield
AIMS: CSF leaks are not uncommon after a base of skull fracture. Currently there is no standardised algorithm for the investigation and management of post-traumatic CSF leaks. In this paper we aim to provide an evidence-based framework for managing post-traumatic CSF leaks. METHODS: We searched the English literature over the past 45 years using CINAHL, EMBASE and MEDLINE for the terms (1) post-traumatic CSF leaks or fistulas, and (2) basilar or base of skull fractures, but excluded papers on post-operative and non-traumatic CSF leaks, and papers on paediatric post- traumatic CSF leaks...
September 26, 2016: British Journal of Neurosurgery
M Kubik, S Lee, C Snyderman, E Wang
BACKGROUND: Skull base injury is an infrequent complication during endoscopic sinus surgery (ESS). We hypothesize that late recognition and repair of CSF leaks during ESS is associated with increased neurologic morbidity. METHODOLOGY: A retrospective review was performed of patients with skull base injury during ESS at a tertiary center from 1999-2015. The study population was separated into early (less than 72 hrs) and late (more than 72 hrs) intervention groups...
September 25, 2016: Rhinology
Ji Hwan Jang, Kyu Hong Kim, Young Min Lee, Joon Soo Kim, Young Zoon Kim
BACKGROUND: The aim of this study is to report the results of pure endoscopic endonasal transsphenoidal surgeries (EETSS) for pituitary adenomas (PAs) and to evaluate the efficacy and safety of this procedure. Additionally, we tried to determine the predicting factors for progression of PAs. METHODS: We reviewed the medical records of 331 consecutive patients who underwent pure EETSS of newly diagnosed PAs between April 1998 and December 2014. Demographic, endocrinological, and radiological features and their outcomes, complications, and hospital stay durations were retrospectively assessed in these patients...
September 20, 2016: World Neurosurgery
Christopher S Graffeo, Avital Perry, Eelco F M Wijdicks
BACKGROUND: Intracranial subarachnoid hemorrhage (SAH) and spinal subdural hematoma (SDH) are rare complications of spine surgery, thought to be precipitated by cerebrospinal fluid (CSF) hypotension in the setting of an intraoperative durotomy or postoperative CSF leak. Considerable clinical variability has been reported, requiring a high level of clinical suspicion in patients with a new, unexplained neurologic deficit after spine surgery. METHODS: Case report...
September 22, 2016: Neurocritical Care
Seong Ho Lee, Jae Sung Park, Young Hwan Ahn
OBJECTIVE: Microvascular decompression (MVD) for hemifacial spasm (HFS) involving the vertebral artery (VA) can be technically challenging. We investigated the therapeutic effects of a bioglue-coated Teflon sling technique on the VA during MVD in 42 cases. METHODS: A bioglue-coated Teflon sling was crafted by the surgeon and applied to patients in whom neurovascular compression was caused by the VA. The radiologic data, intra-operative findings with detailed introduction of the procedure, and the clinical outcomes of each patient were reviewed and analyzed...
September 2016: Journal of Korean Neurosurgical Society
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
Christopher Le, E Bradley Strong, Quang Luu
Cerebrospinal fluid (CSF) leak occurs from traumatic, iatrogenic, and idiopathic etiologies. Its timely diagnosis requires clinical, radiographic, and laboratory testing. Medical and surgical management can mitigate the risk of life-threatening infection and morbidity. This article outlines the pathophysiology, diagnosis, and management or CSF leak of the anterior skull base.
October 2016: Journal of Neurological Surgery. Part B, Skull Base
Rick F Nelson, Joseph P Roche, Bruce J Gantz, Marlan R Hansen
OBJECTIVE: To determine the efficacy and morbidity of repairing spontaneous cerebrospinal fluid (CSF) leaks with the middle cranial fossa (MCF) approach without the use of a lumbar drain (LD), as perioperative use of LD remains controversial. STUDY DESIGN: Retrospective review from 2003 to 2015. SETTING: University of Iowa Hospitals and Clinics and Indiana University Health Center. PATIENTS: Those with a confirmed lateral skull base spontaneous CSF leaks and/or encephaloceles...
September 14, 2016: Otology & Neurotology
Austin S Adams, David O Francis, Paul T Russell
BACKGROUND: Endoscopic repair of anterior skull-base defects has become the gold standard for management of cerebrospinal fluid (CSF) rhinorrhea. Both improved techniques and adjuvant therapies have led to accepted success rates of greater than 90%. As management has evolved, shorter hospitalizations have been required and the goal of this study is to analyze the outcomes of patients repaired on an outpatient basis vs those managed as inpatients postoperatively. METHODS: Patients undergoing endoscopic repair of CSF rhinorrhea between 2004 and 2014 were identified by review of medical records...
September 14, 2016: International Forum of Allergy & Rhinology
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Ki Hwan Jung, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, Yun Jin Kang, Sung Won Kim
OBJECTIVE: To describe the clinical features of invagination of the sphenoid sinus mucosa (ISM) and compare them with other similar cases using a visual analog scale (VAS) to assess the various nasal symptoms and to discuss its clinical significance and means of prevention. STUDY DESIGN: Retrospective chart review at a tertiary referral center. METHODS: Between 2010 and 2015, 8 patients who had undergone EETSA surgery displayed postoperative ISM...
2016: PloS One
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
Bernardo Drummond Braga, Sebastião Berquó Peleja, Guaracy Macedo, Carlos Roberto S A Drummond, Pollyana H V Costa, Marco T Garcia-Zapata, Marcelo Magaldi Oliveira
INTRODUCTION: Neurosurgery simulation has gained attention recently due to changes in the medical system. First-year neurosurgical residents in low-income countries usually perform their first craniotomy on a real subject. Development of high-fidelity, cheap, and largely available simulators is a challenge in residency training. An original model for the first steps of craniotomy with cerebrospinal fluid (CSF) leak avoidance practice using a coconut is described. MATERIAL AND METHODS: The coconut is a drupe from Cocos nucifera L...
September 6, 2016: World Neurosurgery
Kurren S Gill, David Hsu, Patrick Tassone, John Pluta, Gurston Nyquist, Howard Krein, Jurij Bilyk, Ann P Murchison, Alfred Iloreta, James J Evans, Ryan N Heffelfinger, Joseph M Curry
OBJECTIVES: To assess risk factors for cerebrospinal fluid (CSF) leak and complications after microvascular reconstruction of cranio-orbitofacial resection with orbital exenteration (CFOE). STUDY DESIGN: Retrospective case series. METHODS: Seventy consecutive patients at a tertiary hospital underwent 76 procedures with microvascular reconstruction of CFOE defects. Patients were stratified by extent of skull base exposure and presence or absence of dural resection...
September 7, 2016: Laryngoscope
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