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CSF rhinorrhea

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https://www.readbyqxmd.com/read/28887281/cerebrospinal-fluid-leak-rhinorrhea-after-systemic-erlotinib-chemotherapy-for-metastatic-lung-cancer-a-familiar-problem-from-an-unfamiliar-culprit
#1
Blake Priddy, Douglas A Hardesty, André Beer-Furlan, Bradley Otto, Daniel M Prevedello
BACKGROUND: Cerebrospinal fluid (CSF) rhinorrhea after medical therapy for pituitary prolactinoma is a rare but well-described phenomenon. To our knowledge, no CSF leaks have been reported after targeted medical treatment of pituitary or anterior skull base metastases. We report this unusual case to raise awareness of spontaneous CSF leaks in the setting of skull base metastatic disease. CASE PRESENTATION: A 66-year-old woman presented with EGFR-mutant Stage IV adenocarcinoma of the lung...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28875121/spontaneous-cerebrospinal-fluid-rhinorrhea-association-with-body-weight-and-imaging-data
#2
Raphaële Quatre, Arnaud Attye, Christian Adrien Righini, Emile Reyt, Joris Giai, Sébastien Schmerber, Alexandre Karkas
Objective  Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) might be the only clinical manifestation of idiopathic intracranial hypertension (IIH), which has been historically related to overweight. Our goal was to search for an association between SCSFR and increased body weight on the one hand and SCSFR and imaging findings suggestive of IIH on the other hand. Materials and Methods  We retrospectively collected clinical and radiological data of patients operated on endoscopically for SCSFR in our institution from 1993 to 2013...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28868197/combined-simultaneous-transcranial-and-endoscopic-endonasal-resection-of-sphenoorbital-meningioma-extending-into-the-sphenoid-sinus-pterygopalatine-fossa-and-infratemporal-fossa
#3
Masahide Matsuda, Hiroyoshi Akutsu, Shuho Tanaka, Akira Matsumura
BACKGROUND: Sphenoorbital meningiomas are surgically challenging because of their nature to extend to adjacent structures. Here, we describe a case of recurrent sphenoorbital meningioma extending into the sphenoid sinus, pterygopalatine fossa, and infratemporal fossa, which was resected using combined simultaneous transcranial and endoscopic endonasal approaches. CASE DESCRIPTION: A 62-year-old man who had 15 years earlier undergone partial resection of a left sphenoorbital meningioma presented with a 1-year history of progressive proptosis of the left eye...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28866068/treating-csf-rhinorrhea-without-dura-repair-a-case-report-of-posterior-fossa-choroid-plexus-papilloma
#4
François Lechanoine Resident, Ilyess Zemmoura, Stéphane Velut
BACKGROUND: Choroid plexus papilloma revealed by non traumatic cerebrospinal fluid (CSF) rhinorrhea had only been described five times 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...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28819362/recurrent-csf-rhinorrhea-misdiagnosed-as-chronic-allergic-rhinitis-with-subsequent-development-of-bacterial-meningitis
#5
Michael T Ulrich, Lawrence K Loo, Michael B Ing
INTRODUCTION: Cerebrospinal fluid (CSF) rhinorrhea results from an abnormal communication of the dura mater to the nasal mucosa. The majority of cases of CSF rhinorrhea are the result of trauma or surgery involving the skull base. Spontaneous CSF rhinorrhea is a rare clinical entity with increased risk of ascending infection. Delay in diagnosis places the patient at risk of developing meningitis. CASE PRESENTATION: A 36-year-old African American female with significant medical history of obesity and hypertension presented to the emergency department with headache, altered level of consciousness, fever, and neck stiffness...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28731403/safe-and-sustainable-the-extracranial-approach-toward-frontoethmoidal-meningoencephalocele-repair
#6
Paul I Heidekrueger, Myat Thu, Wolfgang Mühlbauer, Charlotte Holm-Mühlbauer, Philippe Schucht, Hans Anderl, Heinrich Schoeneich, Kyawzwa Aung, Mg Mg Ag, Ag Thu Soe Myint, Sabrina Juran, Thiha Aung, Denis Ehrl, Milomir Ninkovic, P Niclas Broer
OBJECTIVE Although rare, frontoethmoidal meningoencephaloceles continue to pose a challenge to neurosurgeons and plastic reconstructive surgeons. Especially when faced with limited infrastructure and resources, establishing reliable and safe surgical techniques is of paramount importance. The authors present a case series in order to evaluate a previously proposed concise approach for meningoencephalocele repair, with a focus on sustainability of internationally driven surgical efforts. METHODS Between 2001 and 2016, a total of 246 patients with frontoethmoidal meningoencephaloceles were treated using a 1-stage extracranial approach by a single surgeon in the Department of Neurosurgery of the Yangon General Hospital in Yangon, Myanmar, initially assisted by European surgeons...
July 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28717092/cerebrospinal-fluid-rhinorrhea-and-subsequent-bacterial-meningitis-due-to-an-atypical-clival-fracture
#7
Rie Tohge, Makio Takahashi
Cases of cerebrospinal fluid (CSF) rhinorrhea due to clival fracture are rare. We present a case of bacterial meningitis with CSF rhinorrhea after a clival fracture. Heavily T2-weighted images showed a bone flap in the thinned clivus and fluid collection in the sphenoid sinus. CSF rhinorrhea developed at 1 month after mild trauma. The fracture may have been caused by the trauma and/or by the pressure gradient between the intracranial CSF space and the sphenoid sinus. A detailed history to identify trauma and an examination to detect bone defects in the skull base are necessary when patients present with bacterial meningitis and persistent rhinorrhea...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28711543/clival-defect-with-primary-csf-rhinorrhea-a-very-rare-presentation-with-challenging-management
#8
Sheikh Asad, Jens Peters-Willke, Warwick Brennan, Saima Asad
BACKGROUND: Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea due to clival defect is an extremely rare presentation, and only 6 cases have been reported in the literature so far(17). CASE DESCRIPTION: We present a unique case of a 64-year-old woman who presented with a 2-year history of ongoing CSF rhinorrhea. She had similar episode at the age of 40 years and suffered from meningitis. She underwent magnetic resonance imaging, computed tomography cisternogram, as well as computed tomography of the brain, which showed clival defect with CSF leak into the sphenoid sinus...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28702154/a-case-report-on-late-presentation-of-occult-dural-lesions
#9
Timothy J Cochrane, Gurpreet Singh Ranger
BACKGROUND: Occult dural injuries are rare and can occur as a result of major or minor head injury. These injuries usually manifest with cerebrospinal fluid rhinorrhea alone, or with meningitis and cerebral abscess, sometimes many years after the original injury. CASE PRESENTATION: We present a case of occult dural injury with endocranial complications which occurred in a 34 year old man, with a history of head injury forty-three years ago. The patient presented with a triad of findings; meningitis, CSF rhinorrhoea and pneumocephalus...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28625940/prodromal-stage-of-disease-dementia-with-lewy-bodies-how-to-diagnose-in-practice
#10
Frédéric Blanc, Marc Verny
Disease with Lewy bodies or dementia with Lewy bodies (DLB), particularly at the prodromal stage, is a complex disease to diagnose because of different clinical beginnings and variable paths in terms of clinical expression. Thus DLB can be entcountered in different input modes: mild cognitive impairment, depression, acute behavioral disorders, confusion and delirium, or sleep disorders. In the aim to better diagnose the disease, should be sought obviously to search for the key symptoms: fluctuations, hallucinations, extra-pyramidal syndrome, and REM sleep behavior disorder...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28583494/spontaneous-csf-rhinorrhea-from-the-trigeminal-canal-in-an-adolescent
#11
Jonathan C Simmonds, Andrew R Scott
We report a case of a seventeen-year old, healthy, non-obese young woman who presented with retro-orbital headaches and metallictasting, left-sided rhinorrhea. Computed tomography revealed a defect along the medial wall of the canal of V2 within a well-pneumatized lateral recess of the left sphenoid sinus. Prior imaging obtained 4 years earlier in the context of nasal trauma showed no such defect - thus lending support for the arachnoid granulation hypothesis of spontaneous CSF leaks from the sphenoid sinus...
July 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28524124/-endoscopic-endonasal-diagnosis-and-treatment-of-skull-base-meningoencephalocele
#12
D N Kapitanov, E V Shelesko, A A Potapov, A D Kravchuk, D N Zinkevich, M V Nersesyan, L A Satanin, A V Sakharov, G V Danilov
PURPOSE: The study purpose was to determine the successful outcome rate of endoscopic endonasal reconstruction of skull base CSF fistulas with removal of meningocele as well as analyze disease relapses. The second purpose of the study was to describe the treatment outcomes, depending on the type, location, and size of meningocele as well as on a technique used to reconstruct the skull base defect. MATERIAL AND METHODS: Three hundred and eleven patients diagnosed with cerebrospinal fluid (CSF) rhinorrhea who underwent surgery at the Burdenko Neurosurgical Institute in the period between 2007 and 2014 were retrospectively analyzed...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28512741/intervention-for-elevated-intracranial-pressure-improves-success-rate-after-repair-of-spontaneous-cerebrospinal-fluid-leaks
#13
REVIEW
William Teachey, Jessica Grayson, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
OBJECTIVES/HYPOTHESIS: Spontaneous cerebrospinal fluid (CSF) leaks are associated with increased intracranial pressure (ICP) and considered a manifestation of idiopathic intracranial hypertension. Although postoperative acetazolamide and placement of CSF shunt systems are considered valuable interventions for elevated ICP, the impact on recurrence rate remains unclear. The objective of this study was to systematically review evidence from reported literature to evaluate whether postoperative ICP management reduces recurrence rates after primary endoscopic repair...
September 2017: Laryngoscope
https://www.readbyqxmd.com/read/28511421/surgical-outcome-of-epicanthus-and-telecanthus-correction-by-double-z-plasty-and-trans-nasal-fixation-with-prolene-suture-in-blepharophimosis-syndrome
#14
Salil Kumar Mandal, Aparna Mandal, James Christian Fleming, Tara Goecks, Andrew Meador, Brian T Fowler
INTRODUCTION: Blepharophimosis Syndrome (BPES) is a complex and rare disease characterized by epicanthus inversus, telecanthus, lateral ectropion, narrowed or shortened inter-palpebral fissure distance and ptosis. It is mostly bilateral and may or may not be symmetrical. It is typically inherited as an autosomal dominant trait. In sporadic cases, the disease may occur without a prior family history as a genetic mutation from a deletion or translocation of the FOXL2 gene, which maps to chromosome 3q23...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28484567/clival-defect-causing-primary-spontaneous-rhinorrhea
#15
Vivek Tandon, Kanwaljeet Garg, Ashish Suri, Ajay Garg
Primary cerebrospinal fluid (CSF) rhinorrhea due to a defect in clivus is an extremely rare entity, till date only four such cases are reported in the world literature. We present a case of 55-year-old female who presented with primary spontaneous CSF rhinorrhea, for which endonasal surgery was performed about 9 years back. Patient developed recurrent CSF leak with a history of meningitis. Repeat imaging showed clival defect causing CSF leak. Transsphenoidal repair was performed under neuronavigation. In this paper, we discuss the possible mechanism of fistula formation and literature is reviewed...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28452710/excavating-meningoencephaloceles-a-newly-recognized-entity
#16
Patricia A Loftus, Sarah K Wise, Pedram Daraei, Kristen Baugnon, John M DelGaudio
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks are largely attributed to idiopathic intracranial hypertension and typically present as skull base defects with or without prolapse of intracranial contents. However, in our practice, we have encountered a distinct type of spontaneous CSF leak that presents in a different manner. OBJECTIVE: To discuss a newly-classified, difficult to treat, subset of spontaneous CSF leaks that present as excavation of the bone of the skull base in a tunnel- or canal-like fashion by a meningocele or meningoencephalocele instead of as a localized area of bony dehiscence...
March 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28413552/trigeminocardiac-reflex-preceding-development-of-postoperative-superior-orbital-fissure-syndrome
#17
Rudrashish Haldar, Prakhar Gyanesh, Arun Srivastava, Guru Prasad Bettaswamy
The superior orbital fissure syndrome (SOFS) is a rare condition presenting as painful unilateral opthalmoplegia, ptosis, pupillary dilatation and anesthesia of the upper eyelid and forehead. It has been described after facial trauma. Other etiologies include infections, tumors or spontaneous hemorrhages in the retro-orbital space. Occurrence of SOFS after surgery in the skull base has not been described before. We recently encountered a case where a young female developed SOFS following surgery for cerebrospinal fluid (CSF) rhinorrhea...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28410953/spontaneous-cerebrospinal-fluid-fistula-in-the-clivus
#18
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/28321378/hemi-transseptal-approach-for-pituitary-surgery-a-follow-up-study
#19
Naif Fnais, Salvatore Di Maio, Susan Edionwe, Anthony Zeitouni, Denis Sirhan, Constanza J Valdes, Marc A Tewfik
Objectives The hemi-transseptal (Hemi-T) approach was developed to overcome the potential drawbacks of the nasoseptal flap (NSF) in endoscopic endonasal transsphenoidal skull base surgery. In this study, we describe further refinements on the Hemi-T approach, and report long-term outcomes as compared with traditional methods of skull base reconstruction. Design A retrospective case-control study. Setting Montreal Neurological Institute and Jewish General Hospital, Montreal, Canada. Participants Patients who underwent endoscopic endonasal transsphenoidal approach to skull base pathology...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28229571/trans-nasal-trans-sphenoidal-brain-injury-by-a-fencing-foil-an-unusual-case-report-and-brief-literature-review
#20
Rafet Özay, Mehmet S Balkan, Çağhan Tönge, Zeki Şekerci
In this report, the authors present an unusual case of a 10-year-old child who suffered a severe headache and rhinorrhea that occurred as a result of fencing foil sports injury via trans-nasal-trans-sphenoidal (TNTS) pathway. Following trauma, the child had shown neurological symptoms such a pupil dilatation, change in consciousness and mild hemiparesia. Imaging demonstrated destruction of bone structures including posterior wall of sphenoid sinus and antero-superior part of sella turcica, and also a contusion at right thalamic region...
November 2017: Journal of Sports Medicine and Physical Fitness
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