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CSF rhinorrhea

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https://www.readbyqxmd.com/read/28413552/trigeminocardiac-reflex-preceding-development-of-postoperative-superior-orbital-fissure-syndrome
#1
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
#2
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
#3
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/transnasal-transsphenoidal-brain-injury-by-a-fencing-foil-an-unusual-case-report-and-brief-literature-review
#4
Rafet Özay, Mehmet S Balkan, Çağhan Tönge, Zeki Şekerci
BACKGROUND: 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 transnasal-transsphenoidal (TNTS) pathway. METHODS: Following to 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 anterosuperior part of sella turcica, and also a contusion at right thalamic region...
February 22, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28180038/an-analysis-of-patients-treated-for-cerebrospinal-fluid-rhinorrhea-in-the-united-states-from-2002-to-2010
#5
Emily Marchiano, Eric T Carniol, Daniel E Guzman, Milap D Raikundalia, Soly Baredes, Jean Anderson Eloy
Background The Nationwide Inpatient Sample (NIS) database was used to analyze the demographic features and concomitant diagnoses in patients admitted with cerebrospinal fluid (CSF) rhinorrhea. Methods We analyzed the NIS database for all hospital admissions of CSF rhinorrhea between 2002 and 2010. Patient demographics, length of stay, hospital charges, concomitant diagnoses, hospital level characteristics, and complications were analyzed for patients undergoing surgical repair (group I) and for those treated without surgical repair (group II)...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28175991/spontaneous-cerebrospinal-fluid-leaks-in-the-anterior-skull-base-secondary-to-idiopathic-intracranial-hypertension
#6
Gabriel Martínez-Capoccioni, Ramón Serramito-García, Maria Martín-Bailón, Alfredo García-Allut, Carlos Martín-Martín
Spontaneous cerebrospinal fluid (CSF) leaks represent a clinical entity in which CSF rhinorrhea occurs in the absence of any inciting event. Spontaneous CSF leaks are associated with elevated intracranial pressure (ICP) or have underlying idiopathic intracranial hypertension (IIH). We report a cohort of patients who have undergone nasal endoscopic repair for spontaneous CSF leaks. We review our perioperative complications and the effectiveness of the nasal endoscopic approach to repair spontaneous CSF leaks...
February 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28124654/outcomes-of-endoscopic-repair-of-cerebrospinal-fluid-rhinorrhea-without-lumbar-drains
#7
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/28089836/delayed-cerebrospinal-fluid-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#8
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate with the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy is exceedingly rare. METHODS: Retrospective chart review and review of the literature...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28059631/acute-necrotizing-encephalopathy-causing-human-bocavirus
#9
Ayse Betul Ergul, Umit Altug, Kursad Aydin, Ahmet Sami Guven, Yasemin Altuner Torun
Acute necrotizing encephalopathy is characterized by multiple, symmetrical lesions involving the thalamus, brainstem, cerebellum, and white matter and develops secondarily to viral infections. Influenza viruses are the most common etiological agents. Here, we present the first case of acute necrotizing encephalopathy to develop secondarily to human bocavirus. A 3-year-old girl presented with fever and altered mental status. She had had a fever, cough, and rhinorrhea for five days. The patient was admitted to the intensive care unit with an initial diagnosis of encephalitis when vomiting, convulsions, and loss of consciousness developed...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28008629/lower-airway-disease-and-pituitary-surgery-is-there-an-association-with-postoperative-cerebrospinal-fluid-leak
#10
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/27993737/bolstering-the-nasoseptal-flap-using-sphenoid-sinus-fat-packing-a-technical-case-report
#11
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 postoperative cerebrospinal fluid leak. A nasoseptal flap (NSF) is a vascularized graft that has greatly diminished the incidence of cerebrospinal fluid 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...
March 2017: World 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
#12
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/27890184/imaging-of-cerebrospinal-fluid-rhinorrhea-and-otorrhea
#13
REVIEW
Mahati Reddy, Kristen Baugnon
As the obesity epidemic grows in the United States, rhinorrhea and otorrhea from spontaneous cerebrospinal fluid (CSF) leaks secondary to untreated idiopathic intracranial hypertension are increasing in prevalence. CSF rhinorrhea and otorrhea should also be carefully evaluated in posttraumatic and postsurgical settings, because untreated CSF leaks often have serious consequences. The work-up, diagnosis, and characterization of a CSF leak can be complex, often requiring a multimodality approach to optimize surgical planning...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27846635/multilayered-closure-of-cerebrospinal-fluid-rhinorrhea-with-inlay-fascia-lata-autologous-fat-and-outlay-fascia-lata-our-experience
#14
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/27824967/asymmetric-radiotracer-activity-of-enlarged-cerebral-spinal-fluid-space-on-radionuclide-cisternography-with-spet-ct
#15
Julie C Bulman, Jason Wachsmann, Fangyu Peng
OBJECTIVE: Cerebrospinal fluid (CSF) leak is a well-known complication of skull or sinus surgery. Radionuclide cisternography has high sensitivity for detection of CSF leak, commonly performed in conjunction with radioactivity assay of nasal pledgets. Our objective was to highlight the usefulness of single photon emission tomography/computed tomography (SPET/CT) in radionuclide cisternography by presenting a case of a 41 years old man with right sided rhinorrhea following craniotomies and sinus surgery, who was subjected to radioactivity assay of nasal pledgets and radionuclide cisternography for suspected CSF leak...
September 2016: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/27773901/a-case-of-bacterial-meningitis-caused-by-methicillin-resistant-staphylococcus-lugdunensis-after-surgery
#16
Yasuhiro Sasaki, Ayumi Kanamaru, Hisae Uchida, Masataka Yano, Hiroshi Tada
An 51-year-old man had undergone surgery for Rathke's cleft cyst by transsphenoidal approach on October 2015. After the surgery, cerebrospinal fluid (CSF) rhinorrhea arose. Surgical treatment of CSF rhinorrhea was performed by the same approach. Ten days after reoperation, he suffered from severe headache, high fever, and nuchal rigidity. CSF findings indicated bacterial meningitis. CSF culture showed methicillin-resistant Staphylococcus lugdunensis. He received vancomycin intravenously for 19 days and recovered from the bacterial meningitis with no serious complication...
November 29, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27729302/unusual-association-between-spontaneous-lateral-sphenoid-encephalocele-and-chiari-malformation-type-i-endoscopic-repair-through-a-transpterygoid-approach
#17
Daniele Starnoni, Roy Thomas Daniel, Mercy George, Mahmoud Messerer
BACKGROUND: Spontaneous meningoencephaloceles of the lateral sphenoid sinus are rare entities, and their peculiar location represents a surgical challenge due to the importance of a wide exposure and skull base reconstruction. They are thought to arise from the congenital base defect of the lateral sphenoid or in some cases have been postulated to represent a rare manifestation of altered cerebrospinal fluid (CSF) dynamics. We report the first case in the literature of a Chiari malformation type I (CMI) and a lateral sphenoid encephalocele, revising the theoretic etiology and surgical technique of endoscopic repair...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27695551/sellar-repair-with-autologous-muscle-and-composite-septal-cartilage-grafts-for-treatment-of-cerebrospinal-fluid-leakage-following-trans-sphenoidal-pituitary-surgery
#18
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
https://www.readbyqxmd.com/read/27677601/efficacy-of-perioperative-lumbar-drainage-following-endonasal-endoscopic-cerebrospinal-fluid-leak-repair
#19
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)...
January 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27628270/outcomes-of-outpatient-endoscopic-repair-of-cerebrospinal-fluid-rhinorrhea
#20
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...
November 2016: International Forum of Allergy & Rhinology
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