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https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#1
Jan Schönberger, Markus Möhlenbruch, Angelika Seitz, Cornelia Bußmann, Heidi Bächli, Stefan Kölker
BACKGROUND: Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. CASE PRESENTATION: An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins...
February 20, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28214636/a-case-of-evolving-bilateral-sphenoidal-meningoencephalocoeles-case-report-and-review-of-literature
#2
Varun Aggarwal, Pankaj Shivhare, E R Jayadevan, Vinod Felix, Mathew Abraham, Suresh Nair, Prakash Nair
The evolution of sphenoid sinus meningoencephalocoeles and cerebrospinal fluid (CSF) rhinorrhoea is poorly understood. We present a case demonstrating the gradual evolution of encephalocoeles from both the lateral walls of a previously normal sphenoid sinus in a patient with dural arteriovenous fistula (DAVF), the CSF leak which developed following staged embolisation of the DAVF was managed by an endoscopic endonasal transpterygoid approach. Our findings suggest that over a period of time, chronic elevation of intracranial pressure (ICP) results in gradual erosion of the lateral wall of the sphenoid with development of meningoencephalocoeles and CSF leaks...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28187060/risk-factors-in-children-older-than-5-years-with-pneumococcal-meningitis-data-from-a-national-network
#3
Fanny Hénaff, Corinne Levy, Robert Cohen, Capucine Picard, Emmanuelle Varon, Christèle Gras Le Guen, Elise Launay
INTRODUCTION: The occurrence of meningitis in children > 5 years old may be associated with specific predisposing factors that can be anatomic, such as cerebrospinal fluid (CSF) fistula or breach, or related to genetic susceptibility or N inborn or acquired immunologic defect. This study aimed to assess the anatomical and immunologic risk factors in children > 5 years old with pneumococcal meningitis and prospectively enrolled in the French national meningitis network. METHODS: We analyzed all data for children 5 to 15 years old with a diagnosis of pneumococcal meningitis between 2001 and 2013...
December 13, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28162204/-evidence-based-clinical-practice-guidelines-for-the-treatment-of-dural-tears-and-the-consequent-cerebrospinal-fluid-leak-during-spine-surgery
#4
(no author information available yet)
Dural tears (DT) and the consequent cerebral spinal fluid (CSF) leak are not rare in spine surgeries. CSF leak can be troublesome, leading to pseudomeningocele, cutaneous CSF fistula, and meningitis. Revision surgery is unavoidable in some cases. The reported incidences of DT and CSF leak are different according to the various pathologies. Ossification of the posterior longitudinal ligament, revision spine surgery and multi-segment laminectomy have higher risks for DT. Various techniques have been described to manage this complication, such as bed rest, repair with dural substitutes, fibrin glue, gelatin sponge, lumbar drain, muscle flap, etc...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28133584/preservation-of-the-myofascial-cuff-during-posterior-fossa-surgery-to-reduce-the-rate-of-pseudomeningocele-formation-and-cerebrospinal-fluid-leak-a-technical-note
#5
Daniel R Felbaum, Kyle Mueller, Amjad Anaizi, Robert B Mason, Walter C Jean, Jean M Voyadzis
INTRODUCTION:  Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk. METHODS:  A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy...
December 28, 2016: Curēus
https://www.readbyqxmd.com/read/28121970/resorbable-mesh-cranioplasty-repair-of-bilateral-cerebrospinal-fluid-leaks-following-pediatric-simultaneous-bilateral-auditory-brainstem-implant-surgery
#6
Giacomo Colletti, Marco Mandalà, Vittorio Colletti, Alberto Deganello, Fabiana Allevi, Liliana Colletti
OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI...
April 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28121968/outcomes-of-the-suture-pull-through-technique-for-repair-of-lateral-skull-base-csf-fistula-and-encephaloceles
#7
Brendan P O'Connell, Jacob B Hunter, Alex D Sweeney, Reid C Thompson, Lola B Chambless, George B Wanna, Alejandro Rivas
OBJECTIVE: Describe the safety profile and surgical outcomes of a combined transmastoid-middle cranial fossa suture "pull-through" technique for repair of lateral skull base defects. STUDY DESIGN: Retrospective. SETTING: Tertiary care hospital. PATIENTS: Patients undergoing surgery for cerebrospinal fluid (CSF) fistula and/or encephalocele. INTERVENTION: Combined transmastoid and middle fossa approach using suture pull-through technique...
March 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28057591/surgical-management-of-spontaneous-spinal-cerebrospinal-fluid-epidural-fistula
#8
Declan G Siedler, Imogen M Ibbett, Nova B Thani
BACKGROUND: Intracranial hypotension secondary to spontaneous spinal cerebrospinal fluid (CSF) fistula is a rare condition that can have serious sequelae. Early diagnosis and treatment can be challenging. CASE DESCRIPTION: We present the case of a 17-year-old male 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...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27993742/immediate-titanium-mesh-implantation-for-patients-with-postcraniotomy-neurosurgical-site-infections-safe-and-aesthetic-alternative-procedure
#9
Gregory Ehrlich, Stefanie Kindling, Holger Wenz, Daniel Hänggi, Dirk Michael Schulte, Peter Schmiedek, Marcel Seiz-Rosenhagen
BACKGROUND: Surgical site infection (SSI) is one of the main complications after craniotomy. The incidence is up to 11% in the literature. The established procedure is debridement, removal of the bone flap, and delayed cranioplasty. Delayed cranioplasty has several disadvantages. A promising approach is the immediate titanium mesh implantation at the time of wound revision. We report our experience with this technique regarding outcome measured by reinfection rates and patient satisfaction...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27914156/-intratechal-chemotherapy-treatment-through-an-ommaya-reservoir-catheter-for-meningeal-carcinomatosis-a-single-centre-experience
#10
José Pedro Lavrador, Nuno Simas, Edson Oliveira, Manuel Herculano Carvalho
INTRODUCTION: Meningeal carcinomatosis is defined as tumour cells infiltration of leptomeninges and subarachnoid space. It is normally related with poor survival (2 - 5 months). The best multidisciplinary treatment for this condition is a matter of discussion. Patient's condition and the natural history of the disease should be considered in the decision making process. MATERIAL AND METHODS: Retrospective cohort analysis of patients submitted to Ommaya Reservoir placement due to systemic solid tumour meningeal carcinomatosis between 2006 and 2014...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27861828/postural-headaches-due-to-cerebrospinal-fluid-leakage-through-subarachnoid-pleural-fistula-a-case-report
#11
Sheng-Feng Lin, Hsing-Yu Weng
BACKGROUND: Postural headaches are commonly associated with spontaneous intracranial hypotension and cerebrospinal fluid (CSF) leakage from the spine. A subarachnoid-pleural fistula (SPF) is a very rare and serious type of CSF fistula that has mostly been reported following traumatic causes. CASE REPORT: Here, the case of a 36-year-old woman who suffered from postural headaches after chiropractic manipulation of her neck was reported. Brain and spinal magnetic resonance (MR) imaging showed brain sagging, a C7-T1 dural defect, and overt CSF leakage...
March 2017: Headache
https://www.readbyqxmd.com/read/27853662/postoperative-cerebrospinal-fluid-leak-rates-with-subfascial-epidural-drain-placement-after-intentional-durotomy-in-spine-surgery
#12
Tianyi Niu, Derek S Lu, Andrew Yew, Darryl Lau, Haydn Hoffman, David McArthur, Dean Chou, Daniel C Lu
Study Design Retrospective chart review. Objective Postoperative cerebrospinal fluid (CSF) leak is a known complication of intraoperative durotomy. Intraoperative placement of subfascial epidural drains following primary dural repair has been proposed as a potential management strategy to prevent formation of CSF cutaneous fistula and symptomatic pseudomeningocele. Here we describe our experience with subfascial drain after intentional durotomy. Methods Medical records of patients who underwent placement of subfascial epidural drains during spinal procedures with intentional intraoperative durotomies over a 4-year period at two institutions were retrospectively reviewed...
December 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27766486/evaluation-of-posterior-clinoid-process-pneumatization-by-multidetector-computed-tomography
#13
Veysel Burulday, Mehmet Hüseyin Akgül, Nuray Bayar Muluk, Mehmet Faik Ozveren, Ahmet Kaya
In the present study, we investigated the types and ratio of posterior clinoid process (PCP) pneumatization in paranasal sinus multidetector computed tomography (MDCT). Paranasal MDCT images of 541 subjects (227 males, 314 females), between 15 and 65 years old, were included into the study. Pneumatization of anterior clinoid process and pneumatization types (I, II, or III) were evaluated in the males and females. PCP pneumatization was detected in 20.7 % of the males and 11.5 % of the females. Right, left, and bilateral PCP pneumatizations were detected in 7...
October 21, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27738899/the-value-of-3d-fiesta-mri-in-detecting-non-iatrogenic-cerebrospinal-fluid-rhinorrhoea-correlations-with-endoscopic-endonasal-surgery
#14
Tao Xie, Wei Sun, Xiaobiao Zhang, Tengfei Liu, Hailing Ding, Fan Hu, Yong Yu, Ye Gu
BACKGROUND: In this study, we investigated the value of three-dimensional (3D) fast-imaging employing steady-state acquisition (FIESTA) magnetic resonance imaging (MRI) in detecting non-iatrogenic cerebrospinal fluid (CSF) rhinorrhoea and compared it with regular MRI and 3D magnetisation prepared rapid acquisition gradient echo (MPRAGE) MRI sequences, as well as high-resolution computed tomography (HRCT) imaging. We also present the endoscopic experiences of such cases. METHOD: From June 2011 to Feb 2016, 17 patients with non-iatrogenic cerebrospinal fluid rhinorrhoea were included...
December 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27666293/management-of-csf-leak-in-base-of-skull-fractures-in-adults
#15
REVIEW
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...
December 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27614217/sample-dependent-diagnostic-accuracy-of-prostaglandin-d-synthase-in-cerebrospinal-fluid-leak
#16
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...
January 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/27526247/recurrent-cranial-chronic-subdural-hematoma-due-to-cervical-cerebrospinal-fluid-fistula-repair-of-both-entities-in-the-same-session
#17
Akin Akakin, Baran Yilmaz, Murat Şakir Ekşi, Emel Ece Özcan-Ekşi, Mustafa Kemal Demir, Zafer Orkun Toktaş, Deniz Konya
Cranial chronic subdural hematoma (CSH) occurs secondary to trauma or just spontaneously. In this clinical report, the authors presented a 39-year-old male patient who was admitted with cranial CSH. In further assessment of the patient, the authors found an underlying cerebrospinal fluid (CSF) leak at the level of cervical spine. Following evacuation of the CSH, it recurred. In the second session, the hematoma was re-evacuated and the CSF fistula repaired. The CSH did not recur again. In young adult patients with recurrent CSH and prior presence of bilateral CSH, a survey for an underlying spinal CSF leak should be considered in the differential, especially in the background of trauma...
September 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27452970/basiespinal-cerebrospinal-fluid-leak-as-a-complication-after-adenoidectomy-case-report-and-literature-review
#18
Ramón Moreno-Luna, Eugenio Cárdenas Ruiz-Valdepeñas, José Ignacio Tato, Monica Rivero-Garvia, Javier Márquez-Rivas, Antonio Mochón Martín
BACKGROUND: Adenoidectomy is one of the most common procedures in the field of pediatric otolaryngology. Postoperative bleeding is one of the most frequent complications (0.4%). In turn, cerebrospinal fluid fistula is a very uncommon but critical complication in this type of surgery. METHODS: We report the case of a 3-year-old patient who underwent adenoidectomy and presented a cerebrospinal fluid leak associated with pneumocephalus and meningitis. RESULTS: The solution provided was a suture in layers of the fistula tract, reinforced with basipharyngeal vascularized and rotation random flap of mucosa, and a free graft of muscle, through a transoral endoscopic approach...
September 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27445081/-idiopathic-intracranial-hypertension-and-spontaneous-cerebrospinal-fluid-fistula-usefulness-of-intracranial-pressure-monitoring
#19
Angel Horcajadas Almansa, Ana Román Cutillas, Ana Jorques Infante, José Ruiz Gómez, Heriberto Busquier
Spontaneous cerebrospinal fluid (CSF) fistulas are rather common in daily practice. The aim of the surgical treatment is closure of the leak, but recurrences are quite frequent. The association between spontaneous CSF fistulas and idiopathic intracranial hypertension (IIH) is not uncommon, and this is probably the cause of the low rate of success of the surgical treatment. Symptoms of IIH associated with spontaneous CSF fistula are atypical, and diagnosis is often missed. Continuous intracranial pressure monitoring is very useful in the diagnosis of chronic IIH and in patients with spontaneous CSF fistula, as it helps in making decisions on the treatment of these patients...
July 18, 2016: Neurocirugía
https://www.readbyqxmd.com/read/27440149/a-classification-system-of-spontaneous-spinal-csf-leaks
#20
Wouter I Schievink, M Marcel Maya, Stacey Jean-Pierre, Miriam Nuño, Ravi S Prasad, Franklin G Moser
OBJECTIVE: Spontaneous spinal CSF leaks cause spontaneous intracranial hypotension but no systematic study of the different types of these CSF leaks has been reported. Based on our experience with spontaneous intracranial hypotension, we propose a classification system of spontaneous spinal CSF leaks. METHODS: We reviewed the medical records, radiographic studies, operative notes, and any intraoperative photographs of a group of consecutive patients with spontaneous intracranial hypotension...
August 16, 2016: Neurology
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