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Csf leakage

Chuan-Han Chen, Jeon-Hor Chen, Hung-Chieh Chen, Jyh-Wen Chai, Po-Lin Chen, Clayton Chi-Cheng Chen
BACKGROUND: Diagnosis of spontaneous intracranial hypotension (SIH) relies on the ability of medical staff to recognize cerebrospinal fluid (CSF) leakage at the spine. However, difficulties with interobserver discrepancy sometimes occurred while reading magnetic resonance myelography (MRM) because clear image definition was lacking. In this study, we tried to determine which pattern of CSF distribution is more reliable for diagnosis of CSF leakage by using MRM. METHODS: From January 2012 to August 2014, 19 SIH patients and 27 healthy controls (HC) were recruited into our study; 10 of the 19 patients were recovered (SIH-R) after treatment...
October 12, 2016: Journal of the Chinese Medical Association: JCMA
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...
October 13, 2016: Acta Neurochirurgica
Sayed Ali Ahmadi, Mostafa Jafari, Mohammad Reza Darabi, Ali Chehrei, Masoud Rezaei, Marjan Mirsalehi
BACKGROUND: Incomplete repair of the dura mater may result in numerous complications such as cerebrospinal fluid (CSF) leakage and meningitis. For this reason, accurate repair of the dura mater is essential. In this study, the effect of systemic and local supplementation of L- arginine on dural healing was evaluated. METHOD: 30 male Wistar rats were utilized and divided into control, local and systemic L-arginine groups with ten rats in each. In each group, a 5 mm experimental incision was performed at the lumbar segment of the dura mater and CSF leakage was induced...
October 4, 2016: World Neurosurgery
Giridhar Murlidharan, Andrew Crowther, Rebecca A Reardon, Juan Song, Aravind Asokan
Adeno-associated viruses (AAV) are currently being evaluated in clinical trials for gene therapy of CNS disorders. However, host factors that influence the spread, clearance, and transduction efficiency of AAV vectors in the brain are not well understood. Recent studies have demonstrated that fluid flow mediated by aquaporin-4 (AQP4) channels located on astroglial end feet is essential for exchange of solutes between interstitial and cerebrospinal fluid. This phenomenon, which is essential for interstitial clearance of solutes from the CNS, has been termed glial-associated lymphatic transport or glymphatic transport...
September 8, 2016: JCI Insight
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
Danica Grujicic, Luigi Maria Cavallo, Teresa Somma, Rosanda Illic, Mihailo Milicevic, Savo Raicevic, Milica Skender Gazibara, Alessandro Villa, Dragan Savic, Domenico Solari, Paolo Cappabianca
BACKGROUND: Primary intraventricular meningiomas (IVMs) make up 0.5-5% of all intracranial meningiomas and represent one of the most challenging lesions in neurosurgery. METHODS: Between 1990 and 2013, 42 patients (30 female, 12 male, mean age of 43.6 years) underwent the resection of their IVM. The removal was performed by posterior-parietal approach in 19 of the 40 lateral ventricle tumors, and one in the third ventricle meningioma. The transcallosal approach was used for three meningiomas, while other lesions underwent temporal (7 cases) and temporo-parietal approaches (12 pts) respectively...
September 26, 2016: World Neurosurgery
Eugenio Cárdenas Ruiz-Valdepeñas, Ariel Kaen, Gustavo Perez Prat
BACKGROUND: Total hypophysectomy it is a classical procedure that currently has many indications especially in patients with Cushing syndrome without good endocrine control. Expanded endonasal endoscopic techniques grant us an alternative standpoint to the classic trans-sphenoidal microscopic approach and a comprehensive assessment of the process METHOD: The author provides technical nuances and describe step by step the radical endoscopic hypophysectomy. The study of cadaveric specimens adds clarifying dissections...
November 2016: Acta Neurochirurgica
Camille Planty, Corey P Mallett, Kevin Yim, Jorge C G Blanco, Marina Boukhvalova, Thomas March, Robbert van der Most, Eric Destexhe
An increased risk of narcolepsy following administration of an AS03-adjuvanted A(H1N1)pdm09 pandemic influenza vaccine (Pandemrix™) was described in children and adolescents in certain European countries. We investigated the potential effects of administration of the AS03-adjuvanted vaccine, non-adjuvanted vaccine antigen and AS03 Adjuvant System alone, on the central nervous system (CNS) in one-month-old cotton rats. Naïve or A(H1N1)pdm09 virus-primed animals received 2 or 3 intramuscular injections, respectively, of test article or saline at two-week intervals...
September 14, 2016: Human Vaccines & Immunotherapeutics
Peyman Petramfar, S Saeed Mohammadi, Farideh Hosseinzadeh
INTRODUCTION: The syndrome of spontaneous intracranial hypotension has been increasingly diagnosed since its discovery through magnetic resonance imaging (MRI). It is a rare syndrome that is due to the leakage of cerebrospinal fluid (CSF) from a tear in the dura and can occur at any age, even among adolescents, but is most frequently seen among females in late middle age. CASE PRESENTATION: Here, we describe a 32-year-old woman with a two-month history of headaches and occasional nausea and vomiting (N/V)...
June 2016: Iranian Red Crescent Medical Journal
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
R S Satter, S H Shantana, D S Asif, K Bhowmick, S S Gaddam
Extradural and epicranial pneumatocele is a rare condition. It may complicate with CSF rhinorrhoea and meningitis which can have a fatal outcome. We present a case of delayed post-operative extradural and epicranial pneumatocele in the frontal region following primary repair of the anterior skull base for a traumatic compound craniofacial injury with CSF leakage. There was no evidence of meningitis or raised ICP. As the patient was neurologically stable; he was managed conservatively and had a spontaneous resolution of the pneumatocele...
July 2016: Mymensingh Medical Journal: MMJ
Z Zhang, Y Nguyen, D De Seta, F Y Russo, A Rey, M Kalamarides, O Sterkers, D Bernardeschi
The management of sporadic vestibular schwannoma (VS) has evolved in the last decades. The aim of this study was to analyse the evolution in surgical outcomes of VSs operated by a neurotological team between 1990 and 2006 by different approaches. A monocentric retrospective review of medical charts of 1006 patients was performed. In order to assess eventual changes and progress, the 17-years period was divided in three periods, each one comprehending 268 VS (1990-1996), 299 VS (1997-2001), and 439 VS (2002-2006)...
September 6, 2016: Acta Otorhinolaryngologica Italica
Giannicola Iannella, Alessandra Manno, Emanuela Pasqualitto, Andrea Ciofalo, Diletta Angeletti, Benedetta Pasquariello, Giuseppe Magliulo
Cerebrospinal fluid (CSF) leakage of the temporal bone region is defined as abnormal communications between the subarachnoidal space and the air-containing spaces of the temporal bone. CSF leak remains one of the most frequent complications after VS surgery. Radiotherapy is considered a predisposing factor for development of temporal bone CSF leak because it may impair dural repair mechanisms, thus causing inadequate dural sealing. The authors describe the case of a 47-year-old man with a massive effusion of CSF which extended from the posterior and lateral skull base to the first cervical vertebrae; this complication appeared after a partial enucleation of a vestibular schwannoma (VS) with subsequent radiation treatment and second operation with total VS resection...
2016: Case Reports in Otolaryngology
Levent Tanrikulu, Michael Buchfelder, Ramin Naraghi
AIM: There is a feared complication for cerebrospinal fluid (CSF) leakage after microvascular decompression (MVD). In this study we present our experience of fleece-bound tissue sealing in MVD with our aim to minimize the rate of postoperative CSF leakage. MATERIAL AND METHODS: We treated 50 patients (female/male: 26/24) with neurovascular compression (NVC) syndromes (trigeminal neuralgia, hemifacial spasm and glossopharyngeal neuralgia) by MVD from the year 2003 to 2006...
April 20, 2016: Turkish Neurosurgery
Özden Erhan Sofuoğlu, Anas Abdallah, Erhan Emel, Ali Ender Ofluoğlu, Müslüm Güneş, Betül Güler
OBJECTIVE AND BACKGROUND: Tethered cord syndrome (TCS) in adults is rarely diagnosed as well as it is a complex clinicopathological entity that remains poorly understood. In this study, clinical outcomes of 23 consecutive congenital TCSs diagnosed in adults have been evaluated to establish a standard approach to treat congenital TCS diagnosed in adults. METHODS: Medical records were retrospectively reviewed in 73 cases of tethered cord syndrome whom underwent surgery in our hospital, between the years 2005 and 2014...
October 2, 2015: Turkish Neurosurgery
Ki-Su Park, Chang-Heon Lee, Seong-Hyun Park, Sung-Kyoo Hwang, Jeong-Hyun Hwang
AIM: The purpose of this study was to investigate whether the intensity of trauma influences the pathogenesis of traumatic chronic subdural hematoma (CSDH). MATERIAL AND METHODS: Thirty one patients, treated surgically for traumatic CSDH, were divided into high-impact and low-impact groups according to the intensity of trauma. They were respectively evaluated with respect to clinical and radiological findings at presentation, and the subdural concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), basic fibroblast growth factor, and beta-trace protein (βTP) [a highly specific protein in the cerebrospinal fluid (CSF)] related to the pathogenesis of CSDH...
September 21, 2015: Turkish Neurosurgery
Kazuhito Takeuchi, Tadashi Watanabe, Tetsuya Nagatani, Yuichi Nagata, Jonsu Chu, Toshihiko Wakabayashi
PURPOSE: The transsphenoidal approach (TSA) is regarded as the first line of treatment for sellar and suprasellar lesions. There are only few case reports of postoperative subdural hematoma after TSA and extended transsphenoidal approach (eTSA), and the detailed incidence and risk factors for this complication are still unknown. We reviewed the incidence and risk factors for subdural hematoma after TSA and eTSA. METHODS: Between January 1, 2013 and December 31, 2014, 165 consecutive patients underwent TSA or eTSA at Nagoya University Hospital and Nagoya Daini Red Cross Hospital...
September 3, 2016: Pituitary
Arash Shahangian, Zachary M Soler, Andrew Baker, Sarah K Wise, Shruthi K Rereddy, Zara M Patel, Nelson M Oyesiku, John M DelGaudio, Constantinos G Hadjipanayis, Bradford A Woodworth, Kristen O Riley, John Lee, Michael D Cusimano, Satish Govindaraj, Mohemmed N Khan, Alkis Psaltis, Peter J Wormald, Stephen Santoreneos, Raj Sindwani, Samuel Trosman, Janalee K Stokken, Troy D Woodard, Pablo F Recinos, W Alexander Vandergrift Iii, Caitlin Boling, Rodney J Schlosser
BACKGROUND: The impact of failed cerebrospinal fluid leak (CSF) leak repair in endoscopic skull base surgery has not been adequately studied. METHODS: In this investigation we reviewed patients who had undergone endoscopic skull base surgery between 2002 and 2014 at 7 international centers. Demographic variables, comorbidities, tumor characteristics, and repair techniques were evaluated to determine association with successful repair of CSF leak. Postoperative complications and length of stay were compared among groups...
August 31, 2016: International Forum of Allergy & Rhinology
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