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https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#1
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#2
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/28254591/a-small-leak-will-sink-the-brain-targeted-c1-c2-patching
#3
Thomas Decramer, Pieter Jan Van Dyck-Lippens, Tom P Franken, Philippe Demaerel, Johannes van Loon, Tom Theys
BACKGROUND: Spontaneous intracranial hypotension (SIH) syndrome results from spontaneous spinal CSF leaks. The first treatment of choice consists of lumbar epidural blood patching. If this fails further imaging is mandatory to explore the possibility of targeted therapy. CASE DESCRIPTION: We describe a case of a 50-year old woman who developed spontaneous intracranial hypotension after minor blunt cervical trauma, complicated with bilateral subdural hematomas. Two lumbar epidural blood patches were unsuccessful...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28077908/magnetic-resonance-imaging-of-a-case-of-central-neurocytoma
#4
Kreshnike Dedushi, Serbeze Kabashi, Mehmet Sahin Ugurel, Naser Ramadani, Sefedin Mucaj, Kamber Zeqiraj
BACKGROUND: The purpose of this study is to investigate the MRI features of central neurocytoma. CASE REPORT: A 45 year old man with 3 months of worsening daily headaches. These headaches were diffuse, lasted for several hours, and mostly occurred in the morning. She was initially diagnosed and treated for migraines but later he had epileptic attack and diplopia and neurolog recomaded MRI. METHODS: precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D-Hi-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W and Flash/T2W oblique coronal plane (perpendicular to temporal lobes) GRE/T2W axial plane for detection of heme products...
December 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28057591/surgical-management-of-spontaneous-spinal-cerebrospinal-fluid-epidural-fistula
#5
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/28036062/an-unusual-case-of-post-traumatic-headache-complicated-by-intracranial-hypotension
#6
Sara Siavoshi, Carrie Dougherty, Jessica Ailani, Kaustubh Yadwadkar, Frank Berkowitz
We present a case of post-traumatic headache complicated by intracranial hypotension resulting in an acquired Chiari malformation and myelopathy with syringomyelia. This constellation of findings suggest a possible series of events that started with a traumatic cerebral spinal fluid (CSF) leak, followed by descent of the cerebellar tonsils and disruption of CSF circulation that caused spinal cord swelling and syrinx. This unusual presentation of post-traumatic headache highlights the varying presentations and the potential sequelae of intracranial hypotension...
December 29, 2016: Brain Sciences
https://www.readbyqxmd.com/read/27989981/heterotopic-intracranial-skin-presenting-as-chronic-draining-sinus-after-remote-craniotomy
#7
Husain Al-Qattan, Joanna E Gernsback, Ajani G Nugent, Kirill A Lyapichev, Ricardo J Komotar, Harvey Chim
BACKGROUND: Craniotomies for trauma are associated with a significant risk of wound complications. We report a case in which a chronic nonhealing draining sinus was caused by an ectopic epidermal lining deep to the craniotomy bone flap, adherent to the underlying dura. CASE DESCRIPTION: A 61-year-old man was examined for a 3-year-old, nonhealing scalp wound resulting after a traumatic brain injury. His initial surgery consisted of an intracranial hematoma evacuation through a temporoparietal craniotomy; this was complicated by wound dehiscence and a chronic sinus draining clear fluid that did not resolve with antimicrobial therapy...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27918153/enlargement-of-meckel-s-cave-in-patients-with-spontaneous-cerebrospinal-fluid-leaks
#8
Geoffrey P Aaron, Elisa Illing, Zachary Lambertsen, Miles Ritter, Erik H Middlebrooks, Joel Cure, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks have imaging findings consistent with chronically elevated intracranial pressure, such as empty sella. Meckel's cave is a CSF-filled space that houses the trigeminal ganglion at the cranial base. Our objective in this study was to evaluate "dilated" Meckel's cave as a radiologic sign in patients with elevated intracranial pressure spontaneous CSF leaks and compare the dimensions with those from a control cohort. METHODS: Meckel's cave dimensions were measured in patients with spontaneous CSF leaks and documented elevated intracranial pressure...
December 5, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27873293/supraorbital-keyhole-microsurgical-fenestration-of-symptomatic-temporal-arachnoid-cysts-in-children-advantages-and-limitations
#9
Sherif Elkheshin, Ahmed Soliman
AIM: To investigate the impact of endoscope assisted microsurgical fenestration of temporal arachnoid cysts, the advantages and limitations of the technique. MATERIAL AND METHODS: Retrospective study including twenty five children of symptomatic temporal arachnoid cysts operated via Eyebrow Supra-Orbital Keyhole Microsurgical Fenestration targeting medial cyst wall, Preoperative MRI brain was done for all patients. RESULTS: Preoperative, clinical presentation included headache (80%), nausea & vomiting (64%), drug resistant epilepsy (52%), macrocephaly (12%) papilledema (28%) motor weakness in the form of right sided hemiparesis (12%) and cranial nerve palsy...
October 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27809892/spontaneous-cerebrospinal-fluid-leak-of-the-sphenoid-sinus-mimicking-allergic-rhinitis-and-managed-successfully-by-a-ventriculoperitoneal-shunt-a-case-report
#10
Youssef Darouassi, Mohamed Mliha Touati, Mehdi Chihani, Ali Akhaddar, Haddou Ammar, Brahim Bouaity
BACKGROUND: Spontaneous cerebrospinal fluid leaks are rare but may lead to confusion with other diseases in patients without history of trauma. We report a rare case unusual for two reasons. First, our patient was put under antiallergic medication for months before the diagnosis of spontaneous cerebrospinal fluid leak of the sphenoid sinus. Second, our patient was managed successfully by a ventriculoperitoneal shunt. CASE PRESENTATION: Our patient was a nonobese 49-year-old Arab man without history of trauma or surgery who presented with rhinorrhea...
November 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27693247/value-of-targeted-epidural-blood-patch-and-management-of-subdural-hematoma-in-spontaneous-intracranial-hypotension-case-report-and-review-of-the-literature
#11
REVIEW
Leigh A Rettenmaier, Brian J Park, Marshall T Holland, Youssef J Hamade, Shuchita Garg, Rahul Rastogi, Chandan G Reddy
BACKGROUND: Spontaneous intracranial hypotension (SIH) is a more common than previously noted condition (1-2.5 per 50,000 persons) 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. METHODS: In this report, we discuss a 62-year-old woman who presented with a 5-week history of orthostatic headaches associated with nausea, emesis, and neck pain...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27660177/subarachnoid-hemorrhage-and-spinal-subdural-hematoma-due-to-acute-csf-hypotension
#12
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
https://www.readbyqxmd.com/read/27605479/-a-case-of-spontaneous-cerebrospinal-fluid-leak-associated-with-cervical-spondylosis
#13
Atsushi Arai, Hirohito Miyamoto, Ryoji Shiomi, Shotaro Tatsumi, Eiji Kohmura
Spontaneous cerebrospinal fluid leak and intracranial hypotension associated with cervical spondylosis have rarely been observed, and only a few cases are reported. A 69-year-old woman, previously treated for rectal and thyroid cancer, complained of a non-postural persistent headache. The patient regularly practiced aerobic exercise, but a month earlier she had started experiencing headache and neck pain while exercising. Computed tomography(CT)showed bilateral chronic subdural hematomas, and magnetic resonance imaging(MRI)revealed diffuse dural enhancement and tonsillar herniation...
September 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27586390/free-middle-turbinate-mucosal-graft-reconstruction-after-primary-endoscopic-endonasal-pituitary-surgery
#14
Samuel J C Fishpool, Anthony Amato-Watkins, Caroline Hayhurst
The objective is to assess whether free middle turbinate (FMT) graft reconstruction, after endoscopic endonasal pituitary surgery, combines an acceptably low post-operative cerebrospinal fluid (CSF) leak rate with acceptable rhinological morbidity. This study identified 50 patients who underwent endoscopic endonasal pituitary surgery by the senior author in our teaching hospital between May 2011 and June 2012. FMT graft reconstruction was used in 32 cases. 18 patients were judged pre-operatively as not suitable for FMT reconstruction according to a novel skull base reconstructive algorithm...
February 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27566748/diskogenic-microspurs-as-a-major-cause-of-intractable-spontaneous-intracranial-hypotension
#15
Jürgen Beck, Christian T Ulrich, Christian Fung, Jens Fichtner, Kathleen Seidel, Michael Fiechter, Kety Hsieh, Michael Murek, David Bervini, Niklaus Meier, Marie-Luise Mono, Pasquale Mordasini, Ekkehard Hewer, Werner J Z'Graggen, Jan Gralla, Andreas Raabe
OBJECTIVE: To visualize and treat spinal dural CSF leaks in all patients with intractable spontaneous intracranial hypotension (SIH) who underwent spinal microsurgical exploration. METHODS: Patients presenting between February 2013 and July 2015 were included in this consecutive case series. The workup included spinal MRI without and with intrathecal contrast, dynamic myelography, postmyelography CT, and microsurgical exploration. RESULTS: Of 69 consecutive patients, 15 had intractable symptoms...
September 20, 2016: Neurology
https://www.readbyqxmd.com/read/27557149/time-dependent-changes-in-dural-enhancement-associated-with-spontaneous-intracranial-hypotension
#16
Peter G Kranz, Timothy J Amrhein, Kingshuk Roy Choudhury, Teerath Peter Tanpitukpongse, Linda Gray
OBJECTIVE: The objective of our study was to determine whether the presence of individual imaging signs of spontaneous intracranial hypotension (SIH) is correlated with increasing duration of headache symptoms. Of particular interest is the relationship of symptom duration to dural enhancement because it is the most commonly identified imaging sign in patients with SIH. MATERIALS AND METHODS: Eighty-nine patients with SIH who underwent pretreatment brain MRI and total-spine CT myelography and whose medical record included data on the duration of clinical symptoms were included in this cross-sectional retrospective study...
December 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27512221/anterior-cervical-discectomy-and-fusion-for-noncontiguous-cervical-spondylotic-myelopathy
#17
Sun Qizhi, Li Peijia, Sun Lei, Chen Junsheng, Li Jianmin
BACKGROUND: Noncontiguous cervical spondylotic myelopathy (CSM) is a special degenerative disease because of the intermediate normal level or levels between supra and infraabnormal levels. Some controversy exists over the optimal procedure for two noncontiguous levels of CSM. The study was to evaluate the outcomes of the anterior cervical discectomy and fusion (ACDF) with zero-profile devices for two noncontiguous levels of CSM. MATERIALS AND METHODS: 17 consecutive patients with two noncontiguous levels of CSM operated between December 2009 and August 2012 were included in the study...
July 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27432666/myelography-modern-technique-and-indications
#18
REVIEW
Stuart R Pomerantz
Myelography describes the instillation of intrathecal contrast media for the imaging evaluation of spinal canal pathology. The technique has evolved with the use of progressively less toxic contrast agents over its 90-year history and the inclusion of advanced image acquisition technology, including both computed tomography (CT) and magnetic resonance imaging (MRI), in addition to plain radiographic projections. The use of myelography for routine evaluation of spinal disease has diminished greatly due to the advent of MRI which has superior soft-tissue contrast and is relatively non-invasive...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27406555/delayed-surgical-repair-of-cranial-burst-fracture-without-strict-dura-closure-a-prudent-choice-in-selected-patients
#19
Han-Song Sheng, Nu Zhang, Jian Lin, Fen-Chun Lin, Bo Yin, Mao-de Wang
OBJECTIVES: Surgical management of cranial burst fracture (CBF) usually involves craniotomy to remove the devitalized brain tissues, followed by watertight repair of dural tears. However, there were times when the dural tear was so extensive that a substantially large bone flap would have to be removed in order to expose the retracted dural margins before it could be repaired. In such cases, strict dural repair would incur a significantly higher risk of damages to the surrounding neural tissues and severe bleeding, especially when the fracture was in the vicinity of eloquent cortical areas and sinus...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27389328/posttraumatic-temporal-bone-meningocele-presenting-as-a-cystic-mass-in-the-external-auditory-canal
#20
Babak Alijani, Hamid Reza Bagheri, Shahrokh Yousefzadeh Chabok, Hamid Behzadnia, Siavash Dehghani
INTRODUCTION: Temporal bone meningoencephalic herniation may occur in head trauma. It is a rare condition with potentially dangerous complications. Several different routes for temporal bone meningoencephalocele have been proposed. CLINICAL REPORT: An11-year-old boy with history of head trauma initially presented with a 9-months history of progressive right-sided hearing loss and facial weakness. The other complaint was formation of a cystic mass in the right external auditory canal...
July 2016: Journal of Craniofacial Surgery
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