2,831 results match your criteria Cerebrospinal Fluid Leak Imaging


Endoscopic Endonasal Reconstruction Using a Pedicled Middle Turbinate Flap for Spontaneous Cerebrospinal Fluid Rhinorrhea.

J Craniofac Surg 2022 May 30;33(3):e318-e320. Epub 2021 Sep 30.

Department of Neurosurgery, Keio university School of Medicine, Tokyo, Japan.

Abstract: Although endoscopic skull-base reconstruction protocols to reduce cerebrospinal fluid (CSF) leakage are reported, the most effective management strategies have not been determined. We describe the successful repair of a spontaneous CSF leak using a vascularized middle turbinate flap (MTF) via an endonasal endoscopic approach and also discuss the effective reconstruction with other available pedicled flaps. An 11-year-old girl had a 5-month history of intermittent CSF rhinorrhea. Read More

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Cerebrospinal fluid hypotension following fall in a child: Case report.

Neurocirugia (Astur : Engl Ed) 2022 Jul-Aug;33(4):195-198

Hospital Dona Estefânia, Centro Hospitalar Lisboa Central, Portugal.

CSF hypotension arises in the context of a leak of CSF which causes negative intracranial pressure. Sacral fractures result from high-energy trauma which are frequently underdiagnosed. A ten-year-old boy presented with hip pain, after a fall. Read More

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A Case of Pituitary Macroadenoma Presenting as Aseptic Meningitis.

S D Med 2022 Feb;75(2):88-90

University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.

Pituitary adenomas are a common brain tumor that are frequently asymptomatic but may initially present with vision deficits or very rarely as meningitis thought to be due to cerebrospinal fluid leakage. In this case report we discuss the initial presentation of a pituitary macroadenoma as aseptic meningitis, particularly in the absence of an identifiable cerebrospinal fluid leak. We also discuss the workup and diagnostic challenges associated with this atypical presentation, including findings on imaging and pertinent laboratory results. Read More

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February 2022

Association of Postoperative Sigmoid Sinus Occlusion and Cerebrospinal Fluid Leak in Translabyrinthine Surgery.

Otolaryngol Head Neck Surg 2022 Jun 7:1945998221102817. Epub 2022 Jun 7.

The Otology Group, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Objective: To characterize the incidence of sigmoid sinus occlusion (SSO) following translabyrinthine (TL) surgery for posterior fossa tumor resection and determine the association with cerebrospinal fluid (CSF) leak.

Study Design: Retrospective case series.

Setting: Tertiary referral center. Read More

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Efficacy of epidural blood patching or surgery in spontaneous intracranial hypotension: an evidence map protocol.

Syst Rev 2022 06 7;11(1):116. Epub 2022 Jun 7.

Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA.

Background: Spontaneous intracranial hypotension (SIH) is a debilitating disorder caused by non-iatrogenic spinal cerebrospinal fluid leaks. SIH is increasingly recognized as an important treatable cause of secondary headaches. Treatment involves either epidural blood patching or surgery, which have considerable differences in their adverse event rates, recovery times, and cost. Read More

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Spontaneous Cerebro-Spinal Fluid Rhinorrhoea Caused by Sustained Intracranial Hypertension.

Cureus 2022 Apr 24;14(4):e24441. Epub 2022 Apr 24.

Emergency Department, Hamad Medical Corporation, Doha, QAT.

Cerebrospinal Fluid (CSF) leakage results from a defect in the skull base, which communicates the subarachnoid space with the nasal cavity. The most common cause of CSF leakage is traumatic, and non-traumatic causes are less common. This case report illustrates a case of a woman who presented to the emergency department with clear fluid pouring from her nose for three weeks with a fever. Read More

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Frontal lobe position after single-layer cadaveric dermal matrix repair of large anterior skull base defects.

World J Otorhinolaryngol Head Neck Surg 2022 Mar 31;8(1):36-41. Epub 2022 Mar 31.

Rhinology & Skull Base Surgery, Department of Otolaryngology University of Miami Miller School of Medicine Miami Florida USA.

Objective: Endoscopic repair of large anterior skull base (ASB) defects has excellent results when using multilayered repairs with a nasoseptal flap. However, in extensive intranasal tumors, a nasoseptal flap may not always be available. One alternative option is a flexible single-layer ASB repair. Read More

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Transsphenoidal Surgery of Giant Pituitary Adenoma: Results and Experience of 239 Cases in A Single Center.

Front Endocrinol (Lausanne) 2022 6;13:879702. Epub 2022 May 6.

Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Background: Transsphenoidal surgery (TSS) is first-line treatment for giant pituitary adenomas (PAs). Although PA is a benign neuroendocrine tumor that originates from adenohypophysial cells, the surgical outcomes and prognosis of giant PAs differ significantly due to multiple factors such as tumor morphology, invasion site, pathological characteristics and so on. The aim of this study was to evaluate surgical outcomes of giant PAs in a single-center cohort. Read More

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The Role of Intra-Operative Duplex Ultrasonography Following Translabyrinthine Approach for Vestibular Schwannoma.

Front Surg 2022 28;9:853704. Epub 2022 Apr 28.

Division of Neurosurgery, House Institute, Los Angeles, California, United States.

Objective: Sigmoid sinus (SS) stenosis is a complication of translabyrinthine approach. Velocity changes in the SS measured by intra-operative doppler ultrasound may help in identifying patients at risk for sinus occlusion.

Patients: SS velocity was measured using doppler ultrasound prior to opening dura and again prior to placement of the abdominal fat graft. Read More

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A case of spontaneous intracranial hypotension in a 45-year-old male with headache, behavior changes and altered mental status.

Radiol Case Rep 2022 Jul 4;17(7):2289-2294. Epub 2022 May 4.

Harlem Hospital Center/Columbia University Irving Medical Center, 506 Lenox Ave, New York, NY 10037, USA.

Spontaneous intracranial hypotension is a rare disease that results from low cerebrospinal fluid (CSF) volume caused by leakage of CSF from the spine in the absence of lumbar puncture, spine surgery, or intervention. The most common presentation is the headache that is usually but not invariably orthostatic. The underlying pathology is a CSF leak resulting from dural weakness involving the nerve root sleeves, ventral dural tears associated with calcified disc herniations, or CSF venous fistula. Read More

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ACR Appropriateness Criteria® Sinonasal Disease: 2021 Update.

J Am Coll Radiol 2022 05;19(5S):S175-S193

Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia.

This article presents guidelines for initial imaging utilization in patients presenting with sinonasal disease, including acute rhinosinusitis without and with suspected orbital and intracranial complications, chronic rhinosinusitis, suspected invasive fungal sinusitis, suspected sinonasal mass, and suspected cerebrospinal fluid leak. CT and MRI are the primary imaging modalities used to evaluate patients with sinonasal disease. Given its detailed depiction of bony anatomy, CT can accurately demonstrate the presence of sinonasal disease, bony erosions, and anatomic variants, and is essential for surgical planning. Read More

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Case of spontaneous intracranial hypotension: clinical, neuroimaging and treatment approach.

BMJ Case Rep 2022 May 10;15(5). Epub 2022 May 10.

Neurology, All India Institute of Medical Sciences, New Delhi, India.

A woman in her 40s presented with a 3-month history of intermittent bilateral daily headache of moderate intensity. She had severe headaches for almost 1 month prior to the presentation, which was aggravated by standing and relieved by lying down. She underwent a non-contrast CT of the head followed by MRI of the brain and spine. Read More

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Surgical Repair of Skull Base CSF Leaks after Cisternography Diagnosis: Analysis of Validity and Surgical Outcome and Impact on Future Treatment Strategies.

Biomed Res Int 2022 29;2022:8740352. Epub 2022 Apr 29.

Department of Neurosurgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany.

Skull base cerebrospinal fluid (CSF) leaks can lead to severe complications and require appropriate diagnosis and treatment. Cisternography is applied when exact localization via conventional imaging is not successful. The present study is aimed at identifying factors with potential impact on radiological results and surgical success. Read More

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Clinical risk factors associated with cerebrospinal fluid leak in facial trauma: A retrospective analysis.

Clin Neurol Neurosurg 2022 06 2;217:107276. Epub 2022 May 2.

University of Florida College of Medicine, Gainesville, FL, USA; Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA.

Objective: Cerebrospinal fluid (CSF) leak occurs most commonly following skull fracture, with a CSF leakage complicating up to 2% of all head traumas. This study aims to identify demographic and injury characteristics correlated with the highest risk of CSF leak in patients with known facial fractures.

Methods: Retrospective data was collected from a previously described trauma registry from 2010 to 2019. Read More

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O-Arm Navigated Cervical Pedicle Screw Fixation in the Treatment of Lower Cervical Fracture-Dislocation.

Orthop Surg 2022 Jun 7;14(6):1135-1142. Epub 2022 May 7.

Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

Objective: To evaluate the safety and efficacy of cervical pedicle screw (CPS) placement with O-arm navigation in the treatment of lower cervical fracture-dislocation.

Methods: A retrospective clinical study was performed involving 42 consecutive patients with lower cervical spine fracture-dislocation who underwent CPS fixation surgery with O-arm navigation (CPS group) or received conventional lateral mass screw (LMS) fixation surgery (LMS group) between August 2015 and August 2019. Accuracy of CPS position was evaluated by postoperative CT. Read More

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[The value of magnetic resonance hydrography in the localization of fistula in patients with cerebrospinal fluid rhinorrhea].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022 Apr;36(4):300-303

Department of Otolaryngology Head and Neck Surgery,Tianjin Huanhu Hospital.

To evaluate the application value of magnetic resonance hydrography in determine the leak location of patients with cerebrospinal fluid rhinorrhea. Clinical data of 58 patients with cerebrospinal fluid rhinorrhea treated in Tianjin Huanhu Hospital from February 2015 to February 2021 were analyzed retrospectively. The leak position was judged by three methods: nasal sinus coronal CT, magnetic resonance hydrography and magnetic resonance hydrography combined with nasal sinus coronal CT. Read More

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Epidural Blood Patch Using a Racz Catheter for Spontaneous Intracranial Hypotension With Unclear Leak Points.

Cureus 2022 Mar 28;14(3):e23559. Epub 2022 Mar 28.

Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa, JPN.

Using a Racz catheter (Brevi-XL™, Epimed Inc., NY, USA) to insert an epidural blood patch (EBP) may be an effective method of reaching the target epidural space in the cervical region. We would like to present a case, wherein a targeted EBP via Racz catheter was used in the management of spontaneous intracranial hypotension. Read More

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Endoscopic Endonasal Dural Reconstruction for a Cerebrospinal Fluid Leak in the Middle Cranial Fossa of a Patient with Gorham-stout Disease with Skull Base Defect.

NMC Case Rep J 2022 1;9:55-61. Epub 2022 Apr 1.

Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.

We report the use of endoscopic endonasal surgery for dural reconstruction following a cerebrospinal fluid leak in a 33-year-old patient with recurrent meningitis since at age of 2 years. Magnetic resonance imaging showed osteolytic changes in the left temporal and sphenoid bones, including the left pterygoid plate, a few left temporal encephaloceles, and cerebrospinal fluid-like fluid in the expanded Meckel's cave and the parapharyngeal space. After endoscopic endonasal surgery, Gorham-Stout disease was diagnosed. Read More

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Targeted epidural blood patch through a catheter in the treatment of spontaneous intracranial hypotension.

Clin Neurol Neurosurg 2022 06 26;217:107268. Epub 2022 Apr 26.

Department of Neurosurgery, Wroclaw Medical University, Wroclaw, Poland.

Objective: Spontaneous intracranial hypotension (SIH) can be effectively treated by epidural blood patch (EBP) following the primary unsuccessful conservative therapy. Nevertheless, multi-site cerebrospinal fluid (CSF) leaks or those originating at the cervical or thoracic spine remain therapeutically challenging. Therefore, this study aimed to present our experience in the treatment of thoracic CSF leaks using epidural catheters for the EBP infusion. Read More

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Trigeminal Neuralgia from Simultaneous Compression by Cerebellopontine Angle Epidermoid and Duplicated Superior Cerebellar Artery Loop: Two-Dimensional Operative Video of Resection and Microvascular Decompression with Endoscopic Assistance.

World Neurosurg 2022 Jul 13;163:67. Epub 2022 Apr 13.

Department of Neurosurgery, Northwest Permanente, Clackamas, Oregon, USA. Electronic address:

A 51-year-old woman presented with 2 years of progressive left facial pain and numbness in maxillary nerve and mandibular nerve distributions. Symptoms were refractory to increasing doses of carbamazepine and gabapentin. Magnetic resonance imaging showed a left cerebellopontine angle nonenhancing mass, with diffusion restriction causing trigeminal nerve compression. Read More

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[Skull and skull base injuries in children and adolescents : Results of a monocentric analysis].

HNO 2022 May 14;70(5):352-360. Epub 2022 Apr 14.

Klinik für Hals‑, Nasen‑, Ohrenheilkunde, KRH Klinikum Nordstadt, Haltenhoffstraße 41, 30167, Hannover, Deutschland.

Background: The present study comprises a retrospective analysis of skull, skull base, and midface fractures in children, to provide clinical orientation for their management. To date, only few data are available on these injuries in this patient group.

Methods: Data from inpatient cases diagnosed with a midface, skull, or skull base fracture in the Children's Hospital Auf der Bult from 2015 to 2020 were evaluated. Read More

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Osseous spicules of the posterior elements causing fast cerebrospinal fluid leaks.

Neuroradiology 2022 Apr 12. Epub 2022 Apr 12.

Division of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Purpose: Dural tears are a common cause of spontaneous spinal CSF leaks. The majority of such leaks occur ventrally along the thecal sac, typically due to ventral osseous spicules that cause a rent in the dura. A minority of dural leaks are posterolateral in location. Read More

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[Spinal Cerebrospinal Fluid Leak: Current Concepts and Management Policies].

No Shinkei Geka 2022 Mar;50(2):441-454

Department of Neurosurgery, National Hospital Organization Fukuyama Medical Center.

In this article we provide an update on the recent developments in understanding the diagnosis and treatment of spinal cerebrospinal fluid(CSF)leaks. Patients with spinal CSF leak show an increasingly broad spectrum of clinical presentations including intractable whiplash-associated disorder(WAD)and orthostatic dysregulation in childhood, in addition to classical spontaneous intracranial hypotension(SIH). A simple understanding of the condition defined by the presence of low CSF pressure is no longer sufficient or accurate. Read More

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Diagnostic approach, therapeutic strategies, and surgical indications in intradural thoracic disc herniation associated with CSF leak, intracranial hypotension, and CNS superficial siderosis.

Neurol Sci 2022 Jul 8;43(7):4167-4173. Epub 2022 Apr 8.

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, University of Milan, Via Giovanni Celoria 11, 20133, Milan, Italy.

Background And Purpose: Intradural disc herniation (IDH) can manifest with radicular or medullary syndrome. In about 15% of cases, IDH may be responsible, through a dural laceration, for a CSF leak, determining spontaneous intracranial hypotension (SIH) and CNS superficial siderosis (CNSss). This paper attempts to present an overview on IDH as the cause for both CSF leak, and subsequent SIH, and CNSss, and to describe a peculiar clinical and neuroradiological scenario related to this condition. Read More

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Intraoperative Injection of Normal Saline Through Lumbar Drainage for Transnasal Endoscopic Repair of Complex CSF Leaks.

Front Surg 2022 21;9:861406. Epub 2022 Mar 21.

Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

Objective: It is well known that accurate location of the leak in the operation is crucial for repairing cerebrospinal fluid leakage. The study aims to investigate the application of intraoperative injection of normal saline through lumbar drainage in repairing complex leaks.

Methods: The fistulas of all patients with CSF leak were located by computed tomography cisternography (CTC) or heavy T2 magnetic resonance imaging (MRI) before surgery. Read More

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Cerebrospinal fluid leak in epidural venous malformations and blue rubber bleb nevus syndrome.

J Neurosurg Spine 2022 Apr 1:1-7. Epub 2022 Apr 1.

1Division of Vascular and Interventional Radiology.

Objective: Clinical manifestations of blue rubber bleb nevus syndrome (BRBNS) and multifocal venous malformation (MVM) vary depending on the location of the lesions. The aim of this study was to assess the risk of developing CSF leaks in patients with epidural venous malformations (VMs).

Methods: The authors retrospectively investigated the relationship between the development of a CSF leak and the presence of epidural VMs. Read More

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Catheter-guided multilevel epidural blood patches in an adolescent boy.

Reg Anesth Pain Med 2022 07 31;47(7):430-433. Epub 2022 Mar 31.

Edward's Family Interdisciplinary Center for Complex Pain, Montreal Children's Hospital, Montreal, Quebec, Canada

Background: There is increasing evidence for the use of multilevel epidural catheter-guided blood patches to treat spontaneous cerebrospinal fluid leaks in adults. Yet, there are scarce data for their use in children. Furthermore, higher level epidural blood patches are uncommon in both adult and pediatric populations. Read More

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Same-Day Bilateral Decubitus CT Myelography for Detecting CSF-Venous Fistulas in Spontaneous Intracranial Hypotension.

AJNR Am J Neuroradiol 2022 04 24;43(4):645-648. Epub 2022 Mar 24.

National Institute for Health Research Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College Hospital, London, UK.

Lateral decubitus CT myelography is a sensitive technique for detecting CSF-venous fistulas in patients with spontaneous intracranial hypotension. It might be necessary to perform bilateral studies to locate a fistula. We report on the feasibility of obtaining diagnostic-quality bilateral decubitus CT myelography in a single session, avoiding the need to schedule separate examinations for the left and right sides on different days. Read More

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Complication Avoidance in Surgical Management of Vertebral Column Tumors.

Curr Oncol 2022 02 25;29(3):1442-1454. Epub 2022 Feb 25.

The Warren Alpert Medical School of Brown University, Providence, RI 02912, USA.

The surgical management of spinal tumors has grown increasingly complex as treatment algorithms for both primary bone tumors of the spine and metastatic spinal disease have evolved in response to novel surgical techniques, rising complication rates, and additional data concerning adjunct therapies. In this review, we discuss actionable interventions for improved patient safety in the operative care for spinal tumors. Strategies for complication avoidance in the preoperative, intraoperative, and postoperative settings are discussed for approach-related morbidities, intraoperative hemorrhage, wound healing complications, cerebrospinal fluid (CSF) leak, thromboembolism, and failure of instrumentation and fusion. Read More

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February 2022

A Retrospective Study of Recurrent Bacterial Meningitis in Children: Etiology, Clinical Course, and Treatment.

Comput Math Methods Med 2022 10;2022:3681871. Epub 2022 Mar 10.

Department of Neurology, Children's Hospital of Hebei, Shijiazhuang 050031, China.

Objectives: Recurrent bacterial meningitis (RBM) is a rare but life-threatening disease. This study aims to analyze the clinical features, potential causes, and therapeutic outcomes of RBM in children.

Methods: This article retrospectively reviews the clinical characteristics, etiologies, and treatments in children with RBM hospitalized in Hebei children's hospital from 2012 to 2020. Read More

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