High-Resolution PET Cisternography With 64Cu-DOTA for CSF Leak Detection

2019 ◽  
Vol 44 (9) ◽  
pp. 735-737
Author(s):  
Martin Freesmeyer ◽  
Matthias Schwab ◽  
Bianca Besteher ◽  
Sebastian Gröber ◽  
Albrecht Waschke ◽  
...  
2002 ◽  
Vol 126 (6) ◽  
pp. 669-676 ◽  
Author(s):  
Jeffrey S. Zapalac ◽  
Bradley F. Marple ◽  
Nathan D. Schwade

OBJECTIVE: Our goal was to assess the efficacy of current diagnostic modalities in the management of skull base cerebrospinal fluid (CSF) fistulas. METHODS: We conducted a retrospective review of all patients presenting to our institution over the past 6 years with skull base CSF fistulas. RESULTS: Fifty-two patients were included in the study. β2-Transferrin analysis of collected specimen was the most efficacious means of confirming a CSF leak. High-resolution computed tomography was the most informative radiographic study, yielding a sensitivity and an accuracy of 87%. Magnetic resonance cisternography, yielding a sensitivity and an accuracy of 78%, was instrumental in localizing the site of leak for a few cases but was most commonly corroborative. Using a graduated diagnostic approach, successful repair was attained in 88% of cases after 1 attempt and 98% after 1 or 2 attempts. CONCLUSION: For patients with skull base CSF fistulas, a graduated diagnostic approach with emphasis on confirmation of leak by β2-transferrin analysis and precise localization by high-resolution computed tomography is both efficacious and cost effective.


2019 ◽  
Vol 25 (1) ◽  
pp. 67-74
Author(s):  
Daniel W. Bradbury ◽  
Ashley E. Kita ◽  
Kensuke Hirota ◽  
Maie A. St. John ◽  
Daniel T. Kamei

Cerebrospinal fluid (CSF) leaks can occur when there is communication between the intracranial cavities and the external environment. They are a common and serious complication of numerous procedures in otolaryngology, and if not treated, persistent leaks can increase a patient’s risk of developing life-threatening complications such as meningitis. As it is not uncommon for patients to exhibit increased secretions postoperatively, distinguishing normal secretions from those containing CSF can be difficult. Currently, there are no proven, available tests that allow a medical provider concerned about a CSF leak to inexpensively, rapidly, and noninvasively rule out the presence of a leak. The gold standard laboratory-based test requires that a sample be sent to a tertiary site for analysis, where days to weeks may pass before results return. To address this, our group recently developed a semiquantitative, barcode-style lateral-flow immunoassay (LFA) for the quantification of the beta-trace protein, which has been reported to be an indicator of the presence of CSF leaks. In the work presented here, we created a rapid diagnostic test kit composed of our LFA, a collection swab, dilution buffers, disposable pipettes, and instructions. Validation studies demonstrated excellent predictive capabilities of this kit in distinguishing between clinical specimens containing CSF and those that did not. Our diagnostic kit for CSF leak detection can be operated by an untrained user, does not require any external equipment, and can be performed in approximately 20 min, making it well suited for use at the point of care. This kit has the potential to transform patient outcomes.


2020 ◽  
Vol 77 ◽  
pp. 110-115
Author(s):  
Bo Ram Kim ◽  
Joon Woo Lee ◽  
Eugene Lee ◽  
Yusuhn Kang ◽  
Joong Mo Ahn ◽  
...  

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Natarajan Muthukumar

Abstract INTRODUCTION 1. To highlight the spectrum of associated pathological (AP) entities that can occur with (split cord malformations) SCMs, 2. the limitations of imaging techniques to diagnose these entities preoperatively, and 3. the failure of current theories of embryogenesis to explain these complex malformations. METHODS Patients with SCMs and associated pathologies (AP) operated between January 2012 and December 2017 were included. All had neurological evaluation, plain radiographs, CT, and MRI. Postoperative complications were recorded. Follow-up ranged from 6 mo to 3 yr. RESULTS A total of 24 of the 30 patients treated during this period had APs. Age: 1 mo 17 yr. A total of 16 had Type II SCMs and 8 had Type I SCMs. A total of 20 of the 24 patients were neurologically intact. Of the remaining 4, 3 had urinary disturbances and 1 had weakness of 1 lower extremity. All patients had 1 or more APs in addition to SCMs excluding fatty filum. High resolution MRI and/or CT were unable to completely identify the full spectrum of the pathology in these patients in whom the diagnosis was often made intraoperatively.The associated anomalies included in the descending order of frequency included: LDMs (limited dorsal myeloschisis), lipomas; spondylocostal dysostosis, spinal arachnoid cyst, spinal dermal sinus, and neurenteric cyst. Fatty filum was present in 22 of the 24 patients and were sectioned. Intraoperative neurophysiological monitoring was used in the last 6 patients. Complications included cerebrospinal fluid (CSF) leak in 4 patients and wound break down in 2. Of the 4 with neurological deficits, 2 improved. No patient worsened neurologically during the follow-up. CONCLUSION In total 80% of SCMs have APs. Even high resolution imaging cannot completely identify the full spectrum of the pathology in SCMs A high index of suspicion and meticulous search for AP is required while operating patients with SCMs


1967 ◽  
Vol 31 ◽  
pp. 45-46
Author(s):  
Carl Heiles

High-resolution 21-cm line observations in a region aroundlII= 120°,b11= +15°, have revealed four types of structure in the interstellar hydrogen: a smooth background, large sheets of density 2 atoms cm-3, clouds occurring mostly in groups, and ‘Cloudlets’ of a few solar masses and a few parsecs in size; the velocity dispersion in the Cloudlets is only 1 km/sec. Strong temperature variations in the gas are in evidence.


2019 ◽  
Vol 42 ◽  
Author(s):  
J. Alfredo Blakeley-Ruiz ◽  
Carlee S. McClintock ◽  
Ralph Lydic ◽  
Helen A. Baghdoyan ◽  
James J. Choo ◽  
...  

Abstract The Hooks et al. review of microbiota-gut-brain (MGB) literature provides a constructive criticism of the general approaches encompassing MGB research. This commentary extends their review by: (a) highlighting capabilities of advanced systems-biology “-omics” techniques for microbiome research and (b) recommending that combining these high-resolution techniques with intervention-based experimental design may be the path forward for future MGB research.


1994 ◽  
Vol 144 ◽  
pp. 593-596
Author(s):  
O. Bouchard ◽  
S. Koutchmy ◽  
L. November ◽  
J.-C. Vial ◽  
J. B. Zirker

AbstractWe present the results of the analysis of a movie taken over a small field of view in the intermediate corona at a spatial resolution of 0.5“, a temporal resolution of 1 s and a spectral passband of 7 nm. These CCD observations were made at the prime focus of the 3.6 m aperture CFHT telescope during the 1991 total solar eclipse.


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