scholarly journals Spontaneous temporal cerebrospinal fluid leak

2021 ◽  
Vol 13 (2) ◽  
pp. 22-27
Author(s):  
Bárbara Cecília Borges Moreira ◽  
Alexandre Fernandes de Azevedo ◽  
Mirian Cabral Moreira de Castro
Keyword(s):  
Cerebrospinal Fluid ◽  
Temporal Bone ◽  
Clinical Presentation ◽  
Cerebrospinal Fluid Leak ◽  
Neurological Complications ◽  
Chronic Infections ◽  
Obstructive Sleep ◽  
History Of ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

Spontaneous cerebrospinal fluid leaks of the temporal bone are uncommon conditions, but with increasing incidence in the last years. They represent the osteodural defect of the middle and posterior fossae floor with consequent communication between the subarachnoid space and the middle ear and mastoid cells, not associated with a history of trauma, chronic infections, tumors, surgery or irradiation. Physiopathogenesis is not well defined, being associated with the faulty development of the temporal bone and/or the presence of aberrant arachnoid granulations, in addition to being favored by idiopathic intracranial hypertension, obstructive sleep apnea and obesity. It has the potential for serious neurological complications, which is why surgical treatment is recommended. The main approaches involve transmastoid access and craniotomy access through the middle fossa, or a combination of both. This paper reports on a case attended at Grupo Santa Casa BH and performs a literature review and on aspects related to the clinical presentation and management of the condition.

Radiological findings in spontaneous cerebrospinal fluid leaks of the temporal bone

2021 ◽  
pp. 1-7
Author(s):  
T Hendriks ◽  
A Thompson ◽  
R Boeddinghaus ◽  
H E I Tan ◽  
J Kuthubutheen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Temporal Bone ◽  
Cerebrospinal Fluid Leak ◽  
Resonance Imaging ◽  
Cerebrospinal Fluid Leaks ◽  
Temporal Bones ◽  
Fluid Leak

Abstract Background and objective Spontaneous cerebrospinal fluid leak of the temporal bone is an emerging clinical entity for which prompt and accurate diagnosis is difficult given the subtle signs and symptoms that patients present with. This study sought to describe the key temporal bone abnormalities in patients with spontaneous cerebrospinal fluid leak. Methods A retrospective cohort study was conducted of adult patients with biochemically confirmed spontaneous cerebrospinal fluid leak. Demographics and radiological features identified on computed tomography imaging of the temporal bones and/or magnetic resonance imaging were analysed. Results Sixty-one patients with spontaneous cerebrospinal fluid leak were identified. Fifty-four patients (88.5 per cent) underwent both temporal bone computed tomography and magnetic resonance imaging. Despite imaging revealing bilateral defects in over 75 per cent of the cohort, only two patients presented with bilateral spontaneous cerebrospinal fluid leaks. Anterior tegmen mastoideum defects were most common, with an average size of 2.5 mm (range, 1–10 mm). Conclusion Temporal bone computed tomography is sensitive for the identification of defects when suspicion exists. In the setting of an opacified middle ear and/or mastoid, close examination of the skull base is crucial given that this fluid is potentially cerebrospinal fluid.

scholarly journals Erratum to “Surgical outcomes in the treatment of temporal bone cerebrospinal fluid leak: A systematic review” [Auris Nasus Larynx 45 (2018) 903–910]

2019 ◽  
Vol 46 (3) ◽  
pp. 483
Author(s):  
Federico Maria Gioacchini ◽  
Ettore Cassandro ◽  
Matteo Alicandri-Ciufelli ◽  
Shaniko Kaleci ◽  
Claudia Cassandro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebrospinal Fluid ◽  
Temporal Bone ◽  
Surgical Outcomes ◽  
Cerebrospinal Fluid Leak ◽  
Fluid Leak

Management of temporal bone meningo-encephalocoele

2008 ◽  
Vol 122 (11) ◽  
pp. 1168-1174 ◽  
Author(s):  
K K Ramalingam ◽  
R Ramalingam ◽  
T M SreenivasaMurthy ◽  
G R Chandrakala
Keyword(s):  
Cerebrospinal Fluid ◽  
Temporal Bone ◽  
Otitis Media ◽  
Cerebrospinal Fluid Leak ◽  
Ossicular Chain ◽  
Brain Herniation ◽  
Suppurative Otitis Media ◽  
Ossicular Chain Reconstruction ◽  
Fluid Leak ◽  
Mastoid Surgery

AbstractMeningo-encephalocoele of the temporal bone, also known as fungus cerebri, is a rare occurrence in clinical practice. We present a series of 13 patients with chronic otitis media who suffered brain herniation into the mastoid cavity. We also discuss the presentation and management of brain herniation with or without cerebrospinal fluid leak.Study design:Retrospective.Methods:Among 963 cases undergoing revision mastoid surgery, 13 patients suffered brain herniation. These cases were identified and analysed.Results:All 13 patients' initial diagnosis was chronic suppurative otitis media with cholesteatoma, and all had undergone previous mastoid surgery resulting in a defect in the tegmen and weakening of the dura mater. The revision procedures performed included 10 (76.9 per cent) modified radical mastoidectomies without ossicular chain reconstruction and one (7.6 per cent) modified radical mastoidectomy with ossicular chain reconstruction; two (15.3 per cent) patients required a blind sac closure. Brain herniation and/or cerebrospinal fluid leak were repaired by a transmastoid ± minicraniotomy procedure.Conclusions:Injury to the tegmen and dura should be avoided during surgery for chronic middle-ear disease. Cerebrospinal fluid leaks, if encountered, should be managed in the same surgical session. The transmastoid approach is helpful in repairing defects smaller than 1 cm in diameter, whereas the combined transmastoid-minicraniotomy approach provides good access when closing defects larger than 1 cm in diameter and also enables auto-calvarial grafting.

“Gasket-seal” Watertight Closure in Minimal-access Endoscopic Cranial Base Surgery

2008 ◽  
Vol 62 (suppl_5) ◽  
pp. ONS342-ONS343 ◽  
Author(s):  
Lewis Z. Leng ◽  
Seth Brown ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Cranial Base ◽  
Minimal Access ◽  
Anterior Cranial Base ◽  
Tissue Sealant ◽  
Cerebrospinal Fluid Leaks ◽  
Cranial Base Surgery ◽  
Watertight Closure ◽  
Fluid Leak

Abstract Objective: Transnasal endoscopic cranial base surgery is a novel minimal-access method for reaching the midline cranial base. Postoperative cerebrospinal fluid leak remains a persistent challenge. A new method for watertight closure of the anterior cranial base is presented. Methods: To achieve watertight closure of the anterior cranial base, autologous fascia lata was used to create a “gasket seal” around a bone buttress, followed by application of a tissue sealant such as DuraSeal (Confluent Surgical, Inc., Waltham, MA). The gasket-seal closure was used to seal the anterior cranial base in a series of 10 patients with intradural surgery for suprasellar craniopharyngiomas (n = 5), planum meningiomas (n = 3), clival chordoma (n = 1), and recurrent iatrogenic cerebrospinal fluid leak (n = 1). Lumbar drains were placed intraoperatively in five patients and remained in place for 3 days postoperatively. Results: After a mean follow-up period of 12 months, there were no cerebrospinal fluid leaks. Conclusion: The gasket-seal closure is an effective method for achieving watertight closure of the anterior cranial base after endoscopic intradural surgery.

Temporal Bone Encephalocele and Cerebrospinal Fluid Leak Repair via the Middle Cranial Fossa Approach

2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Matthew Carlson ◽  
William Copeland ◽  
Stanley Pelosi ◽  
Colin Driscoll ◽  
Michael Link ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Temporal Bone ◽  
Cerebrospinal Fluid Leak ◽  
Middle Cranial Fossa ◽  
Middle Cranial Fossa Approach ◽  
Cranial Fossa ◽  
Fluid Leak

Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks

2014 ◽  
Vol 128 (7) ◽  
pp. 626-629 ◽  
Author(s):  
J Rimmer ◽  
C Belk ◽  
V J Lund ◽  
A Swift ◽  
P White
Keyword(s):  
Cerebrospinal Fluid ◽  
Streptococcus Pneumoniae ◽  
Antibiotic Prophylaxis ◽  
Skull Base ◽  
Cerebrospinal Fluid Leak ◽  
Prophylactic Antibiotics ◽  
Anterior Skull Base ◽  
Web Based ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

AbstractObjective:There are no UK guidelines for the use of antibiotics and/or immunisations in patients with an active anterior skull base cerebrospinal fluid leak. This study aimed to define current UK practice in this area and inform appropriate guidelines for ENT surgeons.Method:A web-based survey of all members of the British Rhinological Society was carried out and the literature in this area was reviewed.Results:Of those who responded to the survey, 14 per cent routinely give prophylactic antibiotics to patients with cerebrospinal fluid leaks, and 34.9 per cent recommend immunisation against at least one organism, most commonly Streptococcus pneumoniae (86.7 per cent).Conclusion:There is no evidence to support the use of antibiotic prophylaxis in patients with a cerebrospinal fluid leak. We propose that all such patients are advised to seek immunisation against pneumococcus, meningococcus and haemophilus.

Endoscopic modified Lothrop procedure for repair of lateral frontal sinus cerebrospinal fluid leak

2008 ◽  
Vol 123 (1) ◽  
pp. 145-147 ◽  
Author(s):  
J K Anverali ◽  
A A Hassaan ◽  
H A Saleh
Keyword(s):  
Cerebrospinal Fluid ◽  
Frontal Sinus ◽  
World Literature ◽  
Cerebrospinal Fluid Leak ◽  
Lumbar Drain ◽  
Alternative Approach ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

AbstractObjective:To describe a previously unreported case of repair of a lateral frontal sinus cerebrospinal fluid leak, using the endoscopic modified Lothrop procedure.Method:Case report of new technique, with reference to the world literature.Results:An effective endoscopic, transnasal repair of a lateral frontal sinus cerebrospinal fluid leak was achieved in a 60-year-old man. The defect was closed with fat, fascia lata and free mucosal grafts. The left nasal cavity was packed and a lumbar drain left in situ post-operatively. The drain and packs were removed one week later and the patient discharged with no complications, and no recurrence at 12 months' follow up.Conclusion:Such cerebrospinal fluid leaks have traditionally been repaired using an external approach with osteoplastic flaps and obliteration of the sinus. We highlight the endoscopic modified Lothrop technique as an effective alternative approach to repair of cerebrospinal fluid leaks in poorly accessible areas of the frontal sinus.

Delayed cerebrospinal fluid leak after penetrating cervical trauma

Trauma ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 63-65 ◽  
Author(s):  
Charles Fredericks ◽  
James R Yon ◽  
John Kubasiak ◽  
Anupam Basu ◽  
Kimberly Nagy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Stab Wound ◽  
Cervical Spinal Cord ◽  
Cerebrospinal Fluid Leak ◽  
Resonance Imaging ◽  
Cervical Trauma ◽  
Cord Injury ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

Stab wound injury to the cervical spinal cord is a rare occurrence and usually presents with immediate, disastrous, and permanent neurological consequences. Rarer, and potentially as severe, is the complication of a delayed cerebrospinal fluid leak following a stab wound to the cervical spine. In this case, magnetic resonance imaging demonstrates a cerebrospinal fluid leak that extends to the skin with injury to the posterior dura at the C1/C2 level. Epidemiology and management of penetrating cervical spinal cord injury and delayed cerebrospinal fluid leaks are discussed.

Cerebrospinal Fluid Leak of Temporal Bone Origin

1995 ◽  
Vol 112 (5) ◽  
pp. P39-P39
Author(s):  
Ronald A. Hoffman
Keyword(s):  
Cerebrospinal Fluid ◽  
Temporal Bone ◽  
Cerebrospinal Fluid Leak ◽  
Educational Objectives ◽  
Fluid Leak

Educational objectives: To diagnose cerebrospinal fluid leak and to be knowledgeable regarding therapy.

Management of intra-operative cerebrospinal fluid leak following endoscopic trans-sphenoidal pituitary surgery

2010 ◽  
Vol 125 (3) ◽  
pp. 311-313 ◽  
Author(s):  
C G L Hobbs ◽  
A Darr ◽  
W V Carlin
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Pituitary Surgery ◽  
Gelatin Sponge ◽  
Cerebrospinal Fluid Leakage ◽  
Fluid Leakage ◽  
Cerebrospinal Fluid Leaks ◽  
Low Incidence ◽  
Fluid Leak

AbstractObjective:Cerebrospinal fluid leakage is the most common complication of endoscopic trans-sphenoidal pituitary surgery. However, there is no uniformly accepted way of managing this complication when it occurs intra-operatively. This paper describes a quick, simple technique, involving layered fibrin glue and gelatin sponge, which does not compromise post-operative patient follow up.Method:Retrospective review of all endoscopic pituitary surgery cases conducted at a single institution since the introduction of this technique in 2002.Results:A total of 120 endoscopic pituitary operations were performed (96 primary procedures and 24 revisions). All intra-operative cerebrospinal fluid leaks were managed using the described method, with a failure rate of 3.6 per cent. The overall post-operative leakage rate was 1.7 per cent.Conclusion:This simple, conservative technique avoids the need for further dissection and the use of non-absorbable foreign material, and has a low incidence of post-operative cerebrospinal fluid leakage.

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