Traumatic cerebrospinal fluid fistula simulating tears

1978 ◽  
Vol 49 (1) ◽  
pp. 121-123 ◽  
Author(s):  
Kiran K. Joshi ◽  
H. Alan Crockard
Keyword(s):  
Cerebrospinal Fluid ◽  
Young Child ◽  
Cribriform Plate ◽  
Csf Leak ◽  
Cerebrospinal Fluid Fistula ◽  
Medial Aspect ◽  
Csf Rhinorrhea ◽  
Content Type ◽  
Fluid Fistula ◽  
Fine Print

✓ A young child developed delayed cerebrospinal fluid (CSF) rhinorrhea and CSF leak from the eye presenting as tears. The “tears” were CSF which had tracked from the cribriform plate through the ethmoidal air sinuses to the medial aspect of the left orbit. There was marked chemosis and it was considered likely that the tears had leaked through damaged conjunctiva.

Meningitis following acute traumatic cerebrospinal fluid fistula

1970 ◽  
Vol 33 (3) ◽  
pp. 312-316 ◽  
Author(s):  
Edwin E. MacGee ◽  
Joseph C. Cauthen ◽  
Charles E. Brackett
Keyword(s):  
Cerebrospinal Fluid ◽  
Prophylactic Antibiotics ◽  
Present Series ◽  
Cerebrospinal Fluid Fistula ◽  
Csf Rhinorrhea ◽  
Content Type ◽  
Csf Fistula ◽  
Fluid Fistula ◽  
Fine Print

✓ The effect of prophylactic antibiotics in preventing meningitis are reviewed in 58 cases of acute traumatic cerebrospinal fluid (CSF) fistula. A summary of the literature plus data from the present series show a total of 402 cases of acute traumatic CSF fistula; there were 46 cases (14%) of meningitis in 325 patients receiving expectant antibiotics, and four cases (5%) in 77 patients treated without antibiotics. No statistically significant conclusion can be drawn from these data regarding the usefulness of expectant antibiotics in acute traumatic CSF rhinorrhea or otorrhea.

Treatment of postoperative subgaleal cerebrospinal fluid fistulas by using fibrin sealant

1999 ◽  
Vol 90 (6) ◽  
pp. 1143-1145 ◽  
Author(s):  
Tomas Menovsky ◽  
Joost de Vries ◽  
Heinz-Georg Bloss
Keyword(s):  
Cerebrospinal Fluid ◽  
Fibrin Sealant ◽  
Simple Technique ◽  
Cerebrospinal Fluid Fistula ◽  
Content Type ◽  
Fluid Fistula ◽  
Fine Print

✓ The authors describe a simple technique by which a postoperative subgaleal cerebrospinal fluid fistula is treated by local tapping and injection of fibrin sealant through the same needle.

Complications of spinal drainage in the management of cerebrospinal fluid fistula

1981 ◽  
Vol 54 (3) ◽  
pp. 392-395 ◽  
Author(s):  
Carl J. Graf ◽  
Cordell E. Gross ◽  
David W. Beck
Keyword(s):  
Cerebrospinal Fluid ◽  
Nursing Staff ◽  
Cerebrospinal Fluid Fistula ◽  
Content Type ◽  
Csf Fistula ◽  
Csf Drainage ◽  
Fluid Fistula ◽  
Fine Print

✓ Continuous cerebrospinal fluid (CSF) drainage may be used in the treatment of CSF fistula. The procedure, however, is not without risk. Marked gradients between the intracranial and intraspinal CSF pressures and intravasation of air through an unsealed fistula may produce serious neurological problems. The use of continuous CSF drainage requires an alert, informed nursing staff to avert catastrophe.

Cerebrospinal fluid fistula from fractured acrylic cranioplasty plate

1976 ◽  
Vol 45 (2) ◽  
pp. 227-228 ◽  
Author(s):  
Harvey M. Henry ◽  
Caesar Guerrero ◽  
Robert A. Moody
Keyword(s):  
Cerebrospinal Fluid ◽  
Methyl Methacrylate ◽  
Cerebrospinal Fluid Fistula ◽  
Content Type ◽  
X Ray ◽  
External Evidence ◽  
Fluid Fistula ◽  
Fine Print

✓ The authors report a patient who developed a cerebrospinal fluid fistula secondary to a fractured methyl methacrylate cranioplasty plate. There was no external evidence of trauma. X-ray films showed no evidence of the fracture. It is suggested that the impregnation of methyl methacrylate with a radiopaque material would result in visualization of such fractures.

Intradiploic cerebrospinal fluid fistula

1981 ◽  
Vol 54 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Antonio C. G. D'Almeida ◽  
Robert B. King
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Fistula ◽  
Content Type ◽  
Operative Findings ◽  
Fluid Fistula ◽  
Fine Print

✓ Two patients with asymptomatic osteolytic skull lesions were found to have cerebrospinal fluid diploic fistulas. The radiographic and operative findings have not been reported previously.

Repair of cerebrospinal fluid fistula following transoral transclival approach to a basilar aneurysm

1979 ◽  
Vol 50 (6) ◽  
pp. 834-836 ◽  
Author(s):  
Akira Yamaura ◽  
Hiroyasu Making ◽  
Katsumi Isobe ◽  
Tsuneo Takashima ◽  
Takao Nakamura ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Cavity ◽  
Cerebrospinal Fluid Fistula ◽  
Content Type ◽  
Rotation Flap ◽  
Complete Closure ◽  
Fluid Fistula ◽  
Fine Print

✓ A technique for closure of a cerebrospinal fluid fistula following a transoral transclival approach to a basilar aneurysm is described. Transposition of a rotation flap of the mucosa of the septum and the floor of the posterior nasal cavity in the choana resulted in complete closure of the thin and fragile nasopharynx without tension at the suture site.

Acquired Chiari I malformation secondary to spontaneous spinal cerebrospinal fluid leakage and chronic intracranial hypotension syndrome in seven cases

1998 ◽  
Vol 88 (2) ◽  
pp. 237-242 ◽  
Author(s):  
John L. D. Atkinson ◽  
Brian G. Weinshenker ◽  
Gary M. Miller ◽  
David G. Piepgras ◽  
Bahram Mokri
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypotension ◽  
Chiari I Malformation ◽  
Csf Leak ◽  
Cerebrospinal Fluid Leakage ◽  
Content Type ◽  
Intracranial Hypotension Syndrome ◽  
Csf Leakage ◽  
Chiari I ◽  
Fine Print

Object. Spontaneous spinal cerebrospinal fluid (CSF) leakage with development of the intracranial hypotension syndrome and acquired Chiari I malformation due to lumbar spinal CSF diversion procedures have both been well described. However, concomitant presentation of both syndromes has rarely been reported. The object of this paper is to present data in seven cases in which both syndromes were present. Three illustrative cases are reported in detail. Methods. The authors describe seven symptomatic cases of spontaneous spinal CSF leakage with chronic intracranial hypotension syndrome in which magnetic resonance (MR) images depicted dural enhancement, brain sagging, loss of CSF cisterns, and acquired Chiari I malformation. Conclusions. This subtype of intracranial hypotension syndrome probably results from chronic spinal drainage of CSF or high-flow CSF shunting and subsequent loss of brain buoyancy that results in brain settling and herniation of hindbrain structures through the foramen magnum. Of 35 cases of spontaneous spinal CSF leakage identified in the authors' practice over the last decade, MR imaging evidence of acquired Chiari I malformation has been shown in seven. Not to be confused with idiopathic Chiari I malformation, ideal therapy requires recognition of the syndrome and treatment directed to the site of the spinal CSF leak.

scholarly journals Iatrogenic cerebrospinal fluid leak after repeated nasal swab tests for COVID-19: illustrative case

2021 ◽  
Vol 2 (17) ◽  
Author(s):  
Johnson Ku ◽  
Chieh-Yi Chen ◽  
Jason Ku ◽  
Hsuan-Kan Chang ◽  
Jau-Ching Wu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Cavity ◽  
Nasal Swab ◽  
Cerebrospinal Fluid Leak ◽  
Cribriform Plate ◽  
Csf Leak ◽  
Illustrative Case ◽  
Endoscopic Endonasal ◽  
Csf Rhinorrhea ◽  
Csf Leakage

BACKGROUND Nasal swab tests are one of the most essential tools for screening coronavirus disease 2019 (COVID-19). The authors report a rare case of iatrogenic cerebrospinal fluid (CSF) leak from the anterior skull base after repeated nasal swab tests for COVID-19, which was treated with endoscopic endonasal repair. OBSERVATIONS A 41-year-old man presented with clear continuous rhinorrhea through his left nostril for 5 days after repeated nasal swabbing for COVID-19. There were no obvious risk factors for spontaneous CSF leak. Computed tomography cisternography showed contrast accumulation in the left olfactory fossa and along the left nasal cavity. Such findings aligned with a preliminary diagnosis of CSF leakage through the left cribriform plate. Magnetic resonance imaging confirmed the presence of a CSF fistula between his left cribriform plate and superior nasal concha. The patient underwent endoscopic endonasal repair. CSF rhinorrhea ceased after the surgery, and no recurrence was noted during the 12-week postoperative follow-up period. LESSONS Although rare, iatrogenic CSF leakage can be a serious complication following COVID-19 nasal swab tests, especially when infection may cause significant neurological sequelae. Healthcare providers should become familiar with nasal cavity anatomy and be well trained in performing nasal swab tests.

Preservation of olfaction in anterior craniofacial approaches

1993 ◽  
Vol 79 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Robert F. Spetzler ◽  
James M. Herman ◽  
Stephen Beals ◽  
Edward Joganic ◽  
John Milligan
Keyword(s):  
Cribriform Plate ◽  
Csf Leak ◽  
En Bloc ◽  
Reconstructive Procedures ◽  
Content Type ◽  
The Mean ◽  
Ethmoid Sinuses ◽  
Fine Print ◽  
Csf Leaks

✓ Through the combined efforts of neurosurgeons, head and neck surgeons, and craniofacial surgeons, the standard transbasal approach to the frontal fossa has been modified to include removal of the orbital roofs, nasion, and ethmoid sinuses. This approach has been combined further with facial disassembly procedures to provide extensive midline exposure to the midface and clival region. Extended frontal approaches, however, necessitate removal of the crista galli and sectioning of the olfactory rootlets with the associated risk of anosmia, cerebrospinal fluid (CSF) leak, and the need for complex reconstruction of the frontal floor. To avoid these problems, the authors have modified the technique of handling the cribriform plate to preserve the olfactory unit. Circumferential osteotomy cuts are made around the cribriform plate to allow an en bloc removal with its attachment to both the dura and underlying mucosa. Opening of the dura is avoided and the cribriform bone is used to reconstruct the floor. Four patients underwent this approach, for treatment of an angiofibroma in three and a fibrosarcoma in one. The mean follow-up period was 7 months. No patients developed a CSF leak, and within 8 weeks olfaction had returned in all patients. There was no other associated morbidity. These data suggest that this modification of the transbasilar approach can alleviate extensive reconstructive procedures and CSF leaks while preserving olfaction.

Cerebrospinal fluid leak after acoustic neuroma surgery: influence of tumor size and surgical approach on incidence and response to treatment

2001 ◽  
Vol 94 (2) ◽  
pp. 217-223 ◽  
Author(s):  
Jeffrey W. Brennan ◽  
David W. Rowed ◽  
Julian M. Nedzelski ◽  
Joseph M. Chen
Keyword(s):  
Cerebrospinal Fluid ◽  
Acoustic Neuroma ◽  
Surgical Approach ◽  
Tumor Size ◽  
Surgical Repair ◽  
Leakage Rate ◽  
Csf Leak ◽  
Content Type ◽  
Csf Leakage ◽  
Fine Print

Object. The aims of this study were to review the incidence of cerebrospinal fluid (CSF) leakage complicating the removal of acoustic neuroma and to identify factors that influence its occurrence and treatment. Methods. Prospective information on consecutive patients who underwent operation for acoustic neuroma was supplemented by a retrospective review of the medical records in which patients with CSF leaks complicating tumor removal were identified. This paper represents a continuation of a previously published series and thus compiles the authors' continuous experience over the last 24 years of practice. In 624 cases of acoustic neuroma the authors observed an overall incidence of 10.7% for CSF leak. The rate of leakage was significantly lower in the last 9 years compared with the first 15, most likely because of the abandonment of the combined translabyrinthine (TL)—middle fossa exposure. There was no difference in the leakage rate between TL and retrosigmoid (RS) approaches, although there were differences in the site of the leak (wound leaks occurred more frequently after a TL and otorrhea after an RS approach, respectively). Tumor size (maximum extracanalicular diameter) had a significant effect on the leakage rate overall and for RS but not for TL procedures. The majority of leaks ceased with nonsurgical treatments (18% with expectant management and 49% with lumbar CSF drainage). However, TL leaks (especially rhinorrhea) required surgical repair significantly more often than RS leaks. This has not been reported previously. Conclusions. The rate of CSF leakage after TL and RS procedures has remained stable. Factors influencing its occurrence include tumor size but not surgical approach. The TL-related leaks had a significantly higher surgical repair rate than RS-related leaks, an additional factor to consider when choosing an approach. The problem of CSF leakage becomes increasingly important as nonsurgical treatments for acoustic neuroma are developed.

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