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.

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.

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.

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.

Tunneled lumbar drain

2002 ◽  
Vol 96 (6) ◽  
pp. 1130-1131 ◽  
Author(s):  
Michael Hahn ◽  
Raj Murali ◽  
William T. Couldwell
Keyword(s):  
Cerebrospinal Fluid ◽  
Lateral Position ◽  
Tuohy Needle ◽  
External Drainage ◽  
Content Type ◽  
Rapid Procedure ◽  
Lumbar Drain ◽  
Csf Drainage ◽  
Usual Manner ◽  
Fine Print

✓ The authors report a simple and rapid procedure for tunneling a lumbar drain subcutaneously to facilitate chronic cerebrospinal fluid (CSF) drainage. A standard lumbar puncture (LP) is performed with a large-bore Tuohy needle (14- to 16-gauge), the drainage catheter is advanced into the subarachnoid space, and the needle is removed. The free Tuohy needle is then passed from a lateral position and brought out through the initial LP site. The free catheter is fed through the needle, and the needle is removed. The drain is attached to an external drainage bag in the usual manner. The authors have found this method particularly useful in some skull base and spinal surgical applications in which longer term continuous CSF drainage is desired.

Ultrastructural morphology of the olfactory pathway for cerebrospinal fluid drainage in the rabbit

1986 ◽  
Vol 64 (3) ◽  
pp. 466-473 ◽  
Author(s):  
Stephanie S. Erlich ◽  
J. Gordon McComb ◽  
Shigeyo Hyman ◽  
Martin H. Weiss
Keyword(s):  
Cerebrospinal Fluid ◽  
Connective Tissue ◽  
Electron Microscopic Examination ◽  
Olfactory Pathway ◽  
Electron Microscopic ◽  
En Bloc ◽  
Major Pathway ◽  
Content Type ◽  
Csf Drainage ◽  
Fine Print

✓ Previous physiological studies indicate that the olfactory region serves as a major pathway for cerebrospinal fluid (CSF) drainage into the lymphatic system. The present study was undertaken to determine the ultrastructural characteristics of this egress route. New Zealand White rabbits received a single bolus injection of the tracer ferritin (MW 400,000) into both lateral ventricles in such a manner as not to raise the intraventricular pressure above the normal level. The animals were sacrificed via intracardiac perfusion of fixative between less than 12 minutes and 4 hours following injection. The cribriform region was removed en bloc, decalcified, sectioned coronally, and prepared for light and electron microscopic examination. The arachnoid, dura, and periosteum surrounding the fila olfactoria passing through the cribriform plate merge together and form the perineurium, which consists of multiple layers of loosely overlapping cells with widely separated junctions and few vesicles. The perineurium surrounding the olfactory filaments at the superficial submucosal level is only one cell thick. The subarachnoid space freely communicates with the perineural space surrounding each filament. No morphological barrier between the perineural space and the loose submucosal connective tissue was identified. Whether or not the perineurium was multi- or singlelayered, ferritin was noted in abundance between the loosely overlapping perineural cells and in the submucosal connective tissue. The distribution of ferritin at 12 minutes was similar to that at 4 hours; however, the quantity of ferritin was increased at 4 hours. These results indicate that no significant barrier to CSF drainage is present at the rabbit cribriform region and that CSF reaches the submucosal region rapidly via open pathways.

scholarly journals Cerebrospinal fluid fistula management – border pathology ENT-neurosurgery

2015 ◽  
Vol 62 (3) ◽  
pp. 303-306
Author(s):  
Corneliu Toader ◽  
◽  
Mioriţa Toader ◽  
Mircea Drăghici ◽  
Alina Oprea ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Dominant Role ◽  
Diagnostic Methods ◽  
High Rate ◽  
Anatomical Location ◽  
Cerebrospinal Fluid Fistula ◽  
Csf Fistula ◽  
Rate Of Success ◽  
Fluid Fistula

The authors of this article mention the diagnostic methods, the surgery techniques and the postoperative care for the patients diagnosed with fistula of cerebrospinal fluid (CSF). The surgery cure depends on many factors, including here the etiology of the rhino-basis defect, intracranial pressure, anatomical location of the rhino-basis defect and it is strictly individualized, which depends on the success of all surgery procedures. ENT physicians, together with the neurosurgeons, were able to have a dominant role in the diagnostic evaluation and in the treatment of skull base pathology can give us a CSF fistula. Nasal endoscopy has revolutionized the treatment of CSF fistula, with a high rate of success.

Limiting ischemic spinal cord injury using a free radical scavenger 21-aminosteroid and/or cerebrospinal fluid drainage

1993 ◽  
Vol 79 (5) ◽  
pp. 742-751 ◽  
Author(s):  
Paul C. Francel ◽  
Bruce A. Long ◽  
Jacek M. Malik ◽  
Curtis Tribble ◽  
John A. Jane ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cerebrospinal Fluid ◽  
Perfusion Pressure ◽  
Ischemia And Reperfusion ◽  
Content Type ◽  
Csf Pressure ◽  
Csf Drainage ◽  
Cord Injury ◽  
Fine Print

✓ Traumatic spinal cord injury occurs in two phases: biomechanical injury, followed by ischemia and reperfusion injury. Biomechanical injury to the spinal cord, preceded or followed by various pharmaceutical manipulations or interventions, has been studied, but the ischemia/reperfusion aspect of spinal cord injury isolated from the biomechanical injury has not been previously evaluated. In the current study, ischemia to the lumbar spinal cord was induced in albino rabbits via infrarenal aortic occlusion, and two interventions were analyzed: the use of U74006F (Tirilazad mesylate), a 21-aminosteroid, and cerebrospinal fluid (CSF) drainage. These treatment modalities were tested alone or in combination. In Phase 1 of this study, the rabbits received 1.0 mg/kg of Tirilazad or an equal volume of vehicle (controls) prior to the actual occlusion, three doses of Tirilazad (1 mg/kg each) during the occlusion, then several doses after the occlusion. Of the Tirilazad-treated animals, 30% became paraplegic while 70% of the control animals became paraplegic. Phase 2 involved the same doses of Tirilazad as in Phase 1 and, in addition, CSF pressure monitoring and drainage were performed. The paraplegia rate was 79% in the control animals, 36% in the group receiving Tirilazad alone, 25% in the group with CSF drainage alone, and 20% in the Tirilazad plus CSF drainage group. This rate also correlated with changes noted in CSF pressure; both Tirilazad administration alone and CSF drainage alone induced a decrease in CSF pressure and the two combined produced a further decrease. There was marked improvement in the perfusion pressure when using Tirilazad alone, CSF drainage alone, and Tirilazad therapy in combination with CSF drainage, with the last group producing the largest increase. This change in CSF pressure and perfusion pressure correlated with improved functional neurological outcome. Pathological examination revealed that Tirilazad therapy reduced the extensive and diffuse neuronal, glial, and endothelial damage to (in its most severe form) a more patchy focal region of damage in the gray matter. Cerebrospinal fluid drainage resulted in pyknosis of some motor neurons, and some eosinophilia. The combination of CSF drainage and Tirilazad administration resulted in the least abnormality, with either normal or near-normal spinal cords. It is concluded that Tirilazad administration decreased CSF pressure during spinal cord ischemia and reperfusion and, like CSF drainage, increased and improved the perfusion pressure to the spinal cord, decreased spinal cord damage, and improved functional outcome. These effects may be related to the role that Tirilazad has on free radical scavenging during ischemia and reperfusion, and it is possible that Tirilazad therapy alone or in combination with CSF drainage is an effective adjunct to other neural protective measures in spinal cord injury.

Sign in / Sign up

Export Citation Format

Share Document