scholarly journals Revision Surgery Technique in the Treatment of Refractory Subcutaneous Cerebrospinal Fluid Collection Combined with Intracranial Infection Following Posterior Fossa Surgery

Cureus ◽  
2020 ◽  
Author(s):  
Weilong Ding ◽  
Hua Chen ◽  
Yongsheng Xiang ◽  
Jiancheng Liao ◽  
Xiaoming Qi ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Revision Surgery ◽  
Fluid Collection ◽  
Posterior Fossa Surgery ◽  
Intracranial Infection ◽  
Surgery Technique

Use of ligamentum nuchae graft for dural closure in posterior fossa surgery

1998 ◽  
Vol 89 (1) ◽  
pp. 155-156 ◽  
Author(s):  
Edward J. Kosnik
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Cerebrospinal Fluid Leakage ◽  
Posterior Fossa Surgery ◽  
Content Type ◽  
Fluid Leakage ◽  
Dural Closure ◽  
Fine Print

✓ The technique of harvesting the ligamentum nuchae and its use in posterior fossa surgery are discussed. By using this technique the author has avoided postoperative cerebrospinal fluid leakage in more than 200 procedures.

scholarly journals Cerebrospinal Fluid Leaks and Pseudomeningocele after Posterior Fossa Surgery: Effect of an Autospray Dural Sealant

Cureus ◽  
2020 ◽  
Author(s):  
Young M Lee ◽  
Angel Ordaz ◽  
Beata Durcanova ◽  
Jennifer A Viner ◽  
Philip V Theodosopoulos ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Cerebrospinal Fluid Leaks

Polyethylene Glycol Hydrogel Dural Sealant May Reduce Incisional Cerebrospinal Fluid Leak after Posterior Fossa Surgery

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONS182-ONS187 ◽  
Author(s):  
Khoi D. Than ◽  
Clinton J. Baird ◽  
Alessandro Olivi
Keyword(s):  
Cerebrospinal Fluid ◽  
Polyethylene Glycol ◽  
Fibrin Glue ◽  
Posterior Fossa ◽  
Cerebrospinal Fluid Leak ◽  
Csf Leak ◽  
P Value ◽  
Posterior Fossa Surgery ◽  
Dural Closure ◽  
Fluid Leak

Abstract Objective: Incisional cerebrospinal fluid (CSF) leak remains a significant cause of morbidity, particularly after posterior fossa surgery, with ranges between 4 and 17% in most series. We aimed to determine whether the use of a new polyethylene glycol (PEG) dural sealant product (DuraSeal; Confluent Surgical, Waltham, MA) is effective at preventing incisional CSF leak after posterior fossa surgery. Methods: One hundred cases of posterior fossa surgery with the PEG dural sealant applied at the time of dural closure were prospectively observed from May 2005 to April 2006. All patients underwent posterior fossa craniotomy or craniectomy. Clinical histories were followed to document cases of incisional CSF leak, pseudomeningocele, meningitis, wound infection, and interventions required to treat a CSF leak or pseudomeningocele. A retrospective cohort of 100 patients treated in a similar fashion but with fibrin glue augmented dural closure served as controls. Results: In the PEG group, two of 100 (2%) patients developed an incisional CSF leak postoperatively. By comparison, 10 of 100 (10%) patients in whom fibrin glue was used developed an incisional CSF leak. This difference was statistically significant, with a P value of 0.03. There were no significant differences in the rates of pseudomeningocele, meningitis, or other postoperative interventions. Conclusion: The application of PEG dural sealant to the closed dural edges may be effective at reducing incisional CSF leak after posterior fossa surgery.

Leptomeningeal cyst of the posterior fossa

1986 ◽  
Vol 65 (5) ◽  
pp. 704-705 ◽  
Author(s):  
Shigeru Nemoto ◽  
Harold J. Hoffman
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Fluid Collection ◽  
Leptomeningeal Cyst ◽  
Content Type ◽  
Occipital Encephalocele ◽  
Fine Print

✓ A patient with a posttraumatic leptomeningeal cyst is described. The cyst simulated an occipital encephalocele and communicated with an epidural cerebrospinal fluid collection in the posterior fossa.

The temporoparietal fascia flap folded into a ball in the treatment of retroauricular cerebrospinal fluid fistulae after posterior fossa surgery

2016 ◽  
Vol 158 (6) ◽  
pp. 1221-1224
Author(s):  
Charlotte Jaloux ◽  
Pierre-Hugues Roche ◽  
Baptiste Bertrand ◽  
Dominique Casanova ◽  
Cécile Philandrianos
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Posterior Fossa Surgery ◽  
Temporoparietal Fascia ◽  
Temporoparietal Fascia Flap ◽  
Fascia Flap

scholarly journals Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery

2016 ◽  
Vol 6 (2) ◽  
Author(s):  
Verena Heymanns ◽  
Abidemi W. Oseni ◽  
Ameer Alyeldien ◽  
Homajoun Maslehaty ◽  
Richard Parvin ◽  
...  
Keyword(s):  
New York ◽  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Wound Closure ◽  
Posterior Fossa Surgery ◽  
Dural Closure ◽  
Csf Leakage ◽  
Cerebrospinal Fluid Leaks ◽  
Closure Method ◽  
Csf Leaks

Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark), Gelfoam® (Pfizer Inc., New York, NY, USA) and polymethylmethacrylate (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.

Aseptic meningitis following posterior fossa surgery in children

1974 ◽  
Vol 41 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Peter W. Carmel ◽  
Richard A. R. Fraser ◽  
Bennett M. Stein
Keyword(s):  
Cerebrospinal Fluid ◽  
Posterior Fossa ◽  
Aseptic Meningitis ◽  
Steroid Therapy ◽  
High Protein ◽  
Posterior Fossa Surgery ◽  
Content Type ◽  
Suboccipital Craniectomy ◽  
Postoperative Hydrocephalus ◽  
Fine Print

✓ The results of suboccipital craniectomy for varying types of posterior fossa pathology in 50 children are reported. Thirty-five (70%) experienced aseptic meningitis postoperatively, with spiking fever and meningismus; cerebrospinal fluid (CSF) studies revealed pleocytosis, high protein values, and depression of glucose. The absence of bacterial pathogens in serial CSF cultures distinguishes this syndrome from septic meningitis. Aseptic meningitis does not respond to antibiotics, but steroids in suitable doses will modify or suppress the clinical and CSF picture. This syndrome may predispose to postoperative hydrocephalus, but steroid therapy may diminish this risk.

scholarly journals Superficial siderosis of the central nervous system associated with incomplete dural closure following posterior fossa surgery: report of 3 cases

2015 ◽  
Vol 123 (5) ◽  
pp. 1326-1330 ◽  
Author(s):  
Ravi Kumar ◽  
Jeffrey T. Jacob ◽  
Kirk M. Welker ◽  
Fred M. Cutrer ◽  
Michael J. Link ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Posterior Fossa ◽  
Revision Surgery ◽  
Diagnosis And Treatment ◽  
Superficial Siderosis ◽  
Posterior Fossa Surgery ◽  
Dural Closure ◽  
The Central Nervous System

This report reviews a series of 3 patients who developed superficial siderosis following posterior fossa operations in which dural closure was incomplete. In all 3 patients, revision surgery and complete duraplasty was performed to halt the progression of superficial siderosis. Following surgery, 2 patients experienced resolution of their CSF xanthochromia while 1 patient had reduced CSF xanthochromia. In this paper the authors also review the etiology, pathophysiology, diagnosis, and treatment of this condition. The authors suggest that posterior fossa dural patency and pseudomeningocele are risk factors for the latent development of superficial siderosis and recommend that revision duraplasty be performed in patients with posterior fossa pseudomeningoceles and superficial siderosis to prevent progression of the disease.

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