Comprehensive Algorithm for Skull Base Dural Lesion and Cerebrospinal Fluid Fistula Diagnosis

Meço, Cem; Oberascher, G

doi:10.1097/00005537-200406000-00007

Cited by 103 publications

(117 citation statements)

References 23 publications

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“…CT scans in general, and high-resolution CT (HRCT) scans in particular, produce the best definition of bony structures and are considered to be the method of choice for the investigation of basal skull defects by many authors (118,128). An added advantage, in contrast to other techniques discussed below, is that HRCT is a noninvasive technique.…”

Section: Investigationsmentioning

confidence: 99%

Epidemiology, Etiology, Pathogenesis, and Diagnosis of Recurrent Bacterial Meningitis

2008

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SUMMARY Recurrent bacterial meningitis is a rare phenomenon and generally poses a considerable diagnostic challenge to the clinician. Ultimately, a structured approach and early diagnosis of any underlying pathology are crucial to prevent further episodes and improve the overall outcome for the affected individual. In this article, we are reviewing the existing literature on this topic over the last two decades, encompassing 363 cases of recurrent bacterial meningitis described in 144 publications. Of these cases, 214 (59%) were related to anatomical problems, 132 (36%) were related to immunodeficiencies, and 17 (5%) were related to parameningeal infections. The review includes a detailed discussion of the underlying pathologies and microbiological aspects as well as recommendations for appropriate diagnostic pathways for investigating this unusual entity.

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Section: Investigationsmentioning

confidence: 99%

Epidemiology, Etiology, Pathogenesis, and Diagnosis of Recurrent Bacterial Meningitis

2008

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“…85 Another protein proposed as a potential marker for the diagnosis of CSF rhinorrhea is b-trace protein, or bTP. 4,45,[83][84][85]98,103,112 It is the second most abundant protein in human CSF following albumin 83 and is mainly produced in the epithelial cells of the choroid plexus and in the leptomeninges in the CNS. 83,103 The CSF concentration of bTP is approximately 35-fold higher than in plasma.…”

Section: Diagnosis Of Csf Rhinorrheamentioning

confidence: 99%

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Ziu¹,

Savage²,

Jimenez³

2012

FOC

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Cerebrospinal fluid rhinorrhea is a serious and potentially fatal condition because of an increased risk of meningitis and brain abscess. Approximately 80% of all cases occur in patients with head injuries and craniofacial fractures. Despite technical advances in the diagnosis and management of CSF rhinorrhea caused by craniofacial injury through the introduction of MRI and endoscopic extracranial surgical approaches, difficulties remain. The authors review here the pathophysiology, diagnosis, and management of CSF rhinorrhea relevant exclusively to traumatic anterior skull base injuries and attempt to identify areas in which further work is needed.

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“…CSF drainage not done in any patient pre operatively while 4 (13.3%) patients had undergone post operative CSF drainage. Associated facial bone fractures were not operated pre operatively while 3 (12%) patients had under gone surgery for facial fractures and 3 lastly sinus was not repaired in any patient while it was packed in all 30 (100%) patients.…”

Section: Resultsmentioning

confidence: 99%

Transcranial Dural Repair; Efficacy in the Management of Early Traumatic Cerebrospinal Fluid Rhinorrhea

Amir¹,

Qadir²,

Usman³

2017

TPMJ

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ABSTRACT… Objectives: To determine efficacy of transcranial dural repair in management of early traumatic cerebrospinal fluid (CSF) rhinorrhea by measuring the rate of resolution of rhinorrhea following repair. Material and Study Design: Descriptive study. Period: 18 months from March 2014 to September 2015. Setting: Department of Neurosurgery Naseer Teaching hospital Peshawar. Methods: 30 patients, all head injury patients with CSF rhinorrhea of either gender and any age, reporting to Accident and emergency department were included in the study. MRI Brain T2 Weighted in prone position done in all cases to identify the dural rent. Transcranial intradural repair was done through subfrontal approach. Post op complications were documented and follow at two months. Results: In this study 30 patients with cerebrospinal fluid (CSF) leak were observed. The minimum age was 8 years and the maximum was 59 years. 23 (76.6%) were male and 7 (23.3%) were female. 18 (60%) patients have CSF rhinorrhea due to road traffic accident, 7 (23.3%) patient with history of fall, while 5 (6.6%) patient were in other category. MRI brain T-2 Weighted done in all patient to identify the dural defect. The surgical approach was intradural in all of the 30 (100%) patients having fascia lata graft in 28 (93.3%) patients and pericranium in 2 (7%) patients to cover the defect properly. Among the immediate complications 3 (10%) patients had recurrent CSF leak, 2(6.6%) had meningitis, 5 (16.6%) had Pneumoencephalus while 3(10%) patients had other complications like subarachnoid hemorrhage, wound infection etc. The overall success rate was 90%. Conclusion: It is concluded that in post traumatic cerebrospinal fluid (CSF) rhinorrhea, if the defect in dura is demonstrated it must be repaired as soon as possible in order to prevent fulminant meningitis. Keywords:Cerebrospinal fluid rhinorrhea, efficacy, intradural, meningitis, subarachnoid hemorrhage.

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Comprehensive Algorithm for Skull Base Dural Lesion and Cerebrospinal Fluid Fistula Diagnosis

Cited by 103 publications

References 23 publications

Epidemiology, Etiology, Pathogenesis, and Diagnosis of Recurrent Bacterial Meningitis

Epidemiology, Etiology, Pathogenesis, and Diagnosis of Recurrent Bacterial Meningitis

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Transcranial Dural Repair; Efficacy in the Management of Early Traumatic Cerebrospinal Fluid Rhinorrhea

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