Search Results

You are looking at 1 - 10 of 1,788 items for :

Clear All
Restricted access

Matei A. Banu, Oszkar Szentirmai, Lino Mascarenhas, Al Amin Salek, Vijay K. Anand and Theodore H. Schwartz

I ntracranial air, or pneumocephalus, is a relatively common finding on postoperative imaging studies following both endoscopic endonasal skull base surgery (ESBS) 28 , 33 and open craniofacial procedures. 3 , 51 With modern imaging modalities, as little as 0.5 cc of air can now be detected in the cranial vault. 36 , 49 However, intracranial air can also be an ominous sign of a dural breech and a persistent CSF leak, which dramatically increase the risk of meningitis. 18 , 19 Moreover, increasing amounts of intracranial air can lead to tension

Full access

Ryota Tamura, Ryosuke Tomio, Farrag Mohammad, Masahiro Toda and Kazunari Yoshida

postoperative CSF leakage at our hospital was still not low—12.9% in the first 15 years and 13.2% in the last 15 years. In most cases, the ATPA cannot be performed without opening the air cells, because it requires drilling of the squamous part of the temporal bone and petrous apex, as described above. In general, the large dural defect is covered by a flap of vascularized temporalis fascia, and the opened air cells are replaced by autologous tissues (e.g., fat or muscle tissue) and fibrin glue to prevent a CSF leak. 10 , 36 However, in large series of patients who underwent

Full access

Gazanfar Rahmathulla and H. Gordon Deen

-link along with adhesive arachnoiditis in the L4–5 region, seen by clumping of the nerve roots in the region ( Fig. 2 ). Intraoperatively we observed a pedicle screw-rod construct with an integrated low-lying transverse cross-link curving inwards into the spinal canal. There was a pseudarthrosis at the level of the L4–5 fusion. The cross-link was embedded in the spinal canal, causing significant dural compression, as predicted by the preoperative imaging studies ( Fig. 3A ). We noted a significant CSF leak as soon as we started to dissect and expose soft tissue around the

Restricted access

Takayuki Ishikawa, Kazuhito Takeuchi, Yuichi Nagata, Jungsu Choo, Teppei Kawabata, Tomotaka Ishizaki and Toshihiko Wakabayashi

suturing. We usually suture 3 points of the dura like a triangle. We sometimes suture the dura more tightly when there is a moderate dural defect or grade 2–3 CSF leaks. C: The view after dural suturing. Copyright Takayuki Ishikawa ( lower row ). Published with permission. Figure is available in color online only. Type 2: Extended Endoscopic TSS Without Considerable Dural Defect Group (“Shoelace” Dural Suturing With Fat) The representative lesion for the type 2 group is a craniopharyngioma (not invading the dura), suprasellar arachnoid cyst, and Rathke’s cleft cyst

Restricted access

Neurosurgical Forum: Letters to the editor To the Editor Jack Kushner , M.D. Annapolis, Maryland 413 413 With reference to the article on tissue adhesive for CSF leaks (Maxwell J, Goldman S: Use of tissue adhesive in the surgical treatment of cerebrospinal fluid leaks. J Neurosurg 39: 332–336, September, 1973), I should like to mention another useful technique about which little has been published. For the past 20 years at the Bowman Gray School of Medicine, neurosurgeons have been using stainless steel wire

Restricted access

Brian J. Dlouhy, Karthik Madhavan, John D. Clinger, Ambur Reddy, Jeffrey D. Dawson, Erin K. O'Brien, Eugene Chang, Scott M. Graham and Jeremy D. W. Greenlee

is often important for prevention of postoperative CSF leaks. 6 , 9 , 23 However, no reconstruction technique has been shown to be superior to another. 6 In addition to proper sellar reconstruction, understanding the additional risk factors associated with postoperative CSF leakage is important for limiting this significant complication. Obesity is an increasing public health problem in the US and is associated with significant morbidity. 31 In 2007–2008, the prevalence of obesity was 32.2% among adult men and 35.5% among adult women, where “overweight” was

Full access

Chikezie I. Eseonu, C. Rory Goodwin, Xin Zhou, Debebe Theodros, Matthew T. Bender, Dimitrios Mathios, Chetan Bettegowda and Michael Lim

M icrovascular decompression (MVD) is a surgical technique used for the treatment of cranial nerve neuralgias or spasm via alleviation of pathologic nerve compression using a retrosigmoid suboccipital approach. 11 Trigeminal neuralgia and hemifacial spasm, as a result of compression of cranial nerves V and VII, respectively, account for the majority of cranial nerve diseases addressed with MVD. 12 Despite progressive advances in surgical technique, complications with MVD still occur. CSF leaks are a serious postoperative complication. The incidence of

Full access

.2000.9.1.7 Spontaneous spinal cerebrospinal fluid leaks: a review Wouter I. Schievink 7 2000 9 1 1 9 10.3171/foc.2000.9.1.8 FOC.2000.9.1.8 Treatment of the subarachnoid–pleural fistula Serdar Ozgen Burak O. Boran Ilhan Elmaci Ugur Ture M. Necmettin Pamir 7 2000 9 1 1 4 10.3171/foc.2000.9.1.9 FOC.2000.9.1.9 Neurosurg Focus Neurosurgical FOCUS 1092-0684 Journal of Neurosurgery Publishing Group 1 7 2000 July 2000 9 1 10.3171/foc.2000.9.issue-1 Cranial and Spinal CSF Leaks

Restricted access

Hugh Harrington, H. Richard Tyler and Keasley Welch

C hronic headache due to cerebrospinal fluid (CSF) leak is a serious complication of lumbar puncture. Treatment of the condition can be difficult. We report the case of a 58-year-old woman who suffered incapacitating headache and occipital paresthesiae for 5 years after lumbar myelography. A suspected CSF leak was finally confirmed using a special radiographic technique. After surgical repair of the deficit, there was almost complete alleviation of symptoms. Case Report In January, 1975, this previously healthy 53-year-old woman underwent myelography as

Restricted access

John W. Rutland, Satish Govindaraj, Corey M. Gill, Michael Shohet, Alfred M. C. Iloreta Jr., Joshua B. Bederson, Raj K. Shrivastava and Bradley N. Delman

cavity and paranasal sinuses. The goals of surgery for both traumatic and primary spontaneous CSF leaks are to seal the cranial defect and to separate the cranial vault from the sinonasal tract, while preserving ocular and cranial nerve function. Advancements in endoscopic transnasal sinus surgery have permitted high rates of successful CSF leak repair while minimizing the need for transcranial approaches to the anterior skull base. 3 , 7 , 14 Despite many advances in the field of endoscopic surgery, the optimal diagnosis and management of anterior skull base CSF