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Wouter I. Schievink, Vittorio M. Morreale, John L. D. Atkinson, Fredric B. Meyer, David G. Piepgras, and Michael J. Ebersold

cerebrospinal fluid leak. Ophthalmology 101 : 244 – 251 , 1994 Hortan JC, Fishman RA: Neurovisual findings in the syndrome of spontaneous intracranial hypotension from dural cerebrospinal fluid leak. Ophthalmology 101: 244–251, 1994 5. Lehman RAW , Stears JC , Wesenberg RL , et al : Familial osteosclerosis with abnormalities of the nervous system and meninges. J Pediatr 90 : 49 – 54 , 1977 Lehman RAW, Stears JC, Wesenberg RL, et al: Familial osteosclerosis with abnormalities of the nervous system and

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Wouter I. Schievink, Fredric B. Meyer, John L. D. Atkinson, and Bahram Mokri

cerebrospinal fluid leak. Fig. 2. Axial (left) and coronal (right) T 2 -weighted magnetic resonance images displaying an abnormal collection of cerebrospinal fluid (CSF) in the left T-1 nerve-root foramen (arrows) in Case 8, representing a focal CSF leak or meningeal diverticulum. Fig. 3. Postmyelography computerized tomography scans showing extrathecal contrast extending bilaterally along the C-7 nerve roots into the paraspinal soft tissues in Case 5 (left) and sharply demarcated extrathecal collections of contrast along the ventral and

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Frank Mihlon, Peter G. Kranz, Andreia Roxana Gafton, and Linda Gray

glue therapy of cerebrospinal fluid leaks in the spine after surgery . AJR Am J Roentgenol 175 : 443 – 446 , 2000 10.2214/ajr.175.2.1750443 4 Patel MR , Louie W , Rachlin J : Postoperative cerebrospinal fluid leaks of the lumbosacral spine: management with percutaneous fibrin glue . AJNR Am J Neuroradiol 17 : 495 – 500 , 1996 5 Sencakova D , Mokri B , McClelland RL : The efficacy of epidural blood patch in spontaneous CSF leaks . Neurology 57 : 1921 – 1923 , 2001 10.1212/WNL.57.10.1921 6 Tafazal SI , Sell PJ : Incidental

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Wouter I. Schievink, M. Marcel Maya, and Mary Riedinger

. Schievink WI : Spontaneous spinal cerebrospinal fluid leaks: a review. Neurosurg Focus 9 (1) : Article 8 , 2000 Schievink WI: Spontaneous spinal cerebrospinal fluid leaks: a review. Neurosurg Focus 9 (1): Article 8, 2000 13. Schievink WI , Line J : Recurrent spontaneous spinal cerebrospinal fluid leak associated with “nude nerve root” syndrome. Neurosurgery (In press) Schievink WI, Line J: Recurrent spontaneous spinal cerebrospinal fluid leak associated with “nude nerve root” syndrome. Neurosurgery (In press

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Cedric D. Shorter, David E. Connor Jr., Jai Deep Thakur, Gale Gardner, Anil Nanda, and Bharat Guthikonda

C erebrospinal fluid leaks are a significant concern for surgeons who treat skull base pathology. Cerebrospinal fluid leaks from the middle fossa can be especially challenging to evaluate and treat. Uncomplicated, minuscule amounts of CSF leakage may only cause discomfort and not require surgical intervention. 34 However, symptoms such as hearing loss or recurrent meningitis mandate surgical exploration and repair of cranial defects. Appropriate management of CSF leaks requires a high index of suspicion and proper utilization and interpretation of

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Gurston G. Nyquist, Vijay K. Anand, Saral Mehra, Ashutosh Kacker, and Theodore H. Schwartz

B demonstrate the lesion medial (C) or lateral (D) to the middle turbinate. Cerebrospinal fluid leaks can be divided into posttraumatic, iatrogenic, and spontaneous, the first of which generally resolve without surgical intervention. The latter 2 categories can be particularly challenging to repair due to their high volume of flow, the difficulty in identifying the precise location of the leak, the potential for unrecognized mild increases in intracranial pressure, or congenital thinning of the skull base. The purpose of this study was to review a series of

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Jürgen Beck, Ulrich Hubbe, Jan-Helge Klingler, Roland Roelz, Luisa Mona Kraus, Florian Volz, Niklas Lützen, Horst Urbach, Kristin Kieselbach, and Christian Fung

Federation, September 8–12, 2021, held virtually; as an oral presentation at the European Association of Neurosurgical Societies, October 3–7, 2021, held virtually; and as an oral presentation at the 72nd Annual Meeting of the German Society of Neurosurgery, June 6–9, 2021, held virtually. References 1 Schievink WI , Morreale VM , Atkinson JL , Meyer FB , Piepgras DG , Ebersold MJ . Surgical treatment of spontaneous spinal cerebrospinal fluid leaks . J Neurosurg . 1998 ; 88 ( 2 ): 243 – 246 . 9452231 10.3171/jns.1998.88.2.0243 2 Schievink

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Wouter I. Schievink, Marc S. Schwartz, M. Marcel Maya, Franklin G. Moser, and Todd D. Rozen

, 2011 7 Schievink WI : Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension . JAMA 295 : 2286 – 2296 , 2006 8 Schievink WI , Maya MM : Frequency of intracranial aneurysms in patients with spontaneous intracranial hypotension. Clinical article . J Neurosurg 115 : 113 – 115 , 2011 9 Schievink WI , Maya MM , Louy C , Moser FG , Tourje J : Diagnostic criteria for spontaneous spinal CSF leaks and intracranial hypotension . AJNR Am J Neuroradiol 29 : 853 – 856 , 2008 10 Schievink WI , Palestrant D , Maya

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Wouter I. Schievink, M. Marcel Maya, Brian K. Pikul, and Charles Louy

Clin Neurosci 13 : 823 – 827 , 2006 17 Sambasivan M : An overview of chronic subdural hematoma: experience with 2300 cases . Surg Neurol 47 : 418 – 422 , 1997 18 Schievink WI : Misdiagnosis of spontaneous intracranial hypotension . Arch Neurol 60 : 1713 – 1718 , 2003 19 Schievink WI : Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension . JAMA 295 : 2286 – 2296 , 2006 20 Schievink WI , Maya MM , Louy C , Moser FG : Diagnostic criteria for spontaneous spinal CSF leaks and intracranial hypotension . AJNR

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Alejandro J. Lopez, Robert K. Campbell, Omar Arnaout, Yvonne M. Curran, Ali Shaibani, and Nader S. Dahdaleh

. Development 139 : 3633 – 3643 , 2012 10.1242/dev.080051 18 Sato Y , Honda Y , Maruoka H , Kunoh H , Oizumi K : Subdural hematoma following disappearance of orthostatic headache and pressure normalization in two patients with spontaneous intracranial hypotension . Cephalalgia 18 : 60 – 63 , 1998 10.1046/j.1468-2982.1998.1801060.x 19 Schievink WI : Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension . JAMA 295 : 2286 – 2296 , 2006 10.1001/jama.295.19.2286 20 Schievink WI , Ebersold MJ , Atkinson JL : Roller