scholarly journals Supplementary Comment on “Computed Tomography Evaluation of Air Cells in the Petrous Bone —Relationship With Postoperative Cerebrospinal Fluid Rhinorrhea—”

2003 ◽  
Vol 43 (9) ◽  
pp. 469-469
Author(s):  
Ketan R. BULSARA ◽  
Ossama AL-MEFTY
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Petrous Bone ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Air Cells

CT Cisternography of Paradoxical Cerebrospinal Fluid Rhinorrhea after Operation for Acoustic Neuroma

2005 ◽  
Vol 18 (5-6) ◽  
pp. 555-558 ◽  
Author(s):  
B. Thomas ◽  
S. Purkayastha ◽  
S. Vattoth ◽  
A.K. Gupta
Keyword(s):  
Cerebrospinal Fluid ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Csf Leak ◽  
Ct Cisternography ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Acoustic Neuroma Surgery ◽  
Air Cells ◽  
Mastoid Air Cells

Cerebrospinal fluid (CSF) rhinorrhea after acoustic neuroma surgery is a well-known complication. CT cisternography can be used to demonstrate the entry of CSF from cerebellopontine angle cistern into the mastoid air cells, middle ear and then into nasopharynx via Eustachian tube. We report a case of paradoxical CSF rhinorrhea after surgery for acoustic neuroma in which the path of CSF leak was accurately demonstrated using CT cisternography.

Fat Implant is Superior to Muscle Implant in Vestibular Schwannoma Surgery for the Prevention of Cerebrospinal Fluid Fistulae

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONS38-ONS43 ◽  
Author(s):  
Wolf O. Lüdemann ◽  
Lennart H. Stieglitz ◽  
Venelin Gerganov ◽  
Amir Samii ◽  
Madjid Samii
Keyword(s):  
Cerebrospinal Fluid ◽  
Vestibular Schwannoma ◽  
Inverse Correlation ◽  
Tumor Grade ◽  
Petrous Bone ◽  
Csf Leak ◽  
Fat Tissue ◽  
Csf Leakage ◽  
Cranial Base Surgery ◽  
Air Cells

Abstract Objective: Meticulous sealing of opened air cells in the petrous bone is necessary for the prevention of cerebrospinal fluid (CSF) fistulae after vestibular schwannoma surgery. We performed a retrospective analysis to determine whether muscle or fat tissue is superior for this purpose. Methods: Between January 2001 and December 2006, 420 patients underwent retrosigmoidal microsurgical removal by a standardized procedure. The opened air cells at the inner auditory canal and the mastoid bone were sealed with muscle in 283 patients and with fat tissue in 137 patients. Analysis was performed regarding the incidence of postoperative CSF fistulae and correlation with the patient's sex and tumor grade. Results: The rate of postoperative CSF leak after application of fat tissue was lower (2.2%) than after use of muscle (5.7%). Women had less postoperative CSF leakage (3.4%) than men (5.6%). There was an inverse correlation with tumor grade. Patients with smaller tumors seemed to have a higher rate of CSF leakage than those with large tumors without hydrocephalus. Only large tumors with severe dislocation of the brainstem causing hydrocephalus showed a higher incidence of CSF leaks. Conclusion: Fat implantation is superior to muscle implantation for the prevention of CSF leakage after vestibular schwannoma surgery and should, therefore, be used for the sealing of opened air cells in cranial base surgery.

Cerebrospinal Fluid Rhinorrhea due to Transethmoidal Encephalocele Following Occipital Meningioma Resection in an Adult: A Case Report

2018 ◽  
Vol 80 (02) ◽  
pp. 138-140
Author(s):  
Robert Bartoš ◽  
Petr Vachata ◽  
Martin Sameš ◽  
Tomáš Radovnický
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Treatment Options ◽  
Rare Condition ◽  
Resonance Imaging ◽  
Csf Rhinorrhea ◽  
Nasal Mass ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Pathophysiologic Mechanisms

AbstractTransethmoidal encephalocele is a rare condition in adult patients. It is usually diagnosed during childhood by cerebrospinal fluid (CSF) rhinorrhea, meningitis, a nasal mass, or seizures. We present a case of an adult woman with CSF rhinorrhea following resection of an occipital meningioma. The cribriform plate defect containing the encephalocele was diagnosed by computed tomography and magnetic resonance imaging. Transcranial surgery using a patch was performed successfully. We also discuss the possible pathophysiologic mechanisms of encephalocele and treatment options.

Cerebrospinal fluid rhinorrhea following acoustic neurinoma surgery

1991 ◽  
Vol 74 (1) ◽  
pp. 152-153 ◽  
Author(s):  
Lindsay Symon ◽  
Malcolm F. Pell
Keyword(s):  
Cerebrospinal Fluid ◽  
Fibrin Glue ◽  
Acoustic Neurinoma ◽  
Csf Rhinorrhea ◽  
Content Type ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Csf Leakage ◽  
Air Cells ◽  
Mastoid Air Cells ◽  
Fine Print

✓ The authors describe a method of preventing cerebrospinal fluid (CSF) rhinorrhea following surgery for acoustic neurinoma. Mastoid air cells exposed during craniectomy are skeletonized and packed with bone dust, then covered with Surgicel soaked with Tisseel fibrin glue. The use of this technique has reduced the number of acoustic neurinoma cases requiring secondary mastoidectomy for CSF leakage from 16% to 5%.

scholarly journals When Mount Fuji Can Erupt after Seven Days: A Case Report of Delayed Posttraumatic Tension Pneumocephalus with Literature Review

2020 ◽  
Vol 11 (01) ◽  
pp. 187-190 ◽  
Author(s):  
V. T. T. Rajan ◽  
G. Krrithvi Dharini ◽  
V. S. Sathish Anand ◽  
H. S. Nandish
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Case Report ◽  
Literature Review ◽  
Surgical Intervention ◽  
Raised Intracranial Pressure ◽  
Tension Pneumocephalus ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Initial Injury ◽  
Cranial Fossa

AbstractTension pneumocephalus (TPC) is a neurosurgical emergency that occurs when there is an expansion of trapped intracranial gas causing raised intracranial pressure. Rarely, posttraumatic TPC can occur even after 72 hours although the initial scans are normal. There are less than 20 cases of delayed TPC in the reported literature. Here, we report a case of delayed TPC that occurred 7 days after the initial injury and presented as sudden neurological deterioration. It was promptly diagnosed with a computed tomography brain and appropriate surgical intervention was performed and the outcome was good. We also did a literature review of reported cases of delayed TPC and looked out for factors that may predict its occurrence. The occurrence of an episode of cerebrospinal fluid rhinorrhea, followed by worsening of headache and sensorium in a patient with anterior cranial fossa fracture should alert a neurosurgeon to the possibility of delayed TPC.

Reduction of cerebrospinal fluid rhinorrhea after vestibular schwannoma surgery by reconstruction of the drilled porus acusticus with hydroxyapatite bone cement

2007 ◽  
Vol 107 (2) ◽  
pp. 347-351 ◽  
Author(s):  
Clinton J. Baird ◽  
Alia Hdeib ◽  
Ian Suk ◽  
Howard W. Francis ◽  
Michael J. Holliday ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Prospective Observational Study ◽  
Posterior Wall ◽  
Csf Leak ◽  
Control Group ◽  
Significant Finding ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Hydroxyapatite Cement ◽  
Air Cells

Object Cerebrospinal fluid (CSF) rhinorrhea remains a significant cause of morbidity after resection of vestibular schwannomas (VSs), with rates of rhinorrhea after this procedure reported to range between 0 and 27%. The authors investigated whether reconstruction of the drilled posterior wall of the porus acusticus with hydroxyapatite cement (HAC) would decrease the incidence of postoperative CSF rhinorrhea. Methods A prospective observational study of 130 consecutive patients who underwent surgery for reconstruction of the posterior wall of the drilled porus acusticus with HAC was conducted between October 2002 and September 2005. All patients underwent a retrosigmoid transmeatal approach for VS resection and were followed up to document cases of CSF rhinorrhea, incisional CSF leak, meningitis, or rhinorrhea-associated meningitis. A cohort of 150 patients with VSs who were treated with the same surgical approach but without HAC reconstruction served as a control group. Results The authors found that HAC reconstruction of the porus acusticus wall significantly reduced the rate of postoperative CSF rhinorrhea in their patients. In the patients treated with HAC, rhinorrhea developed in only three patients (2.3%) compared with 18 patients (12%) in the control group. This was a statistically significant finding (p = 0.002, odds ratio = 5.8). Conclusions The use of HAC in the reconstruction of the drilled posterior wall of the porus acusticus, occluding exposed air cells, greatly reduces the risk of CSF rhinorrhea.

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