Cerebrospinal fluid leaks from penetrating injuries: diagnosis and treatment
| Autor: | John Christos Styliaras, Richard Dalyai, James S. Harrop, H. Amgad, Ashwini Sharan |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Leak
medicine.medical_specialty medicine.diagnostic_test business.industry Biomedical Engineering Radionuclide cisternogram medicine.disease Surgery Pseudomeningocele Lumbar Cerebrospinal fluid Anesthesia Vomiting Medicine Radiology Nuclear Medicine and imaging Orthopedics and Sports Medicine Neurology (clinical) Anatomy Headaches medicine.symptom business Meningitis |
| Zdroj: | ArgoSpine News & Journal. 24:183-187 |
| ISSN: | 1957-7737 1957-7729 |
| Popis: | Penetrating Spinal Cord Injuries are often complicated by Cerebrospinal Fluid (CSF) leaks, which can be diagnosed either at initial presentation, or present themselves in a delayed fashion. Symptoms are usually non-specific and include positional headaches, nausea, vomiting, vertigo, and may even include hypotension, cranial nerve palsies, and in severe cases, meningitis. Imaging to detect CSF leaks include: plain radiographs, CT and MRI, CT-myelogram, radionuclide cisternograms, MRI with intrathecal gadolinium. Initial treatment of CSF leaks is conservative, including bedrest, hydration/overhydration, and medications such as caffeine and theophylline. Although overall treatment protocols are controversial, there seems to be a consensus that if a CSF leak persists for over 96 hours, it should be surgically treated, as it would inevitably increase the risks of pseudomeningocele formation and meningitis. Surgical options include a blood/fibrin patch, the placement of a lumbar drain, and ultimately surgical exploration and primary closure of the dural defect. |
| Databáze: | OpenAIRE |
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