[QxMD MEDLINE Link]. 2022 Feb;45(1):831-841. doi: 10.1007/s10143-021-01614-1. MR cisternography is performed with heavily T2-weighted, fast spin-echo, fat-saturated sequences with thin sections and minimal or no gap. For otorrhea, 1 cotton pledget is placed in each external auditory canal. 2017 Feb. 78 (1):18-23. Data is temporarily unavailable. A new approach for simple radioisotope cisternography examination in cerebrospinal fluid leakage detection. 2009 Oct. 72(4):341-5; discussion 346. When CSF rhinorrhea is suspected, fluorescein may be injected into the lumbar subarachnoid space. Letter to the Editor: Double Ring Sign Does Not Exclude CSF The https:// ensures that you are connecting to the 2000 Jul. Pledgets are placed close to the cribriform plate, in the middle meatus, and in the sphenoethmoidal recess of the right and left nasal cavities. Would you like email updates of new search results? [QxMD MEDLINE Link]. [Full Text]. The underlying defect responsible for cerebrospinal fluid (CSF) leaks, regardless of the etiology, is the same: disruption in the arachnoid and dura mater coupled with an osseous defect and a CSF pressure gradient that is continuously or intermittently greater than the tensile strength of the disrupted tissue. In patients with nonsurgical trauma, waiting a period of 5-7 days to allow conservative measures (bed rest, stool softeners, and lumbar drainage) to assist with secondary closure of the traumatic defect is reasonable. Despite relatively low levels of evidence, recommendations for the diagnosis and management of CSF rhinorrhea can be made based on the current literature. 19(4):633-9. NSF/NFD is a debilitating and sometimes fatal disease. 2008 Jun. Bharucha T, Chanthongthip A, Phuangpanom S, Phonemixay O, Sengvilaipaseuth O, Vongsouvath M, Lee S, Newton PN, Dubot-Prs A. PLoS Negl Trop Dis. This study may also be useful for detecting inactive fistulas, intermittent leaks, or suspected meningoencephaloceles. [QxMD MEDLINE Link]. [11] In contrast to unilateral rhinorrhea, bilateral rhinorrhea gives no clue of the laterality of the defect. Bonnie Kaplan, MD, showed a picture of blood leaking from the ear of an injured patient onto a bed sheet, which forms a double ring sign, in the December Quick Consult. HEENT: nose Flashcards | Quizlet This dislocation allows CSF to flow to the opposite side and manifest at the contralateral naris. [15]. [QxMD MEDLINE Link]. Br J Neurosurg. Defects in the posterior table of the frontal sinus may be approached externally via a coronal incision and osteoplastic flap. Lu X, Zhai X, Li H, Yang X, Hang W, Liu G. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. Radionuclide cisternography is performed by administering a lumbar subarachnoid intrathecal injection of Indium-111 (111In) diethylenetriamine pentaacetic acid (DTPA) in a 500 Ci dose. [7], A literature review by Lobo et al indicated that in addition to increased ICP, risk factors for spontaneous CSF leaks include obesity, female gender, and obstructive sleep apnea. Dandy is credited with the first surgical repair of a CSF leak via a frontal craniotomy approach in 1926. However, locally aggressive lesions such as inverted papilloma and malignant neoplasms can erode the bone of the anterior cranial fossa. Methods: European Pituitary Adenoma Surgery Survey (EU-PASS) results-technical part. 2020 Feb 28. Blunt trauma is the most common cause. The brain is noted to sink downward in the cranium with development of a pseudo-Chiari I malformation. J Clin Diagn Res. Sagittal magnetic resonance myelogram demonstrates a traumatic cerebrospinal fluid leak (small arrows) with disruption of the ligamentum flavum posteriorly (large arrow).
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