1/10. Spontaneous cerebrospinal fluid rhinorrhea associated with chronic renal failure--case report.A 39-year-old woman was admitted with complaints of headache and nasal discharge on the left for 3 months which was later on proved to be cerebrospinal fluid (CSF). Neurological examination found no abnormalities except bilateral papilledema. neuroimaging demonstrated enlargement of the lamina cribrosa foramina through which the olfactory nerves pass, as well as empty sella and cerebral cortical atrophy. Bone mineral densitometry showed osteopenia. CSF Ca and blood parathyroid hormone levels were elevated. CSF pressure was 280 mmH2O. Bilateral frontal craniotomy was performed to expose the anterior fossa. Foraminal enlargement at the lamina cribrosa was confirmed, and islands of extra-osseous calcifications on the arachnoid membrane were identified. The base of the anterior fossa was repaired intradurally with fascial graft and fibrin glue on both sides. No CSF leakage was noted at 1-year follow up. Spontaneous CSF leakage probably resulted from enlargement of the foramina at the lamina cribrosa due to Ca mobilization from bones and pseudotumor cerebri not to the extent of hydrocephalus caused by poor CSF absorption at the arachnoid granulations obliterated by extra-osseous calcareous accumulation.- - - - - - - - - - ranking = 1keywords = pseudotumor cerebri, cerebri, pseudotumor (Clic here for more details about this article) |
2/10. Pseudotumour cerebri, CSF rhinorrhoea and the role of venous sinus stenting in treatment.We present a case of pseudotumour cerebri (PTC), which is important as it illustrates the effects of chronically raised CSF pressure, the relationship between PTC and venous sinus obstruction and the successful treatment of PTC using a venous sinus stent. A 38-year-old woman, previously diagnosed with PTC and unsuccessfully treated 10 years previously re-presented with spontaneous CSF rhinorrhoea. Imaging revealed dramatic changes of chronically raised CSF pressure and a defect in the anterior cranial fossa. The CSF leak was corrected surgically and a lumbo-peritoneal shunt inserted to correct a large postoperative subgaleal CSF collection. Direct retrograde cerebral venography (DRCV) demonstrated venous sinus obstruction due to a filling defect. This was associated with a pressure gradient and a high superior sagittal sinus pressure. The venous sinus obstruction was successfully treated with a venous sinus stent and the lumbo-peritoneal shunt was removed. Chronically raised CSF pressure in untreated cases of PTC may cause widespread changes in the skull, which in this case, culminated in a spontaneous CSF leak despite relatively mild headache and visual symptoms. Furthermore, cases of PTC secondary to venous sinus obstruction may be successfully treated using venous sinus stenting. The index of suspicion for venous sinus stenosis or obstruction should be raised in the investigation of patients with PTC.- - - - - - - - - - ranking = 0.36251388284678keywords = cerebri (Clic here for more details about this article) |
3/10. Unanticipated complication of percutaneous radiofrequency trigeminal rhizotomy: rhinorrhea: report of three cases and a cadaver study.OBJECTIVE AND IMPORTANCE: Several neurosurgical procedures have been developed for the treatment of idiopathic trigeminal neuralgia: vascular decompression of the trigeminal root in the brainstem, percutaneous trigeminal ganglion procedures, and external beam radiosurgery. Percutaneous radiofrequency electrodes target the trigeminal fibers in the gasserian ganglion through the foramen ovale. Several complications of radiofrequency trigeminal rhizotomy (RF-TR) have been described, including puncture of the carotid artery, the cavernous sinus, and the cranial nerves. This study presents a very rare complication of percutaneous RF-TR, rhinorrhea, and attempts to define its mechanism. CLINICAL PRESENTATION: Of 2375 patients with idiopathic trigeminal neuralgia who underwent 2958 percutaneous RF-TR procedures, 3 developed subsequent rhinorrhea, which resolved spontaneously in 2 to 3 days. TECHNIQUE: Two formalin-fixed cadavers were dissected to demonstrate the relationship between the foramen ovale and the tuba auditiva and the mechanism of rhinorrhea. CONCLUSION: This article presents a very rare complication of RF-TR. Rhinorrhea and/or cerebrospinal fluid fistulae in the nasopharyngeal cavity are benign complications of RF-TR that result from puncturing both the membranous portion of the tuba auditiva (eustachian tube) and Meckel's cave with the rhizotomy needle.- - - - - - - - - - ranking = 0.0031247832665821keywords = idiopathic (Clic here for more details about this article) |
4/10. Shunt failure in idiopathic intracranial hypertension presenting with spontaneous cerebrospinal fluid leak.A case of spontaneous cerebrospinal (CSF) fluid leak after ventriculoperitoneal shunt (VPS) failure in a patient with idiopathic intracranial hypertension (IIH) is reported. This is the first report of spontaneous CSF leak in an IIH patient without a history of trauma, sinus surgery, or intracranial surgery. The diagnosis was confirmed using thin-sliced post-contrast computed tomography, which revealed a micro-dehiscence of the cribiform plate at the superior aspect of the ethmoid sinus. The patient underwent VPS revision without complication, resulting in complete amelioration of symptoms and cessation of CSF rhinorrhoea at 1 year follow up.- - - - - - - - - - ranking = 48.173615095425keywords = intracranial hypertension, hypertension, idiopathic (Clic here for more details about this article) |
5/10. CSF fistula and tension pneumatocele 22 years after head injury.An unusual case of CSF fistula and tension pneumatocele developing in a patient 22 years after a severe craniocerebral injury is reported. The patient had been asymptomatic during this long interval, but immediately after a minor head trauma massive rhinorrhea and diffuse pneumocephalus occurred. This was followed by the development of bifrontal tension pneumatocele with intracranial hypertension and neurological deterioration. The patient recovered after closure of the CSF fistula. The pathophysiological mechanism of this rare condition and the pertinent treatment are discussed.- - - - - - - - - - ranking = 9.6331606274517keywords = intracranial hypertension, hypertension (Clic here for more details about this article) |
6/10. Increased intracranial pressure in post-traumatic rhinorrhoea.Increased intracranial pressure coexistent with cerebrospinal fluid (CSF) rhinorrhoea was encountered in five out of 46 patients with a persistent CSF leak. In four patients, hypertension was due to malabsorption of CSF. One patient had a post-traumatic intracerebral cyst. The various degrees of intracranial hypertension, their effects on the clinical course and modes of treatment are demonstrated by the cases reported. Many failures in repairing the fistulous tracts may not stem from lack of technique, but could be the result of treatment of only one of the two concomitant conditions.- - - - - - - - - - ranking = 9.6481341435333keywords = intracranial hypertension, hypertension (Clic here for more details about this article) |
7/10. Benign intracranial hypertension: a cause of CSF rhinorrhoea.Four patients undergoing treatment for benign intracranial hypertension presented with spontaneous CSF rhinorrhoea. The four patients, all women, were aged between 33 and 44 years. They had been receiving treatment for benign intracranial hypertension for a period ranging from eight months to 11 years, before developing the CSF leak. There was no history of previous head injury and there were no congenital anomalies of the floor of the anterior fossa. The site of the CSF fistula was localised to the cribriform plate in all four cases. The pathophysiology of the CSF rhinorrhoea and the surgical management of this group of patients are discussed. The authors propose that benign intracranial hypertension should be included in the classification of high pressure CSF leaks.- - - - - - - - - - ranking = 207.85025307691keywords = benign intracranial hypertension, intracranial hypertension, hypertension (Clic here for more details about this article) |
8/10. Idiopathic spontaneous cerebrospinal fluid rhinorrhoea and pneumocephalus: case report and literature review.We report a case of idiopathic spontaneous cerebrospinal fluid rhinorrhoea associated with marked intraventricular pneumocephalus. The patient, a 60-year-old male, presented with confusion and urinary incontinence. CT cisternography failed to provide preoperative localization of the site of leakage.- - - - - - - - - - ranking = 0.0015623916332911keywords = idiopathic (Clic here for more details about this article) |
9/10. Spontaneous cerebrospinal fluid rhinorrhea in a patient with pseudotumor cerebri.Spontaneous cerebrospinal fluid rhinorrhea developed in a 46-year-old woman with pseudotumor cerebri. The origin of the fistula, the use of contrast computed tomographic cisternography to evaluate this lesion, and its surgical treatment are discussed.- - - - - - - - - - ranking = 5keywords = pseudotumor cerebri, cerebri, pseudotumor (Clic here for more details about this article) |
10/10. Idiopathic CSF rhinorrhoea presenting with tension pneumocephalus and hemiparesis.A case of non-traumatic/non-iatrogenic CSF rhinorrhoea, presenting with tension pneumocephalus and hemiparesis is described. The possible pathological processes involved in this rare case are discussed. Cases in the literature of idiopathic CSF rhinorrhoea and also those of spontaneous pneumocephalus are reviewed.- - - - - - - - - - ranking = 0.0015623916332911keywords = idiopathic (Clic here for more details about this article) |
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