Back to Search
Start Over
False localizing sign of cervico-thoracic CSF leak in spontaneous intracranial hypotension
- Source :
- Neurology. 84:2445-2448
- Publication Year :
- 2015
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2015.
-
Abstract
- Objective: Spontaneous spinal CSF leaks are an important cause of new-onset headaches. Such leaks are reported to be particularly common at the cervico-thoracic junction. The authors undertook a study to determine the significance of these cervico-thoracic CSF leaks. Methods: The patient population consisted of a consecutive group of 13 patients who underwent surgery for CSF leak repair based on CT myelography showing CSF extravasation at the cervico-thoracic junction but without any evidence of an underlying structural lesion. Results: The mean age of the 9 women and 4 men was 41.2 years. Extensive extrathecal longitudinal CSF collections were demonstrated in 11 patients. At surgery, small leaking arachnoid cysts were found in 2 patients. In the remaining 11 patients, no clear source of CSF leakage could be identified at surgery. Resolution of symptoms was achieved in both patients with leaking arachnoid cysts, but in only 3 of the 11 patients with negative intraoperative findings. Postoperative spinal imaging was performed in 9 of the 11 patients with negative intraoperative findings and showed persistence of the longitudinal intraspinal extradural CSF. Further imaging revealed the site of the CSF leak to be ventral to the thoracic spinal cord. Five of these patients underwent microsurgical repair of the ventral CSF leak with resolution of symptoms in all 5 patients. Conclusions: Cervico-thoracic extravasation of dye on myelography does not necessarily indicate the site of the CSF leak. Treatment directed at this site should not be expected to have a high probability of sustained improvement of symptoms.
- Subjects :
- Adult
Male
medicine.medical_specialty
Leak
Dura mater
Intracranial Hypotension
Thoracic Vertebrae
medicine
Humans
Longitudinal Studies
Myelography
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
Middle Aged
Spinal cord
Magnetic Resonance Imaging
Subdural Effusion
Surgery
medicine.anatomical_structure
Thoracic vertebrae
Cervical Vertebrae
Female
Dura Mater
Neurology (clinical)
Headaches
medicine.symptom
Tomography, X-Ray Computed
business
Cervical vertebrae
Subjects
Details
- ISSN :
- 1526632X and 00283878
- Volume :
- 84
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....c2e75ca2f68f8be3544c9c69727498b4