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Cerebrospinal fluid leaks from penetrating injuries: diagnosis and treatment

Cerebrospinal fluid leaks from penetrating injuries: diagnosis and treatment 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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png ArgoSpine News & Journal Springer Journals

Cerebrospinal fluid leaks from penetrating injuries: diagnosis and treatment

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References (31)

Publisher
Springer Journals
Copyright
Copyright © 2013 by ARGOS and Springer-Verlag France
Subject
Medicine & Public Health; Orthopedics; Surgical Orthopedics; Diagnostic Radiology
ISSN
1957-7729
eISSN
1957-7737
DOI
10.1007/s12240-012-0062-x
Publisher site
See Article on Publisher Site

Abstract

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.

Journal

ArgoSpine News & Journal – Springer Journals

Published: Mar 28, 2013

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