Cerebrospinal fluid leaks from penetrating injuries

Diagnosis and treatment

John C. Styliaras, R. Dalyai, H. Amgad, A. Sharan, J. Harrop

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)183-187
Number of pages5
JournalArgoSpine News and Journal
Volume24
Issue number3-4
DOIs
StatePublished - 2012
Externally publishedYes

Fingerprint

Cerebrospinal fluid
Wounds and Injuries
Meningitis
Magnetic resonance imaging
Caffeine
Cranial Nerve Diseases
Bed Rest
Gadolinium
Vertigo
Therapeutics
Theophylline
Clinical Protocols
Fibrin
Spinal Cord Injuries
Radioisotopes
Hydration
Hypotension
Nausea
Vomiting
Headache

Keywords

  • cerebrospinal leak
  • CT-myelogram
  • diagnosis of CSF leak
  • dural defects
  • intrathecal gadolinium
  • penetrating injury
  • radionuclide cisternogram
  • traumatic spinal cord injury
  • treatment of CSF leak

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery
  • Clinical Neurology
  • Anatomy
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging

Cite this

Styliaras, J. C., Dalyai, R., Amgad, H., Sharan, A., & Harrop, J. (2012). Cerebrospinal fluid leaks from penetrating injuries: Diagnosis and treatment. ArgoSpine News and Journal, 24(3-4), 183-187. https://doi.org/10.1007/s12240-012-0062-x

Cerebrospinal fluid leaks from penetrating injuries : Diagnosis and treatment. / Styliaras, John C.; Dalyai, R.; Amgad, H.; Sharan, A.; Harrop, J.

In: ArgoSpine News and Journal, Vol. 24, No. 3-4, 2012, p. 183-187.

Research output: Contribution to journalArticle

Styliaras, JC, Dalyai, R, Amgad, H, Sharan, A & Harrop, J 2012, 'Cerebrospinal fluid leaks from penetrating injuries: Diagnosis and treatment', ArgoSpine News and Journal, vol. 24, no. 3-4, pp. 183-187. https://doi.org/10.1007/s12240-012-0062-x
Styliaras, John C. ; Dalyai, R. ; Amgad, H. ; Sharan, A. ; Harrop, J. / Cerebrospinal fluid leaks from penetrating injuries : Diagnosis and treatment. In: ArgoSpine News and Journal. 2012 ; Vol. 24, No. 3-4. pp. 183-187.
@article{ef6120c94d33499a9df73879afa8c5df,
title = "Cerebrospinal fluid leaks from penetrating injuries: Diagnosis and treatment",
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.",
keywords = "cerebrospinal leak, CT-myelogram, diagnosis of CSF leak, dural defects, intrathecal gadolinium, penetrating injury, radionuclide cisternogram, traumatic spinal cord injury, treatment of CSF leak",
author = "Styliaras, {John C.} and R. Dalyai and H. Amgad and A. Sharan and J. Harrop",
year = "2012",
doi = "10.1007/s12240-012-0062-x",
language = "English (US)",
volume = "24",
pages = "183--187",
journal = "ArgoSpine News and Journal",
issn = "1957-7729",
publisher = "Springer Paris",
number = "3-4",

}

TY - JOUR

T1 - Cerebrospinal fluid leaks from penetrating injuries

T2 - Diagnosis and treatment

AU - Styliaras, John C.

AU - Dalyai, R.

AU - Amgad, H.

AU - Sharan, A.

AU - Harrop, J.

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

KW - cerebrospinal leak

KW - CT-myelogram

KW - diagnosis of CSF leak

KW - dural defects

KW - intrathecal gadolinium

KW - penetrating injury

KW - radionuclide cisternogram

KW - traumatic spinal cord injury

KW - treatment of CSF leak

UR - http://www.scopus.com/inward/record.url?scp=84875926045&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875926045&partnerID=8YFLogxK

U2 - 10.1007/s12240-012-0062-x

DO - 10.1007/s12240-012-0062-x

M3 - Article

VL - 24

SP - 183

EP - 187

JO - ArgoSpine News and Journal

JF - ArgoSpine News and Journal

SN - 1957-7729

IS - 3-4

ER -