Database : MEDLINE
Search on : Cerebrospinal and Fluid and Rhinorrhea [Words]
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[PMID]: 28452710
[Au] Autor:Loftus PA; Wise SK; Daraei P; Baugnon K; DelGaudio JM
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.
[Ti] Title:Excavating meningoencephaloceles: A newly recognized entity.
[So] Source:Am J Rhinol Allergy;31(2):127-134, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks are largely attributed to idiopathic intracranial hypertension and typically present as skull base defects with or without prolapse of intracranial contents. However, in our practice, we have encountered a distinct type of spontaneous CSF leak that presents in a different manner. OBJECTIVE: To discuss a newly-classified, difficult to treat, subset of spontaneous CSF leaks that present as excavation of the bone of the skull base in a tunnel- or canal-like fashion by a meningocele or meningoencephalocele instead of as a localized area of bony dehiscence. METHODS: A retrospective review was performed at a tertiary care rhinology practice to identify a subset of CSF leak patients with an excavating/canal-like skull base defect visualized radiographically on computed tomography (CT) scan or magnetic resonance imaging and/or endoscopically in the operating room. RESULTS: The cohort of patients consisted of 7 females and 1 male with an average age of 53.6 years and a self-reported race of 4:3:1 African-American:Caucasian:Indian. All patients presented with CSF rhinorrhea. The most common leak site was the cribriform and upper septum. Six of the 8 patients had multiple defects and/or progression of their skull base defects, and 5 patients required multiple and/or repeat repairs in the operating room. Seven of the 8 patients underwent a cisternogram because the excavating nature of the leaks made it difficult to identify the specific leak site on high-resolution CT scan alone. CONCLUSION: In spontaneous CSF leaks that are difficult to identify or recur soon after a proper repair, an excavating pattern should be considered. Failure to recognize this type of leak and all of its tributaries, to fully unroof the excavated bone to completely resect the meningocele, and to visualize and close the site of origin will likely result in failure and recurrence of CSF leak.
[Mh] MeSH terms primary: Cerebrospinal Fluid Leak/diagnosis
Encephalocele/diagnosis
Meningocele/diagnostic imaging
Skull Base/diagnostic imaging
Skull Base/pathology
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Cerebrospinal Fluid Leak/surgery
Encephalocele/surgery
Endoscopy
Female
Humans
Magnetic Resonance Imaging
Male
Meningocele/surgery
Middle Aged
Skull Base/surgery
Tomography, X-Ray Computed
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4413

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[PMID]: 29510289
[Au] Autor:Fernandez-Gajardo R; Almeida JP; Suppiah S; Witterick I; Zadeh G
[Ad] Address:Department of Neurological Sciences, University of Chile, Santiago, Chile. Electronic address: rod.fernandez.g@gmail.com.
[Ti] Title:"Ethmoid Meningoencephalocele in A Patient with Cerebrofacial Arteriovenous metameric syndrome: A Case Report".
[So] Source:World Neurosurg;, 2018 Mar 03.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Skull base meningoencephaloceles are a rare condition, frequently secondary to traumatic or iatrogenic causes. Cerebrofacial arteriovenous metameric syndrome (CAMS) is characterized by the presence of retinal, facial and cerebral arteriovenous malformations (AVMs) with metameric distribution. To the best of our knowledge, this is the first reported case associating these two conditions. CASE DESCRIPTION: A 45 years old female previously diagnosed with CAMS type 2 presented with a long history of cerebrospinal fluid (CSF) rhinorrhea. Magnetic resonance imaging and digital subtraction angiography demonstrated a right-sided facial and orbital AVM extending posteriorly along the optic tract into the suprasellar cistern, and a right-sided meningoencephalocele protruding into the olfactory recess and ethmoid sinus. An extended endoscopic endonasal approach was performed to resect the meningoencephalocele and to repair the CSF leak without complications. CONCLUSIONS: We report the unusual association between the development of a meningoencephalocele and a metameric syndrome, and comment on clinical implications in the management of this patient.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  3 / 3033 MEDLINE  
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[PMID]: 27779564
[Au] Autor:Smeds H; Wales J; Asp F; Löfkvist U; Falahat B; Anderlid BM; Anmyr L; Karltorp E
[Ad] Address:*Department of Clinical Science, Intervention and Technology, Karolinska Institutet †Department of Otolaryngology, Karolinska University Hospital, Stockholm ‡Department of Signals and Systems, Chalmers University of Technology, Gothenburg, Sweden §Department of Special Needs Education, University of Oslo, Oslo, Norway ||Department of Radiology, Karolinska University Hospital ¶Department of Molecular Medicine and Surgery, Karolinska Institutet **Department of Clinical Genetics ††Department of Social Work in Health, Karolinska University Hospital, Stockholm, Sweden.
[Ti] Title:X-linked Malformation and Cochlear Implantation.
[So] Source:Otol Neurotol;38(1):38-46, 2017 01.
[Is] ISSN:1537-4505
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To evaluate if cochlear implantation is safe and constitutes an option for hearing rehabilitation of children with x-linked inner ear malformation. STUDY DESIGN: Retrospective patient review in combination with a multidisciplinary follow-up. SETTING: Tertiary referral hospital and cochlear implant program. PATIENTS: Ten children with severe-profound mixed hearing loss and radiological findings consistent with Incomplete Partition type 3 cochlear malformation received cochlear implants during the years 2007 to 2015. Nine of the children had a mutation affecting the gene POU3F4 on Xq21. INTERVENTION: Cochlear implantation. MAIN OUTCOME MEASURES: Surgical events, intraoperative measures and electrical stimulation levels, hearing and spoken language abilities. RESULTS: In all, 15 cochlear implantations were performed. In three cases the electrode was found to be in the internal auditory canal on intraoperative x-ray and repositioned successfully. One child had a postoperative rhinorrhea confirmed to be cerebrospinal fluid but this resolved on conservative treatment. No severe complications occurred. Postoperative electrical stimulation levels were higher in 9 of 10 children, as compared with typically reported average levels in patients with a normal cochlea. Eight patients developed spoken language to various degrees while two were still at precommunication level. However, speech recognition scores were lower than average pediatric cases. CONCLUSION: Cochlear implantation is a safe procedure for children with severe-profound mixed hearing loss related to POU3F4 mutation inner ear malformation. The children develop hearing and spoken language but outcome is below average for pediatric CI recipients.
[Mh] MeSH terms primary: Cochlear Implantation
Hearing Loss, Sensorineural/congenital
Hearing Loss, Sensorineural/surgery
POU Domain Factors/genetics
[Mh] MeSH terms secundary: Child
Child, Preschool
Chromosomes, Human, X
Cochlea/surgery
Cochlear Implantation/adverse effects
Cochlear Implantation/methods
Cochlear Implants
Ear, Inner/abnormalities
Ear, Inner/surgery
Female
Genetic Diseases, X-Linked
Hearing Loss, Sensorineural/genetics
Hearing Tests
Humans
Male
Mutation
Postoperative Complications/epidemiology
Retrospective Studies
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (POU Domain Factors); 0 (POU3F4 protein, human)
[Em] Entry month:1708
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Js] Journal subset:IM
[Da] Date of entry for processing:161026
[St] Status:MEDLINE

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[PMID]: 29330076
[Au] Autor:Yoneoka Y; Akiyama K; Seki Y; Hasegawa G; Kakita A
[Ad] Address:Department of Neurosurgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan; Department of Neurosurgery, Brain Research Institute, Niigata University, Niigata, Japan. Electronic address: yone@bri.niigata-u.ac.jp.
[Ti] Title:Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature.
[So] Source:World Neurosurg;111:381-385, 2018 Mar.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Frontoethmoidal schwannomas are rare. No case manifesting exertional cerebrospinal fluid (CSF) rhinorrhea has ever been reported to the best of our knowledge. CASE DESCRIPTION: In this report, we describe an extremely rare case of frontoethmoidal schwannoma extending through the olfactory groove with exertional CSF rhinorrhea as the initial symptom. A 50-year-old woman was presented to our clinic for frequent nasal discharge on exertion. A postcontrast computed tomographic scan demonstrated heterogeneously enhanced tumor from the anterior cranial fossa to the anterior ethmoid sinus. A gadolinium-enhanced T1-weighted magnetic resonance image revealed a well-defined heterogeneously enhanced tumor situated in the midline anterior cranial fossa and anterior ethmoid sinus. After the resection, the defect of the right anterior skull base was reconstructed with a fascia graft and adipose tissue taken from the abdomen, as well as a pedicle periosteum flap. A histologic examination revealed the tumor as schwannoma. Her rhinorrhea completely resolved. She regained her sense of smell and taste 1 month after the operation. CONCLUSION: According to previous reports, olfactory groove, and paraolfactory groove/periolfactory groove schwannomas can be divided into 4 types: subfrontal, nasoethmoidal, frontoethmoidal, and ethmofrontal. Among them, a frontoethmoidal schwannoma can manifest exertional CSF rhinorrhea as an initial symptom.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

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[PMID]: 29490552
[Au] Autor:Lucke-Wold B; Brown EC; Cetas JS; Dogan A; Gupta S; Hullar TE; Smith TL; Ciporen JN
[Ad] Address:School of Medicine, West Virginia University, Morgantown, West Virginia; and.
[Ti] Title:Minimally invasive endoscopic repair of refractory lateral skull base cerebrospinal fluid rhinorrhea: case report and review of the literature.
[So] Source:Neurosurg Focus;44(3):E8, 2018 Mar.
[Is] ISSN:1092-0684
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Cerebrospinal fluid (CSF) leaks occur in approximately 10% of patients undergoing a translabyrinthine, retrosigmoid, or middle fossa approach for vestibular schwannoma resection. Cerebrospinal fluid rhinorrhea also results from trauma, neoplasms, and congenital defects. A high degree of difficulty in repair sometimes requires repetitive microsurgical revisions-a rate of 10% of cases is often cited. This can not only lead to morbidity but is also costly and burdensome to the health care system. In this case-based theoretical analysis, the authors summarize the literature regarding endoscopic endonasal techniques to obliterate the eustachian tube (ET) as well as compare endoscopic endonasal versus open approaches for repair. Given the results of their analysis, they recommend endoscopic endonasal ET obliteration (EEETO) as a first- or second-line technique for the repair of CSF rhinorrhea from a lateral skull base source refractory to spontaneous healing and CSF diversion. They present a case in which EEETO resolved refractory CSF rhinorrhea over a 10-month follow-up after CSF diversions, wound reexploration, revised packing of the ET via a lateral microscopic translabyrinthine approach, and the use of a vascularized flap had failed. They further summarize the literature regarding studies that describe various iterations of EEETO. By its minimally invasive nature, EEETO imposes less morbidity as well as less risk to the patient. It can be readily implemented into algorithms once CSF diversion (for example, lumbar drain) has failed, prior to considering open surgery for repair. Additional studies are warranted to further demonstrate the outcome and cost-saving benefits of EEETO as the data until now have been largely empirical yet very hopeful. The summaries and technical notes described in this paper may serve as a resource for those skull base teams faced with similar challenging and otherwise refractory CSF leaks from a lateral skull base source.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.3171/2017.12.FOCUS17664

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[PMID]: 29485295
[Au] Autor:Zhao D; Tao S; Zhang D; Qin M; Bao Y; Wu A
[Ad] Address:a Department of Neurosurgery , The First Hospital of China Medical University , Shenyang , China.
[Ti] Title:"Five-layer gasket seal" watertight closure for reconstruction of the skull base in complex bilateral traumatic intraorbital meningoencephaloceles: a case report and literature review.
[So] Source:Brain Inj;:1-4, 2018 Feb 27.
[Is] ISSN:1362-301X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: Traumatic meningoencephalocele primarily occurs as a rare but complex complication of cranial base and orbital roof fractures. Traumatic intraorbital meningoencephalocele, which is rare and easily overlooked, can be life-threatening since cephalomeningitis occurs due to cerebrospinal fluid (CSF) leakage. It is obscure for the operative indications or standard surgical methods of traumatic meningoencephaloceles since the combined intricate craniofacial and basal fractures, brain injury, and CSF leak may exist. This case report proposes a new operative method for the repair of complex skull base fractures following traumatic intraorbital meningoencephalocele. METHODS: A 30-year-old male with a history of complex trauma presented with symptoms of exophthalmos and traumatic CSF rhinorrhea was evaluated via 3D CT of the skull base and brain MRI and was diagnosed with bilateral intraorbital meningoencephaloceles and multiple craniofacial bone, skull base, and orbit fractures. RESULTS: Successful resection of the meningoencephaloceles and reconstruction of the skull base defects were performed via craniotomy using a "five-layer gasket seal" technique that involved, from extracranial to intracranial, a gelatin sponge, muscular paste, vascularized periosteum, RapidSorb Orbital Floor Plate (OrbFloor), and Neuro-Patch layers. CONCLUSIONS: The diagnosis and treatment of complex intraorbital meningoencephalocele require careful attention. Resection of herniated tissue is suggested due to potential contamination. The "five-layer gasket seal" watertight closure technique is recommended for successful repair of the skull base in cases involving traumatic meningoencephalocele with complex skull base fractures.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:Publisher
[do] DOI:10.1080/02699052.2018.1440631

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[PMID]: 29464700
[Au] Autor:Srettabunjong S
[Ad] Address:Department of Forensic Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, 10700.
[Ti] Title:Septic Cavernous Sinus Thrombosis Following a Minor Head Injury: A Rare Cause of Medico-Legal Death.
[So] Source:J Forensic Sci;, 2018 Feb 21.
[Is] ISSN:1556-4029
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Septic cavernous sinus thrombosis (SCST) is an uncommon consequence of head and face infection, but a rare complication after craniofacial fracture. In this case, SCST developed in a 13-year-old girl following a minor fall during volleyball, with impact and resulting abrasive contusion of the left forehead. She developed watery rhinorrhea, progressive headache, fever, nausea, vomiting, and left proptosis with blurred vision, and was admitted to hospital 3 days after injury. Drowsiness, high-grade fever, severe headache, left ocular pain with marked periorbital swelling, and paralysis of extraocular eye movements developed. Computed tomography scan identified left sphenoid and ethmoid sinusitis, a posterior clinoid fracture, and septic cavernous sinus thrombosis. She died after 10 days of in-hospital antibiotic therapy. Death was due to Staphylococcus aureus sepsis with septic pulmonary thromboemboli due to suppurative meningitis and cerebral infarction, due to SCST following apparently minor blunt head injury from an accidental fall.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[St] Status:Publisher
[do] DOI:10.1111/1556-4029.13752

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[PMID]: 29384861
[Au] Autor:Chen GY; Ma L; Xu ML; Zhang JN; He ZD; He CY; Zhao CH; Fu C; Li M; Gao YF
[Ad] Address:First Department of Neurosurgery.
[Ti] Title:Spontaneous cerebrospinal fluid rhinorrhea: A case report and analysis.
[So] Source:Medicine (Baltimore);97(5):e9758, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Spontaneous cerebrospinal fluid leakage is usually caused by developmental abnormalities and is rare, accounting for approximately 5% of the cases of cerebrospinal fluid (CSF) leakage. To the best of our knowledge, clival dysplasia-caused CSF rhinorrhea has never been reported in the neurosurgical field. CONCLUSION: Spontaneous cerebrospinal fluid rhinorrhea is often treated by surgery, and a transsphenoidal approach repair is the main surgical method used, offering the advantages of less trauma, fewer complications, rapid postoperative recovery, and low recurrence rate.
[Mh] MeSH terms primary: Cerebrospinal Fluid Rhinorrhea/diagnostic imaging
Cerebrospinal Fluid Rhinorrhea/surgery
Cranial Fossa, Posterior/diagnostic imaging
[Mh] MeSH terms secundary: Aged
Cerebrospinal Fluid Rhinorrhea/etiology
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging
Male
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009758

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[PMID]: 29242910
[Au] Autor:Mehta K; Naples J; Eisen M
[Ad] Address:University of Connecticut Health Center, Farmington.
[Ti] Title:Cerebrospinal Fluid Rhinorrhea and a Lytic-Appearing Lesion of the Posterior Cranial Fossa.
[So] Source:JAMA Otolaryngol Head Neck Surg;144(2):173-174, 2018 Feb 01.
[Is] ISSN:2168-619X
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Data-Review
[do] DOI:10.1001/jamaoto.2017.2440

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[PMID]: 29443787
[Ti] Title:Spontaneous cerebrospinal fluid rhinorrhea: A case report and analysis: Erratum.
[So] Source:Medicine (Baltimore);97(7):e9954, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[St] Status:In-Data-Review
[do] DOI:10.1097/MD.0000000000009954


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