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Cerebrospinal fluid leaks are classified into two distinct disorders: cranial leaks, and spinal leaks. [10] [11] Where there has been no preceding surgery or medical procedure that may have caused a CSF leak it is called a spontaneous CSF leak (sCSF leak).
Traumatic CSF rhinorrhoea is the most common type of CSF rhinorrhoea. [1] It may be due to severe head injury, or from complications from neurosurgery. [1] Spontaneous CSF rhinorrhoea is the most common acquired defect in the skull base bones (anterior cranial fossa) causing spontaneous nasal liquorrhea.
EBP are usually administered near the site of the cerebrospinal fluid leak (CSF leak), but in some cases the upper part of the spine is targeted. [3] An epidural needle is inserted into the epidural space like a traditional epidural procedure. The blood modulates the pressure of the CSF and forms a clot, sealing the leak.
A headache that is persistent despite a long period of bedrest and occurs only when sitting up may be indicative of a CSF leak from the lumbar puncture site. It can be treated by more bedrest, or by an epidural blood patch , where the person's own blood is injected back into the site of leakage to cause a clot to form and seal off the leak.
Surgery may be performed to seal a CSF leak that does not stop, to relieve pressure on a cranial nerve or repair injury to a blood vessel. [1] Prophylactic antibiotics do not provide a clinical benefit in preventing meningitis. [2] [3] A basilar skull fracture occurs in about 12% of people with a severe head injury. [1]
[9] [15] Surgical repair of the dura may provide symptomatic relief for some patients. [5] It has been reported that acetazolamide can be used to treat dural ectasia in individuals with Marfan syndrome, however, the only supporting evidence for this assertion is a small study of 14 patients which was not peer-reviewed or submitted for publication.
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A pseudomeningocele is an abnormal collection of cerebrospinal fluid (CSF) that communicates with the CSF space around the brain or spinal cord.In contrast to a meningocele, in which the fluid is surrounded and confined by dura mater, in a pseudomeningocele, the fluid has no surrounding membrane, but is contained in a cavity within the soft tissues.
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