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An alternate method of locating the site of a CSF leak is to use heavily T2-weighted MR myelography. [24] This has been effective in identifying the sites of a CSF leak without the need for a CT scan, lumbar puncture, and contrast and at locating fluid collections such as CSF pooling. [70]
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.
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Subdural hygromas require two conditions in order to occur. First, there must be a separation in the layers of the Meninges of the brain. Second, the resulting subdural space that occurs from the separation of layers must remain uncompressed in order for CSF to accumulate in the subdural space, resulting in the hygroma. [1]
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.
Radionuclide cisternography may be used to diagnose a spinal cerebrospinal fluid leak. CSF pressure is measured and imaged over 24 hours. [2] A radionuclide (radioisotope) is injected by lumbar puncture (spinal tap) into the cerebral spinal fluid to determine if there is abnormal CSF flow within the brain and spinal canal which can be altered by hydrocephalus, Arnold–Chiari malformation ...
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.
The treatment of choice in NPH is ventriculoperitoneal shunt surgery (VPS). This treatment needs a VP shunt, which is a catheter with a valve aiming at implementing a one-way outflow of the excessive amount of CSF from the ventricles. It is obligatory to have patency control because of some possible complications such as infections and obstruction.