Beck, Juergen and Gralla, Jan and Fung, Christian and Ulrich, Christian T. and Schucht, Philippe and Fichtner, Jens and Andereggen, Lukas and Gosau, Martin and Hattingen, Elke and Gutbrod, Klemens and Z'Graggen, Werner J. and Reinert, Michael and Huesler, Jueg and Ozdoba, Christoph and Raabe, Andreas (2014) Spinal cerebrospinal fluid leak as the cause of chronic subdural hematomas in nongeriatric patients. JOURNAL OF NEUROSURGERY, 121 (6). pp. 1380-1387. ISSN 0022-3085, 1933-0693
Full text not available from this repository. (Request a copy)Abstract
Object. The etiology of chronic subdural hematoma (CSDH) in nongeriatric patients (<= 60 years old) often remains unclear. The primary objective of this study was to identify spinal CSF leaks in young patients, after formulating the hypothesis that spinal CSF leaks are causally related to CSDH. Methods. All consecutive patients 60 years of age or younger who underwent operations for CSDH between September 2009 and April 2011 at Bern University Hospital were included in this prospective cohort study. The patient workup included an extended search for a spinal CSF leak using a systematic algorithm: MRI of the spinal axis with or without intrathecal contrast application, myelography/fluoroscopy, and postmyelography CT. Spinal pathologies were classified according to direct proof of CSF outflow from the intrathecal to the extrathecal space, presence of extrathecal fluid accumulation, presence of spinal meningeal cysts, or no pathological findings. The primary outcome was proof of a CSF leak. Results. Twenty-seven patients, with a mean age of 49.6 +/- 9.2 years, underwent operaions for CSDH. Hematomas were unilateral in 20 patients and bilateral in 7 patients. In 7 (25.9%) of 27 patients, spinal CSF leakage was proven, in 9 patients (33.3%) spinal meningeal cysts in the cervicothoracic region were found, and 3 patients (11.1%) had spinal cysts in the sacral region. The remaining 8 patients (29.6%) showed no pathological findings. Conclusions. The direct proof of spinal CSF leakage in 25.9% of patients suggests that spinal CSF leaks may be a frequent cause of nongeriatric CSDH.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTRACRANIAL HYPOTENSION; SURGICAL-TREATMENT; RISK-FACTORS; CSF LEAKS; RECURRENCE; chronic subdural hematoma; spinal CSF leak; geriatric; vascular disorders; meningeal cyst |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Aug 2019 09:33 |
| Last Modified: | 07 Aug 2019 09:33 |
| URI: | https://pred.uni-regensburg.de/id/eprint/9147 |
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