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Titolo:
Diagnostic and surgical strategies for intractable spontaneous intracranial hypotension - Case report
Autore:
Inenaga, C; Tanaka, T; Sakai, N; Nishizawa, S;
Indirizzi:
Yaizu Municipal Gen Hosp, Dept Neurosurg, Shizuoka, Japan Yaizu Municipal Gen Hosp Shizuoka Japan Dept Neurosurg, Shizuoka, Japan Yaizu Municipal Gen Hosp, Dept Neurol, Shizuoka, Japan Yaizu Municipal GenHosp Shizuoka Japan p, Dept Neurol, Shizuoka, Japan Hamamatsu Univ, Sch Med, Shizuoka, Japan Hamamatsu Univ Shizuoka JapanHamamatsu Univ, Sch Med, Shizuoka, Japan
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 4, volume: 94, anno: 2001,
pagine: 642 - 645
SICI:
0022-3085(200104)94:4<642:DASSFI>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBROSPINAL-FLUID LEAKS; EPIDURAL BLOOD PATCH;
Keywords:
spontaneous intracranial hypotension; cervical spine; postural headache; radionuclide cisternography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Nishizawa, S 3600 Handacho, Shizuoka 4313192, Japan 3600 Handacho Shizuoka Japan 4313192 hizuoka 4313192, Japan
Citazione:
C. Inenaga et al., "Diagnostic and surgical strategies for intractable spontaneous intracranial hypotension - Case report", J NEUROSURG, 94(4), 2001, pp. 642-645

Abstract

The authors present the case of a 55-year-old man suffering from intractable spontaneous intracranial hypotension, in whom conservative treatment with 19 weeks of bed rest was not effective. In this period the patient twice underwent surgery for bilateral chronic subdural hematoma, a complication of spontaneous intracranial hypotension. Conventional radionuclide cisternography, magnetic resonance imaging, and computerized tomography myelography did not demonstrate cerebrospinal fluid (CSF) leakage. Repeated radionuclide cisternography with the patient in an upright position revealed leakage of the tracer at upper cervical levels. Computerized tomography myelography with breath holding also showed CSF leakage of the contrast medium bilaterally at upper cervical levels. The patient underwent surgery, and bilateral C-2 and C-3 spinal nerve rootpouches were sealed off from the subarachnoid space with oxidized cellulose cotton and fibrin glue. Epiarachnoid spaces around the root sleeves were also sealed to ensure complete resolution of the CSF leakage. After the surgery, the patient was completely free of the disease. In the case of intractable persistent spontaneous intracranial hypotension, surgical treatment is preferable to long-term conservative management. Toidentify CSF leakage, radionuclide cisternography with the patient in the upright position is useful. When obvious leakage is encountered, surgical sealing of the lesion should be performed via a subarachnoid approach.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 07:42:10