Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

Önder, Halil

doi:10.1002/alr.22698

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…We have read with great interest Dr Onder's correspondence 1 regarding our article 2 . In our study, we reported a higher incidence of transverse venous sinus stenosis (TSS) in a group of patients operated on for a spontaneous cerebrospinal fluid (sCSF) leak than in a control group of patients adjusted for age and sex.…”

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confidence: 81%

Reply to: Correspondence ‐ Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

Vérillaud

Bedarida

Labeyrie

2020

Int Forum Allergy Rhinol

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We have read with great interest Dr Onder's correspondence 1 regarding our article. 2 In our study, we reported a higher incidence of transverse venous sinus stenosis (TSS) in a group of patients operated on for a spontaneous cerebrospinal fluid (sCSF) leak than in a control group of patients adjusted for age and sex. Dr Onder's comments focus on 3 main points. The first question that needs to be addressed is whether the diagnostic criteria for intracranial idiopathic hypertension (IIH) are appropriate for sCSF leak patients. Indeed, the diagnostic features described by Dandy in 1937, and later formulated into a set of diagnostic criteria by Smith in 1985, notably include signs and symptoms of increased intracranial pressure (headaches, nausea, vomiting, transient visual obscurations, or papilledema) and increased CSF pressure. 3 Fundoscopy or lumbar puncture opening pressure measurements were performed in only 11 of 29 patients (38%) in our series. Five of these 11 patients had clinical signs of IIH. As pointed by Dr Onder, it is therefore not possible to conclude that there was a high prevalence of IIH among the patients of our series. However, it has been clearly shown that IIH in sCSF leak patients is not systematically associated with papilledema. 4 Moreover, all of our patients had an empty sella. Given the fact that empty sella has a 90.7% specificity for the diagnosis of IIH, 5 we hypothesized that this radiologic sign favored IIH in our patients. We were able to compare pre-and postoperative magnetic resonance images (MRIs) in a subset of the patients (n = 12): the height of pituitary gland was lower after than before surgery (1.9 mm [1.7-3.2] vs 2.2 mm [1.7-3.4]; p = 0.05). This further supports the fact that empty sella is a reflection of elevated intracranial pressure.

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confidence: 81%

Reply to: Correspondence ‐ Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

Vérillaud

Bedarida

Labeyrie

2020

Int Forum Allergy Rhinol

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“…Other MR findings include dilation of the optic nerve sheath, tortuosity of the optic nerve, and posterior flattening of the globe 7. While transverse venous sinus stenosis (VSS) is associated with IIH, recent studies have also demonstrated the association with sCSF rhinorrhea, further supporting the notion of a common underlying process 14. Previous reports have discussed sCSF rhinorrhea as a variant of IIH.…”

Section: Presentation and Pathophysiologymentioning

confidence: 93%

“…7 While transverse venous sinus stenosis (VSS) is associated with IIH, recent studies have also demonstrated the association with sCSF rhinorrhea, further supporting the notion of a common underlying process. 14 Previous reports have discussed sCSF rhinorrhea as a variant of IIH. Biousse et al 15 proposed a unifying model in which IIH/sCSF and VSS are related, suggesting that elevated ICP causes venous compression, venous hypertension, decreased CSF absorption, and in turn worsening intracranial hypertension.…”

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confidence: 99%

Surgical Management of Spontaneous Cerebrospinal Fluid Rhinorrhea

Cave¹,

Marino²,

Lal³

et al. 2022

Contemporary Neurosurgery

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Surgical Management of Spontaneous Cerebrospinal Fluid Rhinorrhea

2022

Contemporary Neurosurgery

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Cerebrospinal fluid (CSF) rhinorrhea results from a communication of the subarachnoid space with the paranasal sinuses, placing patients at risk of ascending meningitis and pneumocephalus. 1 The classification of CSF rhinorrhea is commonly divided into 2 categories: traumatic and nontraumatic (spontaneous). 2,3 Spontaneous cerebrospinal fluid (sCSF) leaks of the skull base are thought to be primarily caused by increased intracranial pressures (ICPs) with a strong association with idiopathic intracranial hypertension (IIH). 4,5 IIH and sCSF leaks share similar risk factors, occurring most commonly in obese, middle-aged female populations. However, in rarer instances, sCSF leaks may be secondary to hydrocephalus and intracranial neoplasms. 1,2 sCSF leaks are associated with higher rates of repair failure, and their refractory nature is thought to be directly related to increased ICPs. 5,6 This report primarily focuses on sCSF rhinorrhea in context of IIH.

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Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

Cited by 3 publications

References 12 publications

Reply to: Correspondence ‐ Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

Reply to: Correspondence ‐ Association of spontaneous cerebrospinal fluid rhinorrhea with transverse venous sinus stenosis: a retrospective matched case‐control study

Surgical Management of Spontaneous Cerebrospinal Fluid Rhinorrhea

Surgical Management of Spontaneous Cerebrospinal Fluid Rhinorrhea

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