Cisternotomy and Liliequist’s Membrane Fenestration as a Surgical Treatment for Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): A Case Report

Eraky, Akram M; Treffy, Randall; Hedayat, Hirad

doi:10.7759/cureus.31363

Cited by 2 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although other pathologies can also increase the ICP [19][20][21][22], cisternostomy is a potential surgical treatment for patients with TBI-related prolonged ICP elevation [21]. A previous case report also demonstrated the effect of cisternostomy in decreasing ICP and its potential role as a surgical treatment for pseudotumor cerebri [23].…”

Section: Discussionmentioning

confidence: 97%

The Role of Cisternostomy in the Management of Severe Traumatic Brain Injury: A Triple-Center Study

Encarnación Ramirez,

Baez,

Marszal Mangbel’ Mikorska

et al. 2023

Surgeries

View full text Add to dashboard Cite

Background: Traumatic brain injury (TBI) is a critical public health problem worldwide, constituting a major cause of mortality and morbidity for people of all ages, but especially in the younger population. Decompressive craniectomy (DC) and cisternostomy are surgical procedures commonly used in the management of severe TBI, but their effectiveness in improving outcomes remains controversial. Methods: We conducted a prospective longitudinal study on patients who underwent surgical treatment for severe TBI between 2021 and 2022. The extended Glasgow outcome scale (GOS-E) was used to assess clinical outcome at 2 weeks, 3 months, and 6 months after surgery. Results: The study included 30 patients (21 men and 9 women) who met the inclusion criteria. Among them, 24 patients (80%) underwent DC combined with cisternostomy, while 6 patients (20%) underwent cisternostomy alone. The initial Glasgow Coma Scale (GCS) score at admission ranged from 4 to 8 points, with an average score of 5.9. The overall mortality and overall morbidity was 13.3% and 20%, respectively. The mortality rate was 12.5% and 16.7% in the DC + cisternostomy group and in the cisternostomy alone group, respectively. No statistically significant difference was seen between the two groups in terms of mortality, morbidity and favorable outcome at 2 weeks, 3 months and 6 months. Conclusions: Our preliminary multi-center study shows a good clinical outcome in patients who underwent DC + cisternostomy or cisternostomy alone in both early and long-term follow-up. Larger multi-center randomized trials are needed to establish the effectiveness of cisternostomy in the management of TBI.

show abstract

Section: Discussionmentioning

confidence: 97%

The Role of Cisternostomy in the Management of Severe Traumatic Brain Injury: A Triple-Center Study

Encarnación Ramirez,

Baez,

Marszal Mangbel’ Mikorska

et al. 2023

Surgeries

View full text Add to dashboard Cite

show abstract

“…The same group described cisternostomy’s cadaveric dissection and surgical technique in a separate paper [ 5 ]. A previous case report by our group demonstrated the effect of cisternostomy in decreasing ICP and its potential role as a surgical treatment for pseudotumor cerebri [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recent advances indicate that ventricular CSF does not communicate with parenchymal IF [ 5 , 6 , 8 ]. As a result, CSF diversion from the ventricular system does not have a strong effect in increasing IF drainage and subsequently decreasing edema and ICP.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cisternostomy as a Surgical Treatment for Traumatic Brain Injury-Related Prolonged and Delayed Intracranial Pressure Elevation: A Case Report

Eraky¹,

Treffy²,

Hedayat³

2023

Cureus

Self Cite

View full text Add to dashboard Cite

Traumatic brain injury (TBI) can be classified into primary, due to the effect of the initial trauma, or secondary, due to increased intracranial pressure (ICP). Increased ICP may cause brain herniation and also decreases cerebral blood perfusion leading to ischemia. Recently, a few studies showed that cisternostomy with decompressive craniectomy (DC) has better outcomes than DC alone in patients with TBI. This can be explained by the recent advances indicating that cisternal cerebrospinal fluid (CSF) communicates with cerebral interstitial fluid (IF) through Virchow-Robin spaces. Theoretically, opening cisterns to atmospheric pressure may induce IF drainage and subsequently decrease ICP. A 55-year-old man presented to the emergency department with subdural hematomas, hemorrhagic contusions, and subarachnoid hemorrhage after falling off a moving truck. ICP elevation was refractory despite increased sedation, initiation of paralysis with Cisatracurium, esophageal cooling, multiple doses of 23.4 % saline and mannitol, and DC. Lumbar drain (LD) placement was performed with beneficial results. Unfortunately, the LD stopped functioning multiple times and each time this occurred, he developed increased ventricular size with elevated ICP. The patient underwent cisternostomy and lamina terminalis fenestration. No further increased ICPs were observed after cisternostomy at a one-month follow-up. Cisternostomy is a potential surgical treatment for patients with TBI-related prolonged ICP elevation.

show abstract

Cisternotomy and Liliequist’s Membrane Fenestration as a Surgical Treatment for Idiopathic Intracranial Hypertension (Pseudotumor Cerebri): A Case Report

Cited by 2 publications

References 12 publications

The Role of Cisternostomy in the Management of Severe Traumatic Brain Injury: A Triple-Center Study

The Role of Cisternostomy in the Management of Severe Traumatic Brain Injury: A Triple-Center Study

Cisternostomy as a Surgical Treatment for Traumatic Brain Injury-Related Prolonged and Delayed Intracranial Pressure Elevation: A Case Report

Contact Info

Product

Resources

About