Differences in Skull Base Thickness in Patients with Spontaneous Cerebrospinal Fluid Leaks

Abstract

Differences in skull base thickness exist in SCSF patients, but whether this predisposes to such leaks or is a consequence of the underlying pathophysiology remains unknown. The endoscopic endonasal approach provides a highly effective means of repairing such leaks with success rates comparable with the endoscopic repair of other leak types. Adjuvant measures including weight reduction, lumbar drain, and acetazolamide use may increase success rates and should be considered in their management.

Spontaneous CSF Rhinorrhea: Prevalence of Multiple Simultaneous Skull Base Defects

“…9 The etiology is most likely related to exposing thin areas of the skull base with persistent, pulsatile, hydrostatic forces that erode the bone and dura to create a fistula. Psaltis et al 10 have shown differences in skull base thickness between patients with spontaneous CSF leaks and controls. However, whether this contributes to such leaks or is an effect of the underlying pathophysiology remains unknown.…”

Ethmoidal meningoencephalocele and CSF leak after posthaemorrhagic ventricular dilatation in a newborn child

“…Patients at high risk for high-pressure hydrocephalus include those who have had a subarachnoid haemorrhage as a result of trauma (accidental or surgical) or stroke and those with spontaneous CSF leaks. Temporary CSF diversion is included in the protocols of many departments, with the objective of reducing the risk of recurrence, whether an endoscopic endonasal approach or an intracranial approach is chosen [4,18,28]. Measurement of CSF pressure after the repair and immediate ventriculoperitoneal shunting if necessary are additional to these protocols [4,7,28].…”

Imaging of Cerebrospinal Fluid Leak

“…Of these, the inferolateral recess defects tend to be the largest and may be associated with arachnoid pits, seen on CT as rounded, scalloped bony defects [2,15]. Patients with spontaneous CSFL frequently show multiple bony defects and generalized skull base attenuation, the latter being statistically significant when compared with general population [15,30].…”