Surgical Management of Spontaneous Spinal Cerebrospinal Fluid Epidural Fistula

Siedler, Declan G.; Ibbett, Imogen; Thani, Nova

doi:10.1016/j.wneu.2016.12.106

Cited by 6 publications

(1 citation statement)

References 42 publications

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“…The patient described herein did not have any preexisting diseases, but just after diagnosis and treatment of spontaneous CSF leakage, paraplegia abruptly developed and consequently, AC was detected at the thoracic spine. There has been few reports of CSF leakage due to spontaneous or post-traumatic rupture of the spinal extradural AC and consequently intracranial hypotension 11). However, we think this is the first report that describes intracranial hypotension resulting from spontaneous spinal CSF leakage, followed by abrupt expansion of the intradural spinal AC at a different site.…”

Section: Discussionmentioning

confidence: 66%

Cervical Cerebrospinal Fluid Leakage Concomitant with a Thoracic Spinal Intradural Arachnoid Cyst

Han

Choi

Park

et al. 2019

Korean J Neurotrauma

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We encountered a very rare case of spontaneous spinal cerebrospinal fluid (CSF) leakage and a spinal intradural arachnoid cyst (AC) that were diagnosed at different sites in the same patient. These two lesions were thought to have interfered with the disease onset and deterioration. A 30-year-old man presented with sudden neck pain and orthostatic headache. Diplopia, ophthalmic pain, and headache deteriorated. CSF leakage was confirmed in C2 by radioisotope cisternography, and an epidural blood patch was performed. While his symptoms improved gradually, paraparesis suddenly progressed. Thoracolumbar magnetic resonance imaging (MRI) revealed an upper thoracic spinal intradural AC, which was compressing the spinal cord. We removed the outer membrane of the AC and performed fenestration of the inner membrane after T3-4 laminectomy. Postoperative MRI showed complete removal of the AC and normalized lumbar subarachnoid space. All neurological deficits including motor weakness, sensory impairment, and voiding function improved to normal. We present a case of spontaneous spinal CSF leakage and consecutive intracranial hypotension in a patient with a spinal AC. Our report suggests that if spinal CSF leakage and a spinal AC are diagnosed in one patient, even if they are located at different sites, they may affect disease progression and aggravation.

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Section: Discussionmentioning

confidence: 66%