Recurrent spontaneous spinal cerebrospinal fluid leak associated with "nude nerve root" syndrome: case report.

Abstract:

OBJECTIVE AND IMPORTANCE:Spontaneous spinal cerebrospinal fluid (CSF) leaks have been noted occasionally at multiple sites in the same patient, but recurrent spontaneous spinal CSF leaks have not been documented. We describe a patient with a recurrent CSF leak who was found at surgery to have an absence of the entire nerve root sleeve at multiple thoracic levels. CLINICAL PRESENTATION:A 29-year-old woman bodybuilder noted an excruciating orthostatic headache associated with nausea. The neurological examination was unremarkable, and a magnetic resonance imaging examination showed the typical changes of intracranial hypotension. Computed tomographic myelography showed an extensive bilateral lower cervical CSF leak. INTERVENTION:The patient underwent bilateral lower cervical nerve root explorations, and several small dural holes were found. The CSF leaks were repaired, but 3 months later, computed tomographic myelography showed a new CSF leak in the midthoracic area. A thoracic laminectomy was performed, and several nerve roots were found to be completely devoid of dura. After the CSF leaks were repaired, there was significant improvement in her headaches. CONCLUSION:A recurrent spontaneous spinal CSF leak may occur in patients with intracranial hypotension at a site previously documented not to be associated with a CSF leak. Absent nerve root sleeves may be found in patients with spontaneous spinal CSF leaks ("nude nerve root" syndrome), and these patients may be at increased risk of developing a recurrent CSF leak.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Schievink WI,Jacques L

doi

10.1227/01.neu.0000089483.30857.11

keywords:

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

1216-8; discussion 1218-9

issue

5

eissn

0148-396X

issn

1524-4040

journal_volume

53

pub_type

杂志文章
  • Surface landmarks for the junction between the transverse and sigmoid sinuses: application of the "strategic" burr hole for suboccipital craniotomy.

    abstract:OBJECTIVE:Localization of internal cranial anatomy based on superficial landmarks is paramount in identifying and avoiding various important structures and, thus, decreasing surgical morbidity. We have studied external skull bony landmarks to facilitate the placement of the initial "strategic" burr hole just inferior a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000341517.65174.63

    authors: Tubbs RS,Loukas M,Shoja MM,Bellew MP,Cohen-Gadol AA

    更新日期:2009-12-01 00:00:00

  • Regulation of hexokinase in cultured gliomas.

    abstract::Positron emission computed tomographic (PECT) scanning studies have demonstrated that high grade gliomas exhibit increased 2-[18F]fluoro-2-deoxyglucose (18FDG) uptake compared to cerebral white matter and low grade gliomas. Hexokinase catalyzes the phosphorylation of glucose, as well as 18FDG and 2-deoxyglucose (2DG),...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198510000-00001

    authors: Graham JF,Cummins CJ,Smith BH,Kornblith PL

    更新日期:1985-10-01 00:00:00

  • Familial Predisposition and Differences in Radiographic Patterns in Spontaneous Nonaneurysmal Subarachnoid Hemorrhage.

    abstract:BACKGROUND:Subarachnoid hemorrhage (SAH) from an intracranial aneurysmal rupture is the most common nontraumatic etiology for SAH, but up to 15% of patients with SAH have no identifiable source. OBJECTIVE:To assess familial predisposition to spontaneous nonaneurysmal SAH (naSAH) and to evaluate whether family history ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyaa396

    authors: Lai PMR,Ng I,Gormley WB,Patel NJ,Frerichs KU,Aziz-Sultan MA,Du R

    更新日期:2021-01-13 00:00:00

  • Anatomic study of the infraorbital foramen for radiofrequency neurotomy of the infraorbital nerve.

    abstract:OBJECTIVE:To examine the anatomy of the infraorbital canal and foramen and the angles at which a radiofrequency probe must be directed to enter the infraorbital foramen and canal, as a guide to performing radiofrequency ablation of the infraorbital nerve in patients with relative or absolute contraindications to lesion...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000336327.10368.79

    authors: Rahman M,Richter EO,Osawa S,Rhoton AL Jr

    更新日期:2009-05-01 00:00:00

  • Recovery of nerve root function after complete quadriplegia from cervical spine fractures.

    abstract::Thirty-five patients with complete myelopathies secondary to cervical spine fractures from C-4 to C-7 underwent spinal decompressions and fusions between 1975 and 1981. Twenty-five of these patients underwent simultaneous nerve root decompressions, 23 with an accompanying anterior decompression and fusion and 2 with a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198611000-00015

    authors: Benzel EC,Larson SJ

    更新日期:1986-11-01 00:00:00

  • Thoracolumbar Junction Orientation: A Novel Guide for Sagittal Correction and Proximal Junctional Kyphosis Prediction in Adult Spinal Deformity Patients.

    abstract:BACKGROUND:Novel radiographic sagittal parameters of the thoracolumbar junction orientation (TLJO, thoracolumbar slope [TLS] and thoracolumbar tilt [TLT]) have been introduced and correlated with lumbopelvic parameters and thoracic kyphosis. OBJECTIVE:To determine a predictive model for reciprocal thoracic kyphosis an...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyaa311

    authors: Moon HJ,Bridwell KH,Theologis AA,Kelly MP,Lertudomphonwanit T,Lenke LG,Gupta MC

    更新日期:2020-12-15 00:00:00

  • Potent mimicry of fibronectin-induced intracellular signaling in glioma cells by the homodimeric snake venom disintegrin contortrostatin.

    abstract:OBJECTIVE:The snake venom disintegrin contortrostatin (CN) is able to inhibit tumor progression and angiogenesis in vivo and therefore is of considerable interest as a potential antitumor drug. CN specifically binds to certain integrins on the tumor cell and angiogenic endothelial cell surface and inhibits their intera...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000163426.25227.56

    authors: Schmitmeier S,Markland FS,Schönthal AH,Chen TC

    更新日期:2005-07-01 00:00:00

  • Stereotactic radiosurgery of angiographically occult vascular malformations: indications and preliminary experience.

    abstract::Stereotactic radiosurgery has been shown to treat successfully angiographically demonstrated arteriovenous malformations of the brain. Angiographic obliteration has represented cure and eliminated the risk of future hemorrhage. The role of radiosurgery in the treatment of angiographically occult vascular malformations...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199012000-00006

    authors: Kondziolka D,Lunsford LD,Coffey RJ,Bissonette DJ,Flickinger JC

    更新日期:1990-12-01 00:00:00

  • Combination therapy with 1,3-bis(2-chloroethyl)-1-nitrosourea and low dose rate radiation in the 9L rat brain tumor and spheroid models: implications for brain tumor brachytherapy.

    abstract::We studied the effects of combination treatment with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and low dose rate radiation in the 9L rat brain tumor in vivo model and the 9L multicellular tumor spheroid model. F-344 rats bearing intracerebral 9L gliosarcomas were implanted with removable 125I sources. Minimal (perip...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Gutin PH,Bernstein M,Sano Y,Deen DF

    更新日期:1984-12-01 00:00:00

  • Normal computed tomograms in acute head injury: correlation of intracranial pressure, ventricular size, and outcome.

    abstract::To assess the predictive value of a normal computed tomographic (CT) scan obtained shortly after head injury, we reviewed all cases of patients with acute closed injury seen at the North Carolina Baptist Hospital over a 42-month period for whom initial CT scanning and continuous intracranial pressure (ICP) monitoring ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Holliday PO 3rd,Kelly DL Jr,Ball M

    更新日期:1982-01-01 00:00:00

  • Propionibacterium acnes causes postoperative brain abscesses unassociated with foreign bodies: case reports.

    abstract::Propionibacterium acnes was isolated in pure culture from brain abscesses that occurred in two patients after intracranial surgery. Although such infections are usually associated with cerebrospinal fluid shunts and other foreign bodies, these cases clearly demonstrate the pathogenicity of this anaerobic diphtheroid i...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-198907000-00026

    authors: Berenson CS,Bia FJ

    更新日期:1989-07-01 00:00:00

  • Benign recurrence of a pilocytic cerebellar astrocytoma 36 years after radical removal: case report.

    abstract::A benign recurrence of a cerebellar juvenile astrocytoma was found in a 52-year-old woman 36 years after the initial radical removal, which was performed when she was 16 years of age. To our knowledge, this is the third detailed case report of the late benign recurrence of cerebellar astrocytoma after total removal. T...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-199104000-00023

    authors: Pagni CA,Giordana MT,Canavero S

    更新日期:1991-04-01 00:00:00

  • The Energy Index Does Not Affect Local Control of Brain Metastases Treated by Gamma Knife Stereotactic Radiosurgery.

    abstract:BACKGROUND:The energy index (EI) is a measure of dose homogeneity within a target volume calculated by the integral dose divided by the product of prescription dose and tumor volume. OBJECTIVE:To assess whether a higher EI is associated with greater local control for brain metastases (BMs) treated by Gamma Knife radio...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0000000000000750

    authors: Jani A,Rozenblat T,Yaeh AM,Nanda T,Saad S,Qureshi YH,Feng W,Sisti MB,Bruce JN,McKhann GM 2nd,Lesser J,Lassman AB,Isaacson SR,Wang TJ

    更新日期:2015-07-01 00:00:00

  • Impact of myelography on the radiotherapeutic management of malignant spinal cord compression.

    abstract::From December 1981 through August 1984, 24 patients with spinal cord compression syndrome due to epidural neoplasms were evaluated for radiotherapy with clinical examination, radiographs of the spine, and myelography. All plain films were reviewed, and mock radiotherapy fields designed using specific criteria for marg...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198610000-00018

    authors: Calkins AR,Olson MA,Ellis JH

    更新日期:1986-10-01 00:00:00

  • Glioma immunology and immunotherapy.

    abstract:OBJECTIVE:Despite advances in conventional therapy, the prognosis for most glioma patients remains dismal. This has prompted an intensive search for effective treatment alternatives. Immunotherapy, one such alternative, has long been recognized as a potentially potent cancer treatment but has been limited by an inadequ...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1097/00006123-200004000-00002

    authors: Parney IF,Hao C,Petruk KC

    更新日期:2000-04-01 00:00:00

  • Stent-mediated wedging of a calcific embolus to recanalize an occluded middle cerebral artery: technical case report.

    abstract:OBJECTIVE:Calcific cerebral emboli are rare yet pose a difficult therapeutic challenge because of their lack of response to thrombolytic therapy and their propensity for fragmentation. CLINICAL PRESENTATION:A 75-year-old woman developed aphasia and hemiparesis after cardiac catheterization from a near-occlusive calcif...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000335088.85470.FC

    authors: Schirmer CM,Thaler DE,Malek AM

    更新日期:2008-07-01 00:00:00

  • Hemangiomatous anomaly of bone in Crouzon's syndrome: case report.

    abstract::A striking and diffuse hemangiomatous architecture was identified by microscopic examination of bone specimens obtained at cranial synostectomy and from the craniofacial area of a young boy with Kleeblättschadel deformity and Crouzon's syndrome. A retrospective review of the histopathological appearance of bone specim...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198503000-00019

    authors: Alpers CE,Edwards MS

    更新日期:1985-03-01 00:00:00

  • External validation of the international mission for prognosis and analysis of clinical trials model and the role of markers of coagulation.

    abstract:BACKGROUND:Markers of coagulation have shown to have important value in predicting traumatic brain injury outcome. OBJECTIVE:To externally validate and investigate the role of markers of coagulation for outcome prediction by using the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) model w...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000430326.40763.ec

    authors: Raj R,Siironen J,Kivisaari R,Hernesniemi J,Tanskanen P,Handolin L,Skrifvars MB

    更新日期:2013-08-01 00:00:00

  • Effects of cytokines on cultured microvascular endothelial cells derived from gerbil brain.

    abstract::Microvascular endothelial cells were isolated from gerbil brain and cultured. These cells retained an endothelial-specific marker, FVIII-related antigen. Alkaline phosphatase activity was also present in early passage. Two weeks after plating, these cells were attached to the culture dishes and had become like cobbles...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-198909000-00009

    authors: Yoshida S,Minakawa T,Takai N,Tanaka R

    更新日期:1989-09-01 00:00:00

  • Cerebrospinal fluid flow in an animal model of noncommunicating syringomyelia.

    abstract:OBJECTIVE:The source of fluid and the mechanism of cyst enlargement in syringomyelia are unknown. It has been demonstrated that cerebrospinal fluid (CSF) normally flows from the subarachnoid space through perivascular spaces and into the spinal cord central canal. The aim of this study was to investigate whether this f...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199905000-00068

    authors: Stoodley MA,Gutschmidt B,Jones NR

    更新日期:1999-05-01 00:00:00

  • Xanthogranuloma of the sciatic nerve: case report.

    abstract:OBJECTIVE AND IMPORTANCE:Xanthogranulomas involving the central or peripheral nervous system are extraordinarily rare. None have been reported in the lower extremity. Here, we report and characterize the first case of xanthogranuloma of the sciatic nerve. CLINICAL PRESENTATION:A 58-year-old woman presented with poorly...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Patil PG,Cummings TJ,Nunley JA,Friedman AH

    更新日期:2004-12-01 00:00:00

  • Surgical approaches to aneurysms of the vertebral and basilar arteries.

    abstract::This report details the surgical treatment of 44 patients with aneurysms of the vertebral and basilar arteries. Three different surgical approaches were utilized depending on the location of the aneurysm. These were an anterior supratentorial approach, a lateral suboccipital approach, and a combined supratentorial and...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198808000-00013

    authors: Solomon RA,Stein BM

    更新日期:1988-08-01 00:00:00

  • Contralateral and ipsilateral microsurgical approaches to carotid-ophthalmic aneurysms.

    abstract:OBJECTIVE:The vicinity of carotid-ophthalmic aneurysms to the roof of the cavernous sinus, to the anterior clinoid process, and to the optic nerve or the optic chiasm requires well-defined surgical techniques. Although microsurgical techniques with ipsilateral direct approaches to these aneurysms have been described in...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199708000-00001

    authors: Fries G,Perneczky A,van Lindert E,Bahadori-Mortasawi F

    更新日期:1997-08-01 00:00:00

  • Bupivacaine Field Block With Clonidine for Postoperative Pain Control in Posterior Spine Approaches: A Randomized Double-Blind Trial.

    abstract:BACKGROUND:The synergistic effect of clonidine with bupivacaine, well established in peripheral nerve blocks, remains controversial in local field block for postoperative analgesia. OBJECTIVE:To investigate the potential analgesic benefit of adding clonidine to bupivacaine during preincisional field block in posterior...

    journal_title:Neurosurgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/neuros/nyx313

    authors: Abdel Hay J,Kobaiter-Maarrawi S,Tabet P,Moussa R,Rizk T,Nohra G,Okais N,Samaha E,Maarrawi J

    更新日期:2018-06-01 00:00:00

  • The sphenoparietal sinus.

    abstract:OBJECTIVE:There is minimal detailed information regarding the sphenoparietal venous sinus found in the extant medical literature. Furthermore, there is controversy in the literature regarding drainage of the Sylvian vein into this sinus. The sphenoparietal sinus can potentially be encountered with cranial base approach...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000249241.35731.C6

    authors: Tubbs RS,Salter EG,Wellons JC 3rd,Blount JP,Oakes WJ

    更新日期:2007-02-01 00:00:00

  • Intrathecal ciliary neurotrophic factor delivery for treatment of amyotrophic lateral sclerosis (phase I trial).

    abstract:OBJECTIVE:This Phase I trial of ciliary neurotrophic factor (CNTF) delivered intrathecally for the treatment of patients with amyotrophic lateral sclerosis was designed to determine the safety of this new mode of administration as well as the pharmacokinetics and drug distribution. METHODS:CNTF was administered using ...

    journal_title:Neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/00006123-199701000-00021

    authors: Penn RD,Kroin JS,York MM,Cedarbaum JM

    更新日期:1997-01-01 00:00:00

  • Angiographic detection and characterization of "cryptic venous anomalies" associated with spinal cord cavernous malformations using flat-panel catheter angiotomography.

    abstract:BACKGROUND:Spinal cord cavernous malformations (CMs) are associated with 2 types of angiographically occult "cryptic venous anomalies," which differ in location with respect to the spinal cord. The anatomic distinction between superficial and intramedullary is important in that the latter heighten the risks of CM resec...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e31825d8f9a

    authors: Pearl MS,Chen JX,Gregg L,San Millàn D,Belzberg A,Jallo G,Gailloud P

    更新日期:2012-09-01 00:00:00

  • Interleukin-12-based immunotherapy against rat 9L glioma.

    abstract:OBJECTIVE:Interleukin-12 (IL-12) may be useful for immunotherapy against gliomas because it can reverse the glioma-induced suppression of T-cell proliferation and interferon-gamma production. We postulated that peripheral infusion of IL-12 along with irradiated tumor cells can lead to immunological rejection of 9L glio...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199804000-00097

    authors: Jean WC,Spellman SR,Wallenfriedman MA,Hall WA,Low WC

    更新日期:1998-04-01 00:00:00

  • A case of a spinal epidural capillary hemangioma: case report.

    abstract:BACKGROUND AND IMPORTANCE:Spinal hemangiomas usually arise from the vertebral body. Epidural hemangiomas are rare lesions, and most reported cases are cavernous. We report a case of a capillary hemangioma in the thoracic epidural space. CLINICAL PRESENTATION:The 57-year-old male patient initially presented with low th...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e3182093320

    authors: Hasan A,Guiot MC,Torres C,Marcoux J

    更新日期:2011-03-01 00:00:00

  • Primary pituitary carcinoma: a clinical pathological study.

    abstract::A 60-year-old woman presented with a history of headache and rapidly progressive complete bilateral ophthalmoplegia. Her endocrine function was normal. Radiographic studies revealed signs of diffuse destruction of the sella turcica by a tumor without suprasellar extension. Biopsies of the lesion within the sphenoid si...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Nudleman KL,Choi B,Kusske JA

    更新日期:1985-01-01 00:00:00