Spontaneous Skull Base Cerebrospinal Fluid Leaks and Their Relationship to Idiopathic Intracranial Hypertension
BACKGROUND: The association between spontaneous skull base cerebrospinal fluid (CSF) leaks and idiopathic intracranial hypertension (IIH) has been suggested, but its significance remains unclear.
OBJECTIVE: To estimate the prevalence of IIH in spontaneous skull base CSF leak patients.
METHODS: Systematic collection of demographics, neuro-ophthalmic and magnetic resonance imaging evaluation of spontaneous skull base CSF leak patients seen pre- and post-leak repair in one neuro-ophthalmology service. Patients with preexisting IIH were diagnosed with definite IIH if adequate documentation was provided; otherwise, they were categorized with presumed IIH. Classic radiographic signs of intracranial hypertension and bilateral transverse venous sinus stenosis were recorded.
RESULTS: Thirty six patients were included (age [interquartile range]: 50 [45;54] years; 94% women; body mass index: 36.8 [30.5;39.9] kg/m2), among whom six (16.7%, [95% confidence interval, CI]: [6.4;32.8]) had a preexisting diagnosis of definite or presumed IIH. Of the remaining 30 patients, four (13.3%, 95%CI: [3.8;30.7]) had optic nerve head changes suggesting previously undiagnosed IIH, while one was newly diagnosed with definite IIH at initial consultation. One out of 29 patients with normal findings of the optic nerve head at presentation developed new onset papilledema following surgery (3.4%, 95%CI: [0.1;17.8]) and was ultimately diagnosed with definite IIH. Overall, the prevalence of definite IIH was 19.4% (95%CI: [8.2;36.0]).
CONCLUSION: Striking demographic overlap exists between IIH patients and those with spontaneous CSF leak. Definite IIH was present in approximately 20% of our patients. However, its true prevalence is likely higher than identified by using classic criteria. We therefore hypothesize that an active CSF leak serves as an auto-diversion for CSF, thereby "treating" the intracranial hypertension and eliminating characteristic signs and symptoms at initial presentation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
American journal of rhinology & allergy - 35(2021), 1 vom: 11. Jan., Seite 36-43 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bidot, Samuel [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cerebrospinal fluid leak |
|---|
| Anmerkungen: |
Date Completed 18.08.2021 Date Revised 18.08.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/1945892420932490 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM311306926 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM311306926 | ||
| 003 | DE-627 | ||
| 005 | 20231225141954.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/1945892420932490 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1037.xml |
| 035 | |a (DE-627)NLM311306926 | ||
| 035 | |a (NLM)32551921 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bidot, Samuel |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Spontaneous Skull Base Cerebrospinal Fluid Leaks and Their Relationship to Idiopathic Intracranial Hypertension |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.08.2021 | ||
| 500 | |a Date Revised 18.08.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The association between spontaneous skull base cerebrospinal fluid (CSF) leaks and idiopathic intracranial hypertension (IIH) has been suggested, but its significance remains unclear | ||
| 520 | |a OBJECTIVE: To estimate the prevalence of IIH in spontaneous skull base CSF leak patients | ||
| 520 | |a METHODS: Systematic collection of demographics, neuro-ophthalmic and magnetic resonance imaging evaluation of spontaneous skull base CSF leak patients seen pre- and post-leak repair in one neuro-ophthalmology service. Patients with preexisting IIH were diagnosed with definite IIH if adequate documentation was provided; otherwise, they were categorized with presumed IIH. Classic radiographic signs of intracranial hypertension and bilateral transverse venous sinus stenosis were recorded | ||
| 520 | |a RESULTS: Thirty six patients were included (age [interquartile range]: 50 [45;54] years; 94% women; body mass index: 36.8 [30.5;39.9] kg/m2), among whom six (16.7%, [95% confidence interval, CI]: [6.4;32.8]) had a preexisting diagnosis of definite or presumed IIH. Of the remaining 30 patients, four (13.3%, 95%CI: [3.8;30.7]) had optic nerve head changes suggesting previously undiagnosed IIH, while one was newly diagnosed with definite IIH at initial consultation. One out of 29 patients with normal findings of the optic nerve head at presentation developed new onset papilledema following surgery (3.4%, 95%CI: [0.1;17.8]) and was ultimately diagnosed with definite IIH. Overall, the prevalence of definite IIH was 19.4% (95%CI: [8.2;36.0]) | ||
| 520 | |a CONCLUSION: Striking demographic overlap exists between IIH patients and those with spontaneous CSF leak. Definite IIH was present in approximately 20% of our patients. However, its true prevalence is likely higher than identified by using classic criteria. We therefore hypothesize that an active CSF leak serves as an auto-diversion for CSF, thereby "treating" the intracranial hypertension and eliminating characteristic signs and symptoms at initial presentation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cerebrospinal fluid leak | |
| 650 | 4 | |a idiopathic intracranial hypertension | |
| 650 | 4 | |a intracranial pressure | |
| 650 | 4 | |a magnetic resonance imaging | |
| 650 | 4 | |a neuro-ophthalmology | |
| 650 | 4 | |a obesity | |
| 650 | 4 | |a otorrhea | |
| 650 | 4 | |a papilledema | |
| 650 | 4 | |a rhinorrhea | |
| 650 | 4 | |a skull base | |
| 700 | 1 | |a Levy, Joshua M |e verfasserin |4 aut | |
| 700 | 1 | |a Saindane, Amit M |e verfasserin |4 aut | |
| 700 | 1 | |a Narayana, Kannan M |e verfasserin |4 aut | |
| 700 | 1 | |a Dattilo, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a DelGaudio, John M |e verfasserin |4 aut | |
| 700 | 1 | |a Mattox, Douglas E |e verfasserin |4 aut | |
| 700 | 1 | |a Oyesiku, Nelson M |e verfasserin |4 aut | |
| 700 | 1 | |a Peragallo, Jason H |e verfasserin |4 aut | |
| 700 | 1 | |a Solares, C Arturo |e verfasserin |4 aut | |
| 700 | 1 | |a Vivas, Esther X |e verfasserin |4 aut | |
| 700 | 1 | |a Wise, Sarah K |e verfasserin |4 aut | |
| 700 | 1 | |a Newman, Nancy J |e verfasserin |4 aut | |
| 700 | 1 | |a Biousse, Valérie |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of rhinology & allergy |d 2009 |g 35(2021), 1 vom: 11. Jan., Seite 36-43 |w (DE-627)NLM187939225 |x 1945-8932 |7 nnns |
| 773 | 1 | 8 | |g volume:35 |g year:2021 |g number:1 |g day:11 |g month:01 |g pages:36-43 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/1945892420932490 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 35 |j 2021 |e 1 |b 11 |c 01 |h 36-43 | ||