Our advanced training, experience, and large number of cases contribute to our excellent results. This can optimize your surgeon's accuracy and help them avoid damage to surrounding tissue.ĭuke is one of the few centers in the country with the expertise to diagnose and treat CSF leaks that cause chronic headaches and other symptoms. ![]() The technique combines CT scans (which are ideal for displaying bony anatomy) and MRI scans (which are ideal for displaying softer tissues and fluids) and uses reference points to identify important neurological structures. You should begin to find relief from pain and other symptoms after seven to ten days.ĬT/MRI fusion is a navigation system, similar to a GPS, used during CSF leak surgery. You’ll be asked to return for follow-up visits one week after surgery and several more times at increasing intervals. This requires a longer hospital stay, usually three to seven days. You’ll need to stay in the hospital for three or four nights.įor leaks on the back of the skull (posterior) or that are difficult to access through the nose or behind the ear, surgeons may perform a traditional craniotomy, which requires a larger opening in the skull. This technique speeds recovery, leaves no visible scars, and requires only a couple of nights’ stay in the hospital.įor leaks on the side of the skull (lateral), surgeons may access and repair the leak through incisions behind the ear, which leave less visible scarring. Once surgeons reach the leak site, they repair the hole by plugging it with tissue or fat.įor leaks on the front of the skull (anterior), surgeons may access and repair the leak through the nostrils using a minimally invasive, endoscopic approach. Surgical approaches are tailored to the exact location of the leak. Surgery is often the best treatment option for cranial CSF leaks. Without treatment, CSF leaks can lead to loss of vision or other senses, hydrocephalus (a buildup of fluid in the cavities inside the brain), dangerous infections like meningitis, or death. The most common signs for cranial CSF leaks include chronic headaches and watery discharge from the nose or ear, especially on one side. Intracranial hypertension can be primary, meaning there is no certain cause, or secondary to another problem, such as a brain bleed. Too much CSF can wear down the skull, making it weak and prone to crack. Intracranial hypertension is similar to high blood pressure, but in the brain. This can be caused by a traumatic injury, tumor, infection, surgery, or intracranial hypertension. When an area of the skull is damaged, becomes thin, or cracks, the dura (the tissue that holds cerebrospinal fluid and surrounds the brain and spine) is exposed and can easily tear. The leak is then patched.Cerebrospinal fluid (CSF) is a watery fluid that protects, nourishes, and removes waste from the brain and spinal cord. In other cases a small craniotomy (temporary window through the skull) above the ear is needed to repair the leak. In patients with small defects, repair can be attempted through the mastoid bone behind the ear. Several different techniques can be used depending on the location and size of the defect. Surgical repair of the leak is often needed to stop the leak, especially in spontaneously occurring cases. Temporal Bone Cerebrospinal Fluid Leaks – Treatment Definitive diagnosis is made by sending a sample of the fluid for special testing. Often imaging with a CT and/or MRI scan is helpful in the diagnosis. ![]() Temporal Bone Cerebrospinal Fluid Leaks – Diagnosis A risk of infection of the lining of the brain known as meningitis can occur. ![]() It can also be associated with trauma to the head or prior surgery. In many instances this can occur by itself (spontaneously) over time. ![]() This may cause fluid to build in the middle ear and can cause hearing loss, ringing of the ear and fullness. Sometimes the CSF can leak into the temporal bone. The ear is near the brain in the temporal bone. In some instances an abnormal connection can develop such that this fluid leaks out from the skull. Temporal Bone Cerebrospinal Fluid Leaks Temporal Bone Cerebrospinal Fluid Leaks – AboutĬerebrospinal fluid (CSF) is just underneath the lining of the brain and spine.
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