Pituitary adenoma with cerebrospinal fluid rhinorrhea is rare clinically. In this paper, through the analysis of a pituitary adenoma patient with initial symptom of cerebrospinal fluid rhinorrhea, we look forward to provide evidence for clinical diagnosis, so that we can avoid misdiagnosis.
Adenoma ; complications ; diagnosis ; Cerebrospinal Fluid Rhinorrhea ; etiology ; Humans ; Pituitary Neoplasms ; complications ; diagnosis

The common etiologies of pneumocephalus, presence of air in the intracranial cavity, are trauma and cranial surgery. Pneumocephalus after spinal surgery is an unusual postoperative complication. We report the case of a male 59-year-old man who developed a pneumacephalus after posterior lumbar surgery for spinal stenosis. Intraoperatively, a cerebrospinal fluid leak following a dural tear was noted and immediately repaired. The next day, the patient complained of headache and dizziness. Head and lumbar computed tomography scans revealed significant air in the frontal region, several cisterns, intraventricle, and extra-dural area in the spine canal. Symptoms were spontaneously resolved within 2 weeks with conservative management.
Cerebrospinal Fluid Rhinorrhea ; Dizziness ; Head ; Headache ; Humans ; Male ; Middle Aged ; Pneumocephalus ; Postoperative Complications ; Spinal Stenosis ; Spine

OBJECTIVE: To analyze the factors of intracranial infection after transnasal endoscopic crannialbase approach. METHOD: Retrospective analysis of 346 patients of ransnasal endoscopic crannialbase approach, logistic regression analysis of the factors was carried out. RESULT: The total number of cases of postoperative infections were 19 cases in 346 patients, the infection rate was 5.49%. The cerebrospinal fluid rhinorrhea , the restitution of skull base, the history of crannialbase approach, the history of radiotherapy and diabetes were infection fators after transnasal endoscopic diabetes (P < 0.05), while sex,age,operative approach,the use of artificial material,longer application of antibiotics before or after operation,and the history of chemotherapy had no obvious effects (P > 0.05). CONCLUSION Intracranial infection after transnasal endoscopic the use of artificial material was affected by many factors. Much attention should be paid for the intracranial infection prevention.
Cerebrospinal Fluid Rhinorrhea ; etiology ; Endoscopy ; Humans ; Postoperative Complications ; Retrospective Studies ; Skull Base ; surgery

OBJECTIVETo review the clinical characteristics of spontaneous intracranial hypotension (SIH) with cerebrospinal fluid (CSF) leakage.

METHODSClinical data of 42 SIH patients with cerebrospinal leakage, whose diagnosis met the criteria of the International Headache Classification, were retrospectively reviewed. The patients were divided into short (n=27) and long (n=15) course groups. The clinical data and imaging features were compared between two groups.

RESULTSThirty-nine patients (92.9%) had orthostatic headache. Compared with the short course group, the frequency of headache were significantly lower in patients with long disease duration (80% vs 100%, P =0.040); the ratio of high CSF opening pressure (>=60.0 mm H2O), the average CSF opening pressure, and the frequencies of subdural hematoma were higher in long course group than those in short course group [60.0% vs 20.8%, (64.7±42.1) vs (40.0±33.8)mm H2O, and 50.0% vs 11.6%; P=0.019, 0.038 and 0.018, respectively]. Forty-two patients underwent CT myelography;definite focal CSF leakage sites were found in all patients and multiple sites of CSF leakage in 38 patients.

CONCLUSIONAll SIH do not necessarily show the typical clinical manifestations, and cranial MRI and CT myelography are helpful in the diagnosis. Because of higher risk of subdural hemorrhage, patients with long disease duration require active intervention.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Otorrhea ; complications ; Cerebrospinal Fluid Rhinorrhea ; complications ; Female ; Humans ; Intracranial Hypotension ; diagnosis ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

A case of non-traumatic "high pressure" cerebrospinal fluid rhinorrhea is reported. There was a huge fibroblastic meningioma in the left parieto-occipital region along with hydrocephalus. Initially a ventriculoperitoneal shunt was done and then 12 days later the tumor mass was removed totally. After the operations the patient became free of leakage and a direct approach for the cerebrospinal fluid rhinorrhea was not needed.
Adult ; Brain Neoplasms/complications* ; Case Report ; Cerebrospinal Fluid Rhinorrhea/etiology* ; Female ; Human ; Meningioma/complications* ; Occipital Lobe* ; Parietal Lobe*

Arnold-Chiari Malformation ; complications ; Cerebrospinal Fluid Rhinorrhea ; etiology ; Female ; Humans ; Infratentorial Neoplasms ; complications ; Magnetic Resonance Imaging ; Meningeal Neoplasms ; complications ; Meningioma ; complications ; Middle Aged

OBJECTIVETo report the results of endoscopic transpterygoid intervention of nine patients with meningoencephalocele and cerebrospinal fluid (CSF) leaks within lateral recess of sphenoid sinus (LRSS). The diagnosis, operative techniques and their related problems were discussed.

METHODSNine hospitalized patients with meningoencephalocele and CSF leaks within lateral recess of sphenoid sinus (LRSS) were included in this paper. Six were male and 3 were female, aged from 27 to 56 years old. Two patients had the histories of endoscopic repair. The preoperative orientation of CSF leaks and meningoencephalocele depended on CT scan and MR cisternography. Endoscopic transpterygoid intervention and the repair of skull base defects were undertaken under general anesthesia.

RESULTSAll the operations were successful. One patient had a postoperative intracranial hypertension and Hydrocephalus. Two patients had postoperative ipsilateral facial, upper lip and palatal hypesthesia. One of them had a xerophthalmia. All the symptoms above mentioned relieved gradually 6 months after operation. No recurrence was found during follow -up for 6 to 58 months (mean 25. 6 months).

CONCLUSIONSEndoscopic transpterygoid intervention for meningoencephalocele and CSF leaks within LRSS is a minimally invasive technique and a straightforward approach.

Adult ; Cerebrospinal Fluid Rhinorrhea ; complications ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male ; Meningocele ; complications ; surgery ; Middle Aged ; Skull Base ; surgery ; Sphenoid Bone ; surgery ; Sphenoid Sinus ; Treatment Outcome

OBJECTIVE: To study the feature and treatment method of patients with empty sella merger cerebro-spinal fluid leakage of nasal. METHOD: There were 8 cases with empty sella merger cerebrospinal fluid leakage of nasal, 2 cases were accepted the repairing surgery of cerebrospinal fluid leakage one time, 4 cases were accepted the repairing surgery of cerebrospinal fluid leakage used endoscope 2 times, 1 case was accepted repairing surgery of cerebrospinal fluid leakage used endoscope merge craniotomy and ventricle celiac bypass, 1 case recurrences after repairing surgery of cerebrospinal fluid was recurred after conservative treatment. Some postoperative were stayed in bed for three weeks and lumbar drainage for 1 week. RESULT: One case of cerebral hemorrhage after surgery was cured with craniotomy, followed for 2 years without recurrence. One case was recurred after conservative treatment. Two cases recurrences after surgery 3 years ago were accepted surgery again followed by one year without recurrence. One case who recurrence 1 year later was accepted repairing surgery of cerebrospinal fluid leakage used endoscope merge craniotomy and ventricle celiac bypass followed six months without recurrence. One cash after once surgery was followed half a year without recurrence. One case with recurrence 5 years later was accepted repairing surgery again. CONCLUSION The patient with empty sella combined cerebrospinal fluid leakage of nasal was rare, the main method was endoscopic sinus surgery treatment, but it recurred usually. The patients with repeatedly recurrence can be considered to accepted the surgery of ventricle celiac bypass. It required long-term postoperative follow-up and review.
Adult ; Cerebrospinal Fluid Rhinorrhea ; complications ; diagnosis ; surgery ; Empty Sella Syndrome ; complications ; diagnosis ; surgery ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery

OBJECTIVE: Although many treatment modalities have been introduced for trigeminal neuralgia (TN), the long-term clinical results remain unsatisfactory. It has been particularly challenging to determine an appropriate treatment strategy for patients who have responded poorly to initial therapies. We analyzed the surgical outcomes in TN patients who failed prior treatments. METHODS: We performed a retrospective analysis of 37 patients with recurrent or persistent TN symptoms who underwent surgery at our hospital between January 2010 and December 2014. Patients with follow-up data of at least one year were included. The prior treatment modalities of the 37 patients included microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and percutaneous procedures such as radiofrequency rhizotomy (RFR), balloon compression, and glycerol rhizotomy (GR). The mean follow-up period was 69.9 months (range : 16–173). The mean interval between the prior treatment and second surgery was 26 months (range : 7–123). We evaluated the surgical outcomes using the Barrow Neurological Institute (BNI) pain intensity scale. RESULTS: Among the 37 recurrent or persistent TN patients, 22 underwent MVD with partial sensory rhizotomy (PSR), 8 received MVD alone, and 7 had PSR alone. Monitoring of the surgical treatment outcomes via the BNI pain intensity scale revealed 8 (21.6%) patients with a score of I, 13 (35.1%) scoring II, 13 (35.1%) scoring III, and 3 (8.2%) scoring IV at the end of the follow-up period. Overall, 91.8% of patients had good surgical outcomes. With regard to postoperative complications, 1 patient had transient cerebrospinal fluid rhinorrhea (2.7%), another had a subdural hematoma (2.7%), and facial sensory changes were noted in 8 (21.1%) patients after surgery. CONCLUSION: Surgical interventions, such as MVD and PSR, are safe and very effective treatment modalities in TN patients who failed initial or prior treatments. We presume that the combination of MVD with PSR enabled us to obtain good short- and long-term surgical outcomes. Therefore, aggressive surgical treatment should be considered in patients with recurrent TN despite failure of various treatment modalities.
Cerebrospinal Fluid Rhinorrhea ; Follow-Up Studies ; Glycerol ; Hematoma, Subdural ; Humans ; Microvascular Decompression Surgery ; Postoperative Complications ; Radiosurgery ; Retrospective Studies ; Rhizotomy ; Trigeminal Neuralgia*

OBJECTIVETo explore the postoperative complication and its preventive measure of cervical open-door expansive laminoplasty with lateral mass screw fixation in treating cervical canal stenosis.

METHODSFrom February 2008 to July 2011, 33 patients with cervical canal stenosis underwent cervical open-door expansive laminoplasty with lateral mass screw fixation. JOA score was used to evaluate clinical effects before and after operation. Of them, complications occurred in 6 cases, male in 2 cases and female in 4 cases. The reason of complications were analyzed.

RESULTSAll the patients were followed up from 6 months to 2 years with an average of 10.3 months. The improvement rate of JOA was 78.8% and incidence rate of complication was 18.2% (6 cases). There were 2 cases of axiality symptoms, 1 case of lateral mass screw pulled-out, 2 cases of cerebrospinal fluid leakage with wound dehiscence, 1 case of nerve root parlysis. These complications correlated with operative design, manipulation,improved degree of cervical curvature,postoperative management and cooperation of patient.

CONCLUSIONAs an effective treatment, cervical open-door expansive laminoplasty with lateral mass screw fixation has lower incidence of axiality pain. Preoperative examination ,postoperative management ,meticulous surgical skill are very important to avoid complications.

Bone Screws ; Cerebrospinal Fluid Rhinorrhea ; etiology ; Cervical Vertebrae ; surgery ; Female ; Humans ; Laminectomy ; adverse effects ; methods ; Male ; Postoperative Complications ; etiology ; prevention & control ; Spinal Stenosis ; surgery