NDLI: Association of benign intracranial hypertension and spontaneous encephalocele with cerebrospinal fluid leak.

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Association of benign intracranial hypertension and spontaneous encephalocele with cerebrospinal fluid leak.

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Association of benign intracranial hypertension and spontaneous encephalocele with cerebrospinal fluid leak.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Brainard, Laura Chen, Douglas A. Aziz, Khaled M. Hillman, Todd A.
Description	Country affiliation: United States Author Affiliation: Brainard L ( Division of Neurotology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.)
Abstract	OBJECTIVE: To determine the incidence of intracranial hypertension in patients with spontaneous encephalocele with cerebrospinal fluid (CSF) leak. STUDY DESIGN: Retrospective case review. SETTING: Tertiary care neurotology practice. PATIENTS: Patients presenting between 2008 and 2011 with spontaneous encephalocele and CSF leak in the temporal bone. INTERVENTION(S): Lumbar puncture with opening pressure measurement after encephalocele repair. MAIN OUTCOME MEASURES: Patient age, sex, postoperative course, body mass index, and postoperative intracranial pressure. RESULTS: Of the 26 patients identified with spontaneous encephalocele with CSF leak, 9 patients had postoperative lumbar puncture data. Of those 9, 89% were female subjects, and 11% were male, with a mean age of 57 and a mean BMI of 41 kg/m (morbidly obese). The mean opening pressure was 24.5 cm H(2)O. Approximately 33% had normal intracranial pressure (mean, 15 cm H(2)O; range, 10-17 cm H(2)O); 67% had elevated intracranial pressure (mean, 29 cm H(2)O; range, 23.5-40 cm H(2)O). The incidence of BIH in the general population is 0.001%. Of the 6 with intracranial hypertension, 3 (50%) were placed on acetazolamide for fundoscopic findings, postoperative headache, and/or visual changes. Mean time to LP after repair of encephalocele was 13 months (range, 4 days to 75 months). CONCLUSION: This study shows that benign intracranial hypertension is prevalent in a significant number of patients presenting with spontaneous encephalocele with CSF otorrhea at a rate much higher than is found in the general population. This finding has direct clinical implications and suggests that all patients with spontaneous encephalocele/CSF leak warrant evaluation for benign intracranial hypertension.
File Format	HTM / HTML
ISSN	15317129
Issue Number	9
Volume Number	33
e-ISSN	15374505
Journal	Otology & Neurotology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2012-12-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Body Mass Index Spinal Puncture Complications Cerebrospinal Fluid Leak Humans Middle Aged Discipline Otolaryngology Male Journal Article Intracranial Pressure Temporal Bone Encephalocele Pathology Obesity, Morbid Cerebrospinal Fluid Rhinorrhea Surgery Otologic Surgical Procedures Pseudotumor Cerebri Female Aged Physiology Retrospective Studies Methods
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Sensory Systems Neurology (clinical)

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