CSF-Venous Fistula of the Clival Skull Base: A Unique Case Study and Literature Review.
CSF-venous fistula
central skull base fracture
clival fracture
clival skull base
digital subtraction myelogram
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
08 Sep 2023
08 Sep 2023
Historique:
revised:
21
08
2023
received:
05
07
2023
accepted:
22
08
2023
medline:
8
9
2023
pubmed:
8
9
2023
entrez:
8
9
2023
Statut:
aheadofprint
Résumé
An adolescent male presented with orthostatic headaches following head trauma. MRI showed cerebellar tonsil displacement and a bony defect in the clival skull base. Digital subtraction myelography (DSM) confirmed a cerebrospinal fluid-venous fistula (CVF). This was repaired endoscopically. CVFs cause uncontrolled flow of CSF into the venous system resulting in symptoms of intracranial hypotension. They're often difficult to identify on initial imaging. This is the first reported CVF originating in the central skull base, and the first treated via endoscopic trans-nasal approach. CVFs may elude initial imaging, making DSM crucial for unexplained spontaneous intracranial hypotension. Laryngoscope, 2023.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
Références
Ravnik J, Hribernik B, Lanišnik B. Endoscopic endonasal approaches to the clival region. Acta Med Acad. 2020;49(Suppl 1):45-53.
Schievink WI, Michael LM 2nd, Maya M, Klimo P Jr, Elijovich L. Spontaneous intracranial hypotension due to skull-base cerebrospinal fluid leak. Ann Neurol. 2021;90(3):514-516.
Hsieh CJ, Kuo LT, Lai DM, Huang AP. Cervical cerebrospinal fluid venous fistula with syringomyelia treated with suboccipital decompression: illustrative case. J Neurosurg Case Lessons. 2022;3(15):CASE2211.
Schievink WI, Moser FG, Maya MM. CSF-venous fistula in spontaneous intracranial hypotension. Neurology. 2014;83(5):472-473.
Kim DK, Carr CM, Benson JC, et al. Diagnostic yield of lateral decubitus digital subtraction myelogram stratified by brain MRI findings. Neurology. 2021;96(9):e1312-e1318.