2016 86:113.īanks CA, Palmer JN, Chiu AG, O’Malley BW Jr, Woodworth BA, Kennedy DW. MRI with intrathecal gadolinium to detect a CSF leak: feasibility and long term safety from an open label single centre cohort study. Vanhee A, Dedeken P, Casselman J, Vanopdenbosch L. The contribution of 3D-CISS and contrast-enhanced MR cisternography in detecting cerebrospinal fluid leak in patients with rhinorrhoea. 2017 52(4):195–7.Īlgin O, Hakyemez B, Gokalp G, Ozcan T, Korfali E, Parlak M. Intrathecal contrast-enhanced magnetic resonance imaging-related brain signal changes: residual gadolinium deposition? Investig Radiol. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Ratilal BO, Costa J, Sampaio C, Pappamikail L. Contemporary management of cerebrospinal fluid rhinorrhea. Cerebrospinal fluid leakage complicating skull base fractures: analysis of 81 cases. Yilmazlar S, Arslan E, Kocaeli H, Dogan S, Aksoy K, Korfali E, Doygun M. Imaging of skull-base cephalocoeles and cerebrospinal fluid leaks. ![]() Skull base fractures and their complications. Non-traumatic cerebrospinal fluid rhinorrhoea. Ommaya AK, Di Chiro G, Baldwin M, Pennybacker JB. Cerebrospinal fluid rhinorrhea and otorrhea: a multimodality imaging approach. Hiremath SB, Gautam AA, Sasindran V, Therakathu J, Benjamin G. Imaging of cerebrospinal fluid rhinorrhea and otorrhea. Diagnosis of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations. Oakley GM, Alt JA, Schlosser RJ, Harvey RJ, Orlandi RR. Imaging of skull base cerebrospinal fluid leaks in adults. HRCT images can also be used for intraoperative image-guided navigation. HRCT scanning of the skull base is the modality of choice for depicting the bone defects however, evaluation of the adjacent soft tissues is best achieved by MRI, making these two cross-sectional tools complementary to each other. Various modalities including HRCT, MRI, and cisternography techniques using CT/MRI or radionuclide scan are described and widely used however, there is no single best modality. Imaging is essential for CSF rhinorrhea to identify the exact site of the leak, to characterize the osteodural defect, to plan surgery, and to evaluate the underlying cause. Also, radiological identification of critical adjacent anatomical structures before surgery increases the rate of surgical success with less morbidity. Imaging is crucial in precise localization and detailed evaluation of the leak, as demonstration of the exact location, size, and contents of the osteodural defect leads to more accurate planning of surgery. Recent improvements in imaging technology, particularly the introduction of multi-detector computed tomography (CT), have led to better delineation of skull base defects. ![]() Accurate detection of the site of CSF leak facilitates appropriate treatment, helping to decrease the risk of life-threatening complications. Since this communication puts the patient at an increased risk of developing meningitis, surgical intervention is required for treatment of continuing CSF rhinorrhea. Cerebrospinal fluid (CSF) rhinorrhea is defined as the leakage of CSF into the nose through an osteodural defect in the skull base, which leads to a fistula between the subarachnoid space and the sinonasal cavity.
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