Treatment of Spinal CSF Leaks and Fistulas.

Q1 Medicine

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI:10.1212/CON.0000000000001568

Narayan R Kissoon, Thien J Huynh

{"title":"Treatment of Spinal CSF Leaks and Fistulas.","authors":"Narayan R Kissoon, Thien J Huynh","doi":"10.1212/CON.0000000000001568","DOIUrl":null,"url":null,"abstract":"Objective: The options for treatment of spontaneous spinal CSF leaks and CSF-venous fistulas have expanded in recent years, and this article reviews the current treatments available, factors that affect treatment outcomes, and an algorithmic approach to treatment.Latest developments: Until recently, treatments for spontaneous intracranial hypotension consisted of supportive care, epidural blood patching, and when the site of CSF leakage was known, surgical repair. CSF-venous fistulas are now known to be common causes of CSF hypotension and are rarely cured by epidural blood patching. Better visualization of CSF-venous fistulas and the novel treatment of CSF-venous fistulas with transvenous embolization have expanded the arsenal of treatment options for spontaneous intracranial hypotension.Essential points: Clinical outcomes improve with timely treatment of spinal CSF leaks and CSF-venous fistulas. Radiographic features direct treatment, which includes epidural blood patching, transvenous embolization, and surgical correction. CSF-venous fistulas respond poorly to epidural blood patching but can respond favorably to surgical obliteration or transvenous embolization.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"688-708"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CONTINUUM Lifelong Learning in Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1212/CON.0000000000001568","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: The options for treatment of spontaneous spinal CSF leaks and CSF-venous fistulas have expanded in recent years, and this article reviews the current treatments available, factors that affect treatment outcomes, and an algorithmic approach to treatment.

Latest developments: Until recently, treatments for spontaneous intracranial hypotension consisted of supportive care, epidural blood patching, and when the site of CSF leakage was known, surgical repair. CSF-venous fistulas are now known to be common causes of CSF hypotension and are rarely cured by epidural blood patching. Better visualization of CSF-venous fistulas and the novel treatment of CSF-venous fistulas with transvenous embolization have expanded the arsenal of treatment options for spontaneous intracranial hypotension.

Essential points: Clinical outcomes improve with timely treatment of spinal CSF leaks and CSF-venous fistulas. Radiographic features direct treatment, which includes epidural blood patching, transvenous embolization, and surgical correction. CSF-venous fistulas respond poorly to epidural blood patching but can respond favorably to surgical obliteration or transvenous embolization.

查看原文本刊更多论文

脊髓液漏及瘘管的治疗。

目的：近年来，自发性脊髓脊液泄漏和CSF静脉瘘的治疗方法越来越多，本文综述了目前可用的治疗方法、影响治疗结果的因素以及一种算法治疗方法。最新进展：直到最近，自发性颅内低血压的治疗包括支持性护理，硬膜外补血，当脑脊液渗漏部位已知时，手术修复。目前已知脑脊液静脉瘘是脑脊液低血压的常见原因，很少通过硬膜外补血来治愈。脑脊液-静脉瘘更好的可视化和经静脉栓塞治疗脑脊液-静脉瘘的新方法扩大了自发性颅内低血压的治疗选择。要点：及时治疗脊脊液渗漏和脊脊液静脉瘘可改善临床疗效。影像学表现为直接治疗，包括硬膜外补血、经静脉栓塞和手术矫正。csf -静脉瘘对硬膜外补血反应不佳，但对手术封堵或经静脉栓塞反应良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

CONTINUUM Lifelong Learning in Neurology Medicine-Medicine (all)

CiteScore

5.80

自引率

0.00%

发文量

175

期刊介绍： Continue your professional development on your own schedule with Continuum: Lifelong Learning in Neurology®, the American Academy of Neurology" self-study continuing medical education publication. Six times a year you"ll learn from neurology"s experts in a convenient format for home or office. Each issue includes diagnostic and treatment outlines, clinical case studies, a topic-relevant ethics case, detailed patient management problem, and a multiple-choice self-assessment examination.