Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak
Abstract Objectives Current evidence suggests a link between idiopathic intracranial hypertension (IIH) and spontaneous cerebrospinal fluid (sCSF) leak, as well as between IIH and dural venous sinus (DVS) narrowing. However, there are limited data linking DVS narrowing and sCSF leak. This study aims...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.1063 |
| _version_ | 1797800284979724288 |
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| author | Karim W. Asi Brian H. Cameron Elliot R. Friedman Jeffrey P. Radabaugh Martin J. Citardi Amber U. Luong William C. Yao |
| author_facet | Karim W. Asi Brian H. Cameron Elliot R. Friedman Jeffrey P. Radabaugh Martin J. Citardi Amber U. Luong William C. Yao |
| author_sort | Karim W. Asi |
| collection | DOAJ |
| description | Abstract Objectives Current evidence suggests a link between idiopathic intracranial hypertension (IIH) and spontaneous cerebrospinal fluid (sCSF) leak, as well as between IIH and dural venous sinus (DVS) narrowing. However, there are limited data linking DVS narrowing and sCSF leak. This study aims to determine the prevalence of DVS narrowing in patients with sCSF leak. Methods A retrospective review of all patients with sCSF leak that presented to a tertiary academic center from 2008 to 2019. Preoperative imaging was independently reviewed by two neuroradiologists to evaluate for DVS narrowing. Available literature was used to estimate the prevalence of DVS narrowing in the general population to allow for comparison. Data were analyzed using Exact binomial test. Results Analysis of 25 patients with appropriate imaging revealed the majority were women (21/25, 84%) with a mean age of 51.89 years (SD 13.96). The majority of these patients were found to have narrowing of the DVS (20/25, 80%). In patient with sCSF leaks, there was a significantly higher proportion of patients with DVS narrowing compared with published literature examining this condition in the general population (80% vs. 40%, CI 0.59–0.93, p < .001). Conclusion The prevalence of DVS narrowing in patients with sCSF leaks is substantial and likely greater than the general population. Moreover, there appears to be narrowing in most patients with sCSF leak. Preoperative radiological evaluation of the DVS using MR venography may be useful in patients with sCSF leaks as DVS stenosis may be an underdiagnosed etiology. Further study is needed to evaluate this. Level of Evidence IV. |
| first_indexed | 2024-03-13T04:31:48Z |
| format | Article |
| id | doaj.art-3c944e56dc3241b3b34cdfac15fafecf |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-03-13T04:31:48Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-3c944e56dc3241b3b34cdfac15fafecf2023-06-19T10:16:46ZengWileyLaryngoscope Investigative Otolaryngology2378-80382023-06-018362162610.1002/lio2.1063Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leakKarim W. Asi0Brian H. Cameron1Elliot R. Friedman2Jeffrey P. Radabaugh3Martin J. Citardi4Amber U. Luong5William C. Yao6Department of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical School The University of Texas Health Science Center at Houston Houston Texas USADepartment of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical School The University of Texas Health Science Center at Houston Houston Texas USADepartment of Radiology Houston Methodist Hospital Houston Texas USABaptist ENT Specialists Baptist Medical Center Jacksonville Florida USADepartment of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical School The University of Texas Health Science Center at Houston Houston Texas USADepartment of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical School The University of Texas Health Science Center at Houston Houston Texas USADepartment of Otorhinolaryngology‐Head and Neck Surgery, McGovern Medical School The University of Texas Health Science Center at Houston Houston Texas USAAbstract Objectives Current evidence suggests a link between idiopathic intracranial hypertension (IIH) and spontaneous cerebrospinal fluid (sCSF) leak, as well as between IIH and dural venous sinus (DVS) narrowing. However, there are limited data linking DVS narrowing and sCSF leak. This study aims to determine the prevalence of DVS narrowing in patients with sCSF leak. Methods A retrospective review of all patients with sCSF leak that presented to a tertiary academic center from 2008 to 2019. Preoperative imaging was independently reviewed by two neuroradiologists to evaluate for DVS narrowing. Available literature was used to estimate the prevalence of DVS narrowing in the general population to allow for comparison. Data were analyzed using Exact binomial test. Results Analysis of 25 patients with appropriate imaging revealed the majority were women (21/25, 84%) with a mean age of 51.89 years (SD 13.96). The majority of these patients were found to have narrowing of the DVS (20/25, 80%). In patient with sCSF leaks, there was a significantly higher proportion of patients with DVS narrowing compared with published literature examining this condition in the general population (80% vs. 40%, CI 0.59–0.93, p < .001). Conclusion The prevalence of DVS narrowing in patients with sCSF leaks is substantial and likely greater than the general population. Moreover, there appears to be narrowing in most patients with sCSF leak. Preoperative radiological evaluation of the DVS using MR venography may be useful in patients with sCSF leaks as DVS stenosis may be an underdiagnosed etiology. Further study is needed to evaluate this. Level of Evidence IV.https://doi.org/10.1002/lio2.1063dural venous stentingidiopathic intracranial hypertensionskull basespontaneous cerebrospinal fluid leakvenous sinus stenosis |
| spellingShingle | Karim W. Asi Brian H. Cameron Elliot R. Friedman Jeffrey P. Radabaugh Martin J. Citardi Amber U. Luong William C. Yao Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak Laryngoscope Investigative Otolaryngology dural venous stenting idiopathic intracranial hypertension skull base spontaneous cerebrospinal fluid leak venous sinus stenosis |
| title | Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak |
| title_full | Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak |
| title_fullStr | Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak |
| title_full_unstemmed | Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak |
| title_short | Dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak |
| title_sort | dural sinus narrowing in patients with spontaneous anterior skull base cerebrospinal fluid leak |
| topic | dural venous stenting idiopathic intracranial hypertension skull base spontaneous cerebrospinal fluid leak venous sinus stenosis |
| url | https://doi.org/10.1002/lio2.1063 |
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