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Suggest Remedy For Recurrent CSF Leak
Question: Recently my dad undergone CSF leak repair surgery by endoscopic approach, that got recurred in 15 days, again he underwent surgery by same approach, CT PNS has been done before 1 st surgery and one more done before 2 nd surgery. I want the analysis of both the reports to know the root cause for recurrent CSF leak.
Brief Answer:
Please upload the CSF reports.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Sure,I would like to analyse the CSF reports.Please scan and upload them.
Also,please tell-
1)Did your dad had any history of head injury or trauma?If yes,it may have an association with the CSF leak.
2)Did he undergo any brain or sinus surgery?
3)Since when,he is having CSF leak and how did it start?
4)Any other medical history?
Waiting for your follow-up query.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Please upload the CSF reports.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Sure,I would like to analyse the CSF reports.Please scan and upload them.
Also,please tell-
1)Did your dad had any history of head injury or trauma?If yes,it may have an association with the CSF leak.
2)Did he undergo any brain or sinus surgery?
3)Since when,he is having CSF leak and how did it start?
4)Any other medical history?
Waiting for your follow-up query.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi XXXXXXX
Thanks for quick response, I have attached CT PNS reports pre surgery and post surgery, I want the comparison of both the reports and please let me know the reasons for the recurrance of CSF leak post surgery with in 15 days.
Other details I will update in the next reply.
Thanks,
XXXX
Thanks for quick response, I have attached CT PNS reports pre surgery and post surgery, I want the comparison of both the reports and please let me know the reasons for the recurrance of CSF leak post surgery with in 15 days.
Other details I will update in the next reply.
Thanks,
XXXX
Brief Answer:
Please consider a correction in the above response/Post surgical changes.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
Firstly,I would like to mention a correction in the above response where by mistake I mentioned 'CSF' instead of 'CT'.
Further,I have gone through the PNS CT pre-surgical and post-surgical reports and after analysing them,I am of the opinion that repeat CSF leak probably occurred because of some post-surgical changes.
Skull base surgery,brain surgery and sinus surgery are common causes of causing some dura or bone defects causing CSF leak.
Here,post-surgical report mentions that the number of bony defects in bilateral cribriform plates increased as compared to pre-surgical CT.So,that was the probable cause of repeat CSF leak.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Please consider a correction in the above response/Post surgical changes.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
Firstly,I would like to mention a correction in the above response where by mistake I mentioned 'CSF' instead of 'CT'.
Further,I have gone through the PNS CT pre-surgical and post-surgical reports and after analysing them,I am of the opinion that repeat CSF leak probably occurred because of some post-surgical changes.
Skull base surgery,brain surgery and sinus surgery are common causes of causing some dura or bone defects causing CSF leak.
Here,post-surgical report mentions that the number of bony defects in bilateral cribriform plates increased as compared to pre-surgical CT.So,that was the probable cause of repeat CSF leak.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Please let me know why the number of bony defects in bilateral cribriform plates increased post surgery. What might be the causes please elobrate.
Brief Answer:
Cribriform plate is a sensitive structure.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
Cribriform plate is a sensitive structure and may get damage with effects of surgery or head injury.
You need to discuss it with the operating surgeon further.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Cribriform plate is a sensitive structure.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
Cribriform plate is a sensitive structure and may get damage with effects of surgery or head injury.
You need to discuss it with the operating surgeon further.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
That has damaged in the process of surgery. before surgery that was fine. can I understand your response in this way?
Brief Answer:
Not conclusively.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
No,I'm not conclusive about it.I have just listed it as a possible cause as Brain or sinus surgery is one of the commonest cause of CSF leak.It may be a possibility here,as well.That does not mean that surgery was not done properly.Its just that the structures at the place(like cribriform plate)are sensitive and prone to be injured with even slight trauma.There have been cases where even heavy sneezing has caused the damage to cribriform plate.Furthermore,some of the cases have spontaneous injuries to the cribriform plate and dura causing CSF leaks,without any apparent reason.
May be,your father had a spontaneous leak in the first place and heightened sensitivity to the same,thus resulting in another event of pathogenetic mechanisms leading to spontaneous leak again.
Or,as I said,surgery may be the reason behind it.
You need to discuss it with the operating surgeon for the final opinion as one who has performed the surgery will be the best person to give a logical reasoning for the same.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Not conclusively.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
No,I'm not conclusive about it.I have just listed it as a possible cause as Brain or sinus surgery is one of the commonest cause of CSF leak.It may be a possibility here,as well.That does not mean that surgery was not done properly.Its just that the structures at the place(like cribriform plate)are sensitive and prone to be injured with even slight trauma.There have been cases where even heavy sneezing has caused the damage to cribriform plate.Furthermore,some of the cases have spontaneous injuries to the cribriform plate and dura causing CSF leaks,without any apparent reason.
May be,your father had a spontaneous leak in the first place and heightened sensitivity to the same,thus resulting in another event of pathogenetic mechanisms leading to spontaneous leak again.
Or,as I said,surgery may be the reason behind it.
You need to discuss it with the operating surgeon for the final opinion as one who has performed the surgery will be the best person to give a logical reasoning for the same.
Hope that I have answered your query.If you have some follow-up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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