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Related Concept Videos

Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

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Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
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Cerebral Edema l: Introduction01:19

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Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
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Increased Intracranial Pressure l: Introduction01:14

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Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
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Glaucoma: Overview01:25

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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

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Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins...
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Brain Abscess l: Introduction01:26

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A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
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Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
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Iatrogenic cerebrospinal fluid oculorrhea.

Mijung Chi1, H Jane Kim, Bengu E Koktekir

  • 1From the *Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea; †Department of Ophthalmology, University of California, San Francisco, California; and ‡Department of Ophthalmology, Selcuk University, Konya, Turkey.

The Journal of Craniofacial Surgery
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PubMed
Summary

Cerebrospinal fluid oculorrhea, a rare condition of CSF leakage from the eye, can occur after brain surgery. This case highlights a successful conservative management of post-surgical CSF oculorrhea.

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Area of Science:

  • Neurosurgery
  • Ophthalmology
  • Neurology

Background:

  • Cerebrospinal fluid (CSF) leakage into or from the orbit (CSF orbitorrhea/oculorrhea) is a rare complication resulting from a communication between the subarachnoid space and the orbit.
  • This condition has been infrequently documented in medical literature.

Observation:

  • A case of CSF oculorrhea following surgical resection of a recurrent sphenoid wing meningioma is presented.
  • The patient, a 67-year-old individual, developed symptoms of tearing from the ipsilateral eye post-craniotomy.
  • A 1-cm laceration in the conjunctiva near the lateral orbital rim was identified, with steady leakage of serous fluid observed.

Findings:

  • The observed fluid leakage was diagnosed as iatrogenic cerebrospinal fluid oculorrhea.
  • Conservative management was initiated for the patient.

Implications:

  • This case underscores the possibility of iatrogenic CSF oculorrhea as a complication of cranial surgery, particularly in the orbital region.
  • Conservative treatment approaches can be effective in resolving this rare condition, potentially avoiding more invasive interventions.