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Updated: May 23, 2025

Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Spinal Cerebrospinal Fluid Leaks/Intracranial Hypotension
1Department of Clinical Neurosciences, Division of Neurology, South Health Campus, Cumming School of Medicine, University of Calgary, 4448 Front Street Southeast, Calgary, Alberta T3M 1M4, Canada.
Abstract:
Spinal cerebrospinal fluid (CSF) leaks occur due to CSF volume loss at the level of the spine. They can occur spontaneously, from trauma, or iatrogenic causes. Classically, patients present with orthostatic headache, but atypical presentations also occur. Initial workup involves ruling out other etiologies with careful history, neurologic examination, and MRI of brain/spine. Treatment starts with conservative measures and nontargeted epidural blood patching (EBP). If not successful, precise leak localization is required with myelography. Targeted therapy can be offered, including EBP/fibrin glue, endovascular treatment for CSF-venous fistulas, and spine surgery in appropriate cases. Early diagnosis and treatment improve outcomes.
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