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Published on: January 27, 2015
Cerebrospinal fluid fistulae in a canine model
C A Syms1, M J Syms, T P Murphy
1Wilford Hall U.S. Air Force Medical Center, Lackland Air Force Base, Texas, USA.
Summary
Intrathecal fluorescein aids in locating cerebrospinal fluid fistulas. However, higher doses may cause central nervous system irritation, necessitating careful dosage recommendations for safe and effective diagnosis.
Area of Science:
- Neurology
- Medical Imaging
- Ophthalmology
Background:
- Cerebrospinal fluid (CSF) fistulas require accurate diagnostic methods.
- High-resolution CT scanning with intrathecal contrast is effective but sometimes insufficient.
- Intrathecal fluorescein offers precise fistula localization.
Purpose of the Study:
- To refine the clinical examination for CSF fistulas using intrathecal fluorescein.
- To investigate the histopathologic effects of fluorescein on the central nervous system in a canine model.
Main Methods:
- A canine model was used to create and visualize surgically induced CSF fistulas.
- A xenon light source was modified for examination with 490 nm light.
- Histopathologic examination of the canine central nervous system after fluorescein instillation.
Main Results:
- Low doses of intrathecal fluorescein allowed accurate visualization of CSF fistulas in canines.
- Higher doses of fluorescein induced microscopic changes in the canine central nervous system, indicative of irritant material.
- These changes suggest a potential mechanism for neurological complications observed in patients.
Conclusions:
- Intrathecal fluorescein is valuable for diagnosing CSF fistulas, especially with optimized light sources.
- Careful dosage is crucial to mitigate potential neurotoxicity and adverse effects.
- Recommendations for appropriate fluorescein dosage in clinical practice are proposed.
