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Closed continuous drainage of cerebrospinal fluid via a lumbar subarachnoid catheter for treatment or prevention of cranial/spinal cerebrospinal fluid fistula. 1992

S A Shapiro, and T Scully
Department of Surgery, Indiana University Medical Center, Indianapolis.

One hundred and seven patients who had a lumbar subarachnoid catheter (teflon or silicone) placed for closed continuous cerebrospinal fluid (CSF) drainage between 1983-1991 are presented. Overall, the drain was successful in achieving the desired goal in 101 of 107 (94%) cases. There were no deaths. Five of 107 (5%) patients developed infections including two cases (2%) of meningitis. There were three cases (3%) of overdrainage with temporary neurologic decline, but all recovered. Five of fifteen (33%) teflon catheters required replacement because of occlusion, but only 5 of 92 (5%) silicone catheters required replacement. Transient lumbar nerve root irritation was seen in 15 of 107 (14%) patients treated for a CSF fistula, and all symptoms resolved after drain removal. CSF fistula/pseudomeningocele after spine surgery was cured by CSF drainage in 36 of 39 (92%) cases; there was a 10% incidence of infection (1 wound, 2 discitis, 1 meningitis). CSF fistula after cranial surgery was cured in 22 of 25 (87%) cases; there was 1 case of (4%) infection and 1 case (4%) of overdrainage. A drain was used to augment a tenuous dural closure in 38 patients with 100% success; no infection occurred and there were 2 cases (5%) of overdrainage. Five patients were successfully treated for traumatic CSF rhinorrhea/otorrhea without complications. The silicone catheter appears superior to the teflon catheter; however, both are simple, safe, and efficacious for the treatment or prevention of CSF fistulas.

UI MeSH Term Description Entries
D008581 Meningitis Inflammation of the coverings of the brain and/or spinal cord, which consist of the PIA MATER; ARACHNOID; and DURA MATER. Infections (viral, bacterial, and fungal) are the most common causes of this condition, but subarachnoid hemorrhage (HEMORRHAGES, SUBARACHNOID), chemical irritation (chemical MENINGITIS), granulomatous conditions, neoplastic conditions (CARCINOMATOUS MENINGITIS), and other inflammatory conditions may produce this syndrome. (From Joynt, Clinical Neurology, 1994, Ch24, p6) Pachymeningitis,Meningitides,Pachymeningitides
D011138 Polytetrafluoroethylene Homopolymer of tetrafluoroethylene. Nonflammable, tough, inert plastic tubing or sheeting; used to line vessels, insulate, protect or lubricate apparatus; also as filter, coating for surgical implants or as prosthetic material. Synonyms: Fluoroflex; Fluoroplast; Ftoroplast; Halon; Polyfene; PTFE; Tetron. FEP,Fluon,Politef,Polytef,TFE,Teflon,Expanded PTFE,Fluoroplast,GORE-TEX,Goretex,PTFE,Tarflen,GORE TEX,PTFE, Expanded
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011843 Radiculopathy Disease involving a spinal nerve root (see SPINAL NERVE ROOTS) which may result from compression related to INTERVERTEBRAL DISK DISPLACEMENT; SPINAL CORD INJURIES; SPINAL DISEASES; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root. Nerve Root Avulsion,Nerve Root Compression,Nerve Root Disorder,Radiculitis,Nerve Root Inflammation,Radiculopathy, Cervical,Avulsion, Nerve Root,Avulsions, Nerve Root,Cervical Radiculopathies,Cervical Radiculopathy,Compression, Nerve Root,Compressions, Nerve Root,Inflammation, Nerve Root,Nerve Root Avulsions,Nerve Root Compressions,Nerve Root Disorders,Nerve Root Inflammations,Radiculitides,Radiculopathies,Radiculopathies, Cervical
D002404 Catheterization Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions. Cannulation,Cannulations,Catheterizations
D002558 Cerebrospinal Fluid Otorrhea Discharge of cerebrospinal fluid through the external auditory meatus or through the eustachian tube into the nasopharynx. This is usually associated with CRANIOCEREBRAL TRAUMA (e.g., SKULL FRACTURE involving the TEMPORAL BONE;), NEUROSURGICAL PROCEDURES; or other conditions, but may rarely occur spontaneously. (From Am J Otol 1995 Nov;16(6):765-71) Cerebrospinal Otorrhea,Cerebrospinal Fluid Otorrhea, Post-Traumatic,Cerebrospinal Fluid Otorrhea, Spontaneous,Cerebrospinal Fluid Otorrhea, Traumatic,Otorrhea, Cerebrospinal Fluid, Post-Traumatic,Otorrhea, Cerebrospinal Fluid, Spontaneous,Otorrhea, Cerebrospinal Fluid, Traumatic,Otorrhea, Post-Traumatic, Cerebrospinal Fluid,Otorrhea, Spontaneous, Cerebrospinal Fluid,Otorrhea, Traumatic Cerebrospinal Fluid,Post-Traumatic Cerebrospinal Fluid Otorrhea,Post-Traumatic Otorrhea, Cerebrospinal Fluid,Spontaneous Cerebrospinal Fluid Otorrhea,Spontaneous Otorrhea, Cerebrospinal Fluid,Traumatic Cerebrospinal Fluid Otorrhea,Traumatic Otorrhea, Cerebrospinal Fluid,Cerebrospinal Fluid Otorrhea, Post Traumatic,Cerebrospinal Fluid Otorrheas,Otorrhea, Cerebrospinal,Otorrhea, Cerebrospinal Fluid,Post Traumatic Cerebrospinal Fluid Otorrhea,Post Traumatic Otorrhea, Cerebrospinal Fluid
D002559 Cerebrospinal Fluid Rhinorrhea Discharge of cerebrospinal fluid through the nose. Common etiologies include trauma, neoplasms, and prior surgery, although the condition may occur spontaneously. (Otolaryngol Head Neck Surg 1997 Apr;116(4):442-9) Cerebrospinal Rhinorrhea,CSF Rhinorrhea,Cerebrospinal Fluid Rhinorrhea, Post-Traumatic,Cerebrospinal Fluid Rhinorrhea, Spontaneous,Cerebrospinal Fluid Rhinorrhea, Traumatic,Post-Traumatic Cerebrospinal Fluid Rhinorrhea,Post-Traumatic Rhinorrhea, Cerebrospinal Fluid,Rhinorrhea, Cerebrospinal Fluid, Post-Traumatic,Rhinorrhea, Cerebrospinal Fluid, Spontaneous,Rhinorrhea, Cerebrospinal Fluid, Traumatic,Rhinorrhea, Post-Traumatic, Cerebrospinal Fluid,Rhinorrhea, Spontaneous Cerebrospinal Fluid,Rhinorrhea, Traumatic Cerebrospinal Fluid,Spontaneous Cerebrospinal Fluid Rhinorrhea,Spontaneous Rhinorrhea, Cerebrospinal Fluid,Traumatic Cerebrospinal Fluid Rhinorrhea,Traumatic Rhinorrhea, Cerebrospinal Fluid,CSF Rhinorrheas,Cerebrospinal Fluid Rhinorrhea, Post Traumatic,Cerebrospinal Fluid Rhinorrheas,Cerebrospinal Rhinorrheas,Post Traumatic Cerebrospinal Fluid Rhinorrhea,Post Traumatic Rhinorrhea, Cerebrospinal Fluid,Rhinorrhea, CSF,Rhinorrhea, Cerebrospinal,Rhinorrhea, Cerebrospinal Fluid,Rhinorrheas, CSF,Rhinorrheas, Cerebrospinal,Rhinorrheas, Cerebrospinal Fluid
D004322 Drainage The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D005004 Ethmoid Bone A light and spongy (pneumatized) bone that lies between the orbital part of FRONTAL BONE and the anterior of SPHENOID BONE. Ethmoid bone separates the ORBIT from the ETHMOID SINUS. It consists of a horizontal plate, a perpendicular plate, and two lateral labyrinths. Cribriform Plate,Horizontal Plate of Ethmoid Bone,Bone, Ethmoid,Bones, Ethmoid,Cribriform Plates,Ethmoid Bones,Plate, Cribriform,Plates, Cribriform
D005402 Fistula Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. Fistulas

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