Biomaterial Database

Spontaneous Spinal Cerebrospinal Fluid Leak: Review and Management Algorithm. 2021

Michael R Jones, and Nathan A Shlobin, and Nader S Dahdaleh

Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Spontaneous spinal cerebrospinal fluid (CSF) leak is a condition that commonly presents with debilitating positional headaches. Often, the cause of the leak is located in the spine. Although often cured with conservative management, including epidural blood patching, a subset of patients are refractory to this initial management. Determining the focal location of the spinal leak can, in some patients, require several imaging modalities. Treatment similarly involves multiple options, including targeted epidural blood and/or fibrin patching as well as surgical closure. In this article, we review the current literature regarding this challenging condition and present an algorithm for management.

UI	MeSH Term	Description	Entries
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000066491	Clinical Decision-Making	Process of formulating a diagnosis based on medical history and physical or mental examinations, and/or choosing an appropriate intervention.	Medical Decision-Making,Clinical Decision Making,Decision-Making, Clinical,Decision-Making, Medical,Medical Decision Making
D013116	Spinal Cord	A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.	Coccygeal Cord,Conus Medullaris,Conus Terminalis,Lumbar Cord,Medulla Spinalis,Myelon,Sacral Cord,Thoracic Cord,Coccygeal Cords,Conus Medullari,Conus Terminali,Cord, Coccygeal,Cord, Lumbar,Cord, Sacral,Cord, Spinal,Cord, Thoracic,Cords, Coccygeal,Cords, Lumbar,Cords, Sacral,Cords, Spinal,Cords, Thoracic,Lumbar Cords,Medulla Spinali,Medullari, Conus,Medullaris, Conus,Myelons,Sacral Cords,Spinal Cords,Spinali, Medulla,Spinalis, Medulla,Terminali, Conus,Terminalis, Conus,Thoracic Cords
D015718	Fibrin Tissue Adhesive	An autologous or commercial tissue adhesive containing FIBRINOGEN and THROMBIN. The commercial product is a two component system from human plasma that contains more than fibrinogen and thrombin. The first component contains highly concentrated fibrinogen, FACTOR VIII, fibronectin, and traces of other plasma proteins. The second component contains thrombin, calcium chloride, and antifibrinolytic agents such as APROTININ. Mixing of the two components promotes BLOOD CLOTTING and the formation and cross-linking of fibrin. The tissue adhesive is used for tissue sealing, HEMOSTASIS, and WOUND HEALING.	Autologous Fibrin Tissue Adhesive,Fibrin Adhesive,Fibrin Glue,Fibrin Sealant System,Fibrinogen Adhesive,Beriplast,Crosseal,Fibrin Klebe System Immuno,Fibrin Seal,Fibrin Sealant,Fibrin Sealant, Human,Tisseel,Tissel,Tissucol,Transglutine,Adhesive, Fibrin,Adhesive, Fibrin Tissue,Adhesive, Fibrinogen,Glue, Fibrin,Human Fibrin Sealant,Seal, Fibrin,Sealant System, Fibrin,Sealant, Fibrin,Sealant, Human Fibrin,Tissue Adhesive, Fibrin
D017217	Blood Patch, Epidural	The injection of autologous blood into the epidural space either as a prophylactic treatment immediately following an epidural puncture or for treatment of headache as a result of an epidural puncture.	Epidural Blood Patch,Blood Patchs, Epidural,Epidural Blood Patchs,Patch, Epidural Blood,Patchs, Epidural Blood
D019468	Disease Management	A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596)	Disease Managements,Management, Disease,Managements, Disease
D065634	Cerebrospinal Fluid Leak	Discharge of cerebrospinal fluid through a hole through the skull bone most commonly draining from the nose (CEREBROSPINAL FLUID RHINORRHEA) or the ear (CEREBROSPINAL FLUID OTORRHEA).	Cerebrospinal Fluid Drainage,Cerebrospinal Fluid Drainage, Post-Traumatic,Cerebrospinal Fluid Drainage, Spontaneous,Cerebrospinal Fluid Drainage, Traumatic,Cerebrospinal Fluid Leak, Post-Traumatic,Cerebrospinal Fluid Leak, Spontaneous,Cerebrospinal Fluid Leak, Traumatic,Cerebrospinal Fluid Leakage,Cerebrospinal Fluid Leakage, Post-Traumatic,Cerebrospinal Fluid Leakage, Spontaneous,Cerebrospinal Fluid Leakage, Traumatic,Spinal Cerebrospinal Fluid Leak,Spinal Cerebrospinal Fluid Leak, Post-Traumatic,Spinal Cerebrospinal Fluid Leak, Spontaneous,Spinal Cerebrospinal Fluid Leak, Traumatic,Cerebrospinal Fluid Drainage, Post Traumatic,Cerebrospinal Fluid Drainages,Cerebrospinal Fluid Leak, Post Traumatic,Cerebrospinal Fluid Leakage, Post Traumatic,Cerebrospinal Fluid Leakages,Cerebrospinal Fluid Leaks,Drainage, Cerebrospinal Fluid,Drainages, Cerebrospinal Fluid,Fluid Drainage, Cerebrospinal,Fluid Drainages, Cerebrospinal,Fluid Leak, Cerebrospinal,Fluid Leakage, Cerebrospinal,Fluid Leakages, Cerebrospinal,Fluid Leaks, Cerebrospinal,Leak, Cerebrospinal Fluid,Leakage, Cerebrospinal Fluid,Leakages, Cerebrospinal Fluid,Leaks, Cerebrospinal Fluid,Spinal Cerebrospinal Fluid Leak, Post Traumatic