Innovations in the Treatment of Spinal Cerebrospinal Fluid Leaks

• Published in: World neurosurgery 2024-07, Vol.187, p.304-312
• Main Authors: Zappi, Kyle, Giantini-Larsen, Alexandra, Yan, Jenny, Konate, Mawa, Garton, Andrew L.A., Knopman, Jared, Stieg, Philip E., Salama, Gayle, Park, John K.
• Format: Article
• Language: English
• Subjects: Cerebrospinal fluid leak; Cerebrospinal Fluid Leak - surgery; Cerebrospinal Fluid Leak - therapy; Embolization of CSF-Venous fistula; Embolization, Therapeutic - methods; Endovascular Procedures - methods; Humans; Neurosurgical Procedures - methods; Surgical repair of skull base CSF leak; Transdural repair of ventral CSF leak
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2024.03.112

Spontaneous spinal cerebrospinal fluid (CSF) leaks are uncommon but can be neurologically debilitating. When initial treatments fail, definitive repair or closure of the leak is indicated. Depending upon the type of leak present, innovative strategies for their treatment have been developed. Among them are open surgical techniques using a transdural approach for the closure of ventral CSF leaks, minimally invasive tubular techniques for the reduction and repair of lateral meningeal diverticula, and endovascular embolization of CSF-venous fistulas. Illustrative cases demonstrating the indications for and implementation of these techniques are provided.