Post by Master Kim on Feb 23, 2015 19:46:08 GMT -5
Spontaneous cerebrospinal fluid leak syndrome (SCSFLS) - en.wikipedia.org/wiki/Spontaneous_cerebrospinal_fluid_leak
Spontaneous cerebrospinal fluid leak syndrome (SCSFLS) is a medical condition in which the cerebrospinal fluid (CSF) held in and around a human brain and spinal cord leaks out of the surrounding protective sac, the dura, for no apparent reason. The dura, a tough, inflexible tissue, is the outermost of the three layers of the meninges, the system of meninges surrounding the brain and spinal cord. (The other two meningeal layers are the pia mater and the arachnoid mater).
A spontaneous cerebrospinal fluid leak is one of several types of cerebrospinal fluid leaks and occurs due to the presence of one or more holes in the dura. A spontaneous CSF leak, as opposed to traumatically caused CSF leaks, arises idiopathically. A loss of CSF greater than its rate of production leads to a decreased volume inside the skull known as intracranial hypotension. A CSF leak is most often characterized by a severe and disabling headache and a spectrum of various symptoms that occur as a result of intracerebral hemorrhage (ICH). These symptoms can include: dizziness, nausea, fatigue, a metallic taste in the mouth (indicative of a cranial leak), myoclonus, tinnitus, tingling in the limbs, and facial weakness among others. A CT scan can identify the site of a cerebrospinal fluid leakage. Once identified, the leak can often be repaired by an epidural blood patch, an injection of the patient's own blood at the site of the leak, fibrin glue injection or surgery.
SCSFLS afflicts 5 out of every 100,000 people. On average, the condition is developed at the age of 42, and women are twice as likely as men to develop the condition. Some people with SCSFLS chronically leak cerebrospinal fluid despite repeated attempts at patching, leading to long-term disability due to pain and nerve damage. SCSFLS was first described by German neurologist Georg Schaltenbrand in 1938 and by American physician Henry Woltman of the Mayo Clinic in the 1950s.
Actor George Clooney suffered from a CSF leak in 2005. Due to the intense pain Clooney considered suicide.
Arnold-Chiari malformation is a complication of spontaneous CSF leak, where brain tissue moves down through the opening at the base of the skull due to low volume and pressure of CSF.
Signs and symptoms
Most people who develop SCSFLS feel a sudden onset of a severe and acute headache. It is a headache usually but not necessarily orthostatic in nature, typically becoming prominent throughout the day, in which usually the pain is worse when the person is vertical and less severe when horizontal. Other symptoms include dizziness and vertigo, facial numbness or weakness, unusually blurry or double vision, neuralgia, fatigue, a metallic taste in the mouth, nausea, or vomiting. Leaking CSF can sometimes be felt or observed as discharge through the nose or ear. Orthostatic headaches can be incapacitating; these ailments often become chronic and can be sufficiently disabling to make those afflicted unable to work. Some patients with CSF leak will develop headaches that begin in the afternoon. This is known as second-half-of-the-day headache. This may be an initial presentation of CSF leak or appear after treatment and likely indicates a slow CSF leak.
Lack of CSF pressure and volume allows the brain to descend through the foramen magnum, or occipital bone, the large opening at the base of the skull. The lower portion of the brain is believed to stretch or impact one or more cranial nerve complexes, thereby causing a variety of sensory symptoms. Nerves that can be affected and their related symptoms are detailed in the table at right.
Spontaneous cerebrospinal fluid leak syndrome (SCSFLS) is a medical condition in which the cerebrospinal fluid (CSF) held in and around a human brain and spinal cord leaks out of the surrounding protective sac, the dura, for no apparent reason. The dura, a tough, inflexible tissue, is the outermost of the three layers of the meninges, the system of meninges surrounding the brain and spinal cord. (The other two meningeal layers are the pia mater and the arachnoid mater).
A spontaneous cerebrospinal fluid leak is one of several types of cerebrospinal fluid leaks and occurs due to the presence of one or more holes in the dura. A spontaneous CSF leak, as opposed to traumatically caused CSF leaks, arises idiopathically. A loss of CSF greater than its rate of production leads to a decreased volume inside the skull known as intracranial hypotension. A CSF leak is most often characterized by a severe and disabling headache and a spectrum of various symptoms that occur as a result of intracerebral hemorrhage (ICH). These symptoms can include: dizziness, nausea, fatigue, a metallic taste in the mouth (indicative of a cranial leak), myoclonus, tinnitus, tingling in the limbs, and facial weakness among others. A CT scan can identify the site of a cerebrospinal fluid leakage. Once identified, the leak can often be repaired by an epidural blood patch, an injection of the patient's own blood at the site of the leak, fibrin glue injection or surgery.
SCSFLS afflicts 5 out of every 100,000 people. On average, the condition is developed at the age of 42, and women are twice as likely as men to develop the condition. Some people with SCSFLS chronically leak cerebrospinal fluid despite repeated attempts at patching, leading to long-term disability due to pain and nerve damage. SCSFLS was first described by German neurologist Georg Schaltenbrand in 1938 and by American physician Henry Woltman of the Mayo Clinic in the 1950s.
Actor George Clooney suffered from a CSF leak in 2005. Due to the intense pain Clooney considered suicide.
Arnold-Chiari malformation is a complication of spontaneous CSF leak, where brain tissue moves down through the opening at the base of the skull due to low volume and pressure of CSF.
Signs and symptoms
Most people who develop SCSFLS feel a sudden onset of a severe and acute headache. It is a headache usually but not necessarily orthostatic in nature, typically becoming prominent throughout the day, in which usually the pain is worse when the person is vertical and less severe when horizontal. Other symptoms include dizziness and vertigo, facial numbness or weakness, unusually blurry or double vision, neuralgia, fatigue, a metallic taste in the mouth, nausea, or vomiting. Leaking CSF can sometimes be felt or observed as discharge through the nose or ear. Orthostatic headaches can be incapacitating; these ailments often become chronic and can be sufficiently disabling to make those afflicted unable to work. Some patients with CSF leak will develop headaches that begin in the afternoon. This is known as second-half-of-the-day headache. This may be an initial presentation of CSF leak or appear after treatment and likely indicates a slow CSF leak.
Lack of CSF pressure and volume allows the brain to descend through the foramen magnum, or occipital bone, the large opening at the base of the skull. The lower portion of the brain is believed to stretch or impact one or more cranial nerve complexes, thereby causing a variety of sensory symptoms. Nerves that can be affected and their related symptoms are detailed in the table at right.