Abstract
Penetrating Spinal Cord Injuries are often complicated by Cerebrospinal Fluid (CSF) leaks, which can be diagnosed either at initial presentation, or present themselves in a delayed fashion. Symptoms are usually non-specific and include positional headaches, nausea, vomiting, vertigo, and may even include hypotension, cranial nerve palsies, and in severe cases, meningitis. Imaging to detect CSF leaks include: plain radiographs, CT and MRI, CT-myelogram, radionuclide cisternograms, MRI with intrathecal gadolinium. Initial treatment of CSF leaks is conservative, including bedrest, hydration/overhydration, and medications such as caffeine and theophylline. Although overall treatment protocols are controversial, there seems to be a consensus that if a CSF leak persists for over 96 hours, it should be surgically treated, as it would inevitably increase the risks of pseudomeningocele formation and meningitis. Surgical options include a blood/fibrin patch, the placement of a lumbar drain, and ultimately surgical exploration and primary closure of the dural defect.
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John Styliaras completed his undergraduate studies at Loyola University Chicago, with a BS in Biology and BA in Political Science. He continued his studies at Georgetown University School of Medicine in Washington DC, where he earned his Medical Degree and a Masters of Science in Biophysics and Physiology. John Styliaras was awarded the Jesuit Award for Leadership and Service by the Dean of Georgetown’s School of Medicine.
His main area of interest is spinal surgery and functional neurosurgery, and is an active member of the American Association of Neurological Surgeons (AANS) and Congress of Neurosurgeons (CNS). John Styliaras is currently training in neurosurgery, as a resident in the department of Neurological Surgery of Thomas Jefferson University Hospital in Philadelphia.
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Styliaras, J.C., Dalyai, R., Amgad, H. et al. Cerebrospinal fluid leaks from penetrating injuries: diagnosis and treatment. ArgoSpine News J 24, 183–187 (2012). https://doi.org/10.1007/s12240-012-0062-x
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DOI: https://doi.org/10.1007/s12240-012-0062-x