METHODS: A dual institutional case-control study examined multiple SBD\'s and encephaloceles on the risk of CSF leak and postoperative failures post-repair. IIH patients with CSF leaks and IIH controls without leaks were selected retrospectively. Chi square analysis evaluated for statistically significant alterations in probability with CSF leak development.
RESULTS: 192 patients were selected with 108 IIH controls and 84 spontaneous CSF leak cases. Signs and symptoms for IIH controls and CSF leak cases respectively were pulsatile tinnitus (60.2 % and 29.8 %), headaches (96.3 % and 63.1 %), papilledema (74.1 % and 12.5 %), visual field defects (60.8 % and 13 %) (p < 0.001). Encephalocele formation in controls was 3.7 % compared to cases at 91.6 % (p < 0.001). Multiple SBD\'s in controls compared cases was 0.9 % and 46.4 % respectively (p < 0.001). Subgroup analysis of CSF leak cases showed 15 patients with two CSF leak repairs due to a recurrence. 27 (39.1 %) single leak cases had multiple SDB\'s while 12 (80 %) recurrent leaks had multiple SDB\'s (p = 0.004).
CONCLUSIONS: Patients with radiographic evidence of multiple SBD\'s and encephaloceles represent a high-risk population with a propensity for CSF leaks. Secondary SBD\'s are common in patients with spontaneous CSF rhinorrhea and higher in patients with a recurrence.
方法:一项双重机构病例对照研究检查了多个SBD和脑囊肿对脑脊液漏和修复后术后失败的风险。回顾性选择有CSF泄漏的IIH患者和无泄漏的IIH对照。卡方分析评估了CSF泄漏发展概率的统计学显着变化。
结果:192例患者入选,其中有108例IIH对照和84例自发性CSF漏。IIH对照组和CSF漏病例的体征和症状分别为搏动性耳鸣(60.2%和29.8%),头痛(96.3%和63.1%),乳头水肿(74.1%和12.5%),视野缺陷(60.8%和13%)(p<0.001)。对照组的脑膨出形成为3.7%,而病例为91.6%(p<0.001)。对照组病例中的多个SBD分别为0.9%和46.4%(p<0.001)。对CSF泄漏病例的亚组分析显示,15例患者因复发而进行了两次CSF泄漏修复。27例(39.1%)单泄漏病例有多个SDB,12例(80%)复发性泄漏有多个SDB(p=0.004)。
结论:具有多个SBD和脑囊肿的影像学证据的患者是具有CSF渗漏倾向的高危人群。继发性SBD在自发性CSF鼻漏患者中常见,在复发患者中更高。