首页|Surgical Treatment Efficacy of CSF-Venous Fistulas: Systematic Review
Surgical Treatment Efficacy of CSF-Venous Fistulas: Systematic Review
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NSTL
Elsevier
? 2022 Elsevier Inc.Background: Cerebrospinal fluid (CSF)-venous fistula presents a pathologic connection between spinal subarachnoid space and adjacent epidural vein or veins. It is one of the 3 main causes of spontaneous intracranial hypotension along with dural defects and meningeal diverticulum. We performed a systematic review of the literature and analyzed individual participants’ data focusing on clinical outcomes after different treatment modalities of CSF-venous fistula. Methods: Systematic review was conducted according to PRISMA recommendations. Literature search was performed in PubMed and Web of Science databases with following key phrases: “CSF-venous fistula”, “Spontaneous intracranial hypotension”. Overall, 97 articles were found during the initial search; 15 were included for the final analysis, with a total number of 137 patients. Results: Epidural blood patch (EBP) was performed as a first-line treatment in 37.1% of patients in individual data group, often not combined with fibrin glue (61.5%). Either partial (69.2%) or no resolution (30.8%) of symptoms was achieved after EBP injection. Nerve root ligation was the most common method of exclusion of CSF-venous fistula. Complete resolution of symptoms was achieved in 69.0% of patients, in 21.4% it was partial and in 9.5% no regress was found. Endovascular treatment was described only in 1 study. Conclusions: Surgical ligation of fistula is a treatment of choice. In approximately 70% of patients complete long-term resolution of symptoms is achieved after surgery. Endovascular treatment and fibrin glue injections are prospective and evolving options, which require further investigation.
CSF-fistulaeCSF?venous fistulaeHypotensionSIH
Konovalov A.、Gadzhiagaev V.、Vinogradov E.、Nikitin N.、Eliava S.、Konovalov N.
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N. N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the
NSTL
Elsevier
