AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Patel, M. R.
Right arrow Articles by Rachlin, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Patel, M. R.
Right arrow Articles by Rachlin, J.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

CT-Guided Percutaneous Fibrin Glue Therapy of Cerebrospinal Fluid Leaks in the Spine After Surgery

Mahesh R. Patel1,2, Paul A. Caruso1, Naveed Yousuf1 and Jacob Rachlin3

1 Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215.
2 Present address: Santa Clara Valley Medical Center, 3031 Tisch Way, Ste. 02, Plaza South, San Jose, CA 25128.
3 Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215.



View larger version (101K):

[in a new window]
  		Fig. 1. —Preparation of two-component fibrin glue assembly shows attachment via two 3-mL syringes to three-way stopcock that is then attached to an 18- to 20-gauge spinal needle. No connecting tubing is used to reduce dead volume.

 


View larger version (145K):

[in a new window]
  		Fig. 2. —In vitro aggregation of fibrin glue within superior portion of tube 5 min after admixture. Note gravity-dependent air—fluid level in container adjacent to tube of fibrin glue (arrows).

 


View larger version (131K):

[in a new window]
  		Fig. 3A. —39-year-old man with lumbar cerebrospinal fluid (CSF) leak detected 4 months after L5—S1 disk excision who later underwent successful fibrin glue patch therapy. Axial CT scan shows large posterior CSF collection.

 


View larger version (125K):

[in a new window]
  		Fig. 3B. —39-year-old man with lumbar cerebrospinal fluid (CSF) leak detected 4 months after L5—S1 disk excision who later underwent successful fibrin glue patch therapy. Axial CT scan after fibrin glue therapy shows placement of plug over suspected site of CSF leak. Note different attenuation of fibrin glue components due to different dilutions of contrast material: fibrin plug (arrows) appears mildly hyperdense to CSF.

 


View larger version (152K):

[in a new window]
  		Fig. 3C. —39-year-old man with lumbar cerebrospinal fluid (CSF) leak detected 4 months after L5—S1 disk excision who later underwent successful fibrin glue patch therapy. Sagittal reconstruction shows fibrin glue covering laminectomy defect. Note extension of fibrin glue (arrows) subdurally. Subdural extension of fibrin glue is common after this procedure.

 


View larger version (99K):

[in a new window]
  		Fig. 4. —63-year-old woman with lumbar cerebrospinal fluid (CSF) leak who later underwent fibrin glue patch therapy with intrathecal extension of fibrin glue, resulting in aseptic meningitis. Axial CT image shows fibrin glue within thecal sac (arrows). Bony fusion material is seen posterior to spine. Dense radiopaque object within left paraspinal soft tissues represents an electrical stimulator device. Because of large size of defect, surgical repair was subsequently performed.

 


View larger version (108K):

[in a new window]
  		Fig. 5A. —29-year-old man with suboccipital cerebrospinal fluid leak after hemangioblastoma resection who later underwent successful fibrin glue patch therapy. Axial CT image shows collection posterior to C2 level.

 


View larger version (115K):

[in a new window]
  		Fig. 5B. —29-year-old man with suboccipital cerebrospinal fluid leak after hemangioblastoma resection who later underwent successful fibrin glue patch therapy. Axial CT image shows spinal needle placed into collection with introduction of fibrin glue.

 


View larger version (71K):

[in a new window]
  		Fig. 5C. —29-year-old man with suboccipital cerebrospinal fluid leak after hemangioblastoma resection who later underwent successful fibrin glue patch therapy. Sagittal reconstruction shows fibrin plug covers site of craniotomy defect.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the American Roentgen Ray Society.