Cargando…

Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review

Spontaneous skull base cerebrospinal fluid (CSF) leaks due to idiopathic intracranial hypertension (IIH) are a rare entity. Patients often present with CSF rhinorrhea, recurrent meningitis, chronic headache, and visual defects, while few patients have been reported to present with neuroendocrine alt...

Descripción completa

Detalles Bibliográficos
Autores principales: Peng, Deqing, Yang, Kaichuang, Wu, Cheng, Gao, Faliang, Sun, Weijun, Lu, Gang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8866819/
https://www.ncbi.nlm.nih.gov/pubmed/35222246
http://dx.doi.org/10.3389/fneur.2022.809224
_version_ 1784655914949672960
author Peng, Deqing
Yang, Kaichuang
Wu, Cheng
Gao, Faliang
Sun, Weijun
Lu, Gang
author_facet Peng, Deqing
Yang, Kaichuang
Wu, Cheng
Gao, Faliang
Sun, Weijun
Lu, Gang
author_sort Peng, Deqing
collection PubMed
description Spontaneous skull base cerebrospinal fluid (CSF) leaks due to idiopathic intracranial hypertension (IIH) are a rare entity. Patients often present with CSF rhinorrhea, recurrent meningitis, chronic headache, and visual defects, while few patients have been reported to present with neuroendocrine alterations. Endonasal endoscopic repair is the first-line treatment for these leaks at present. However, the relatively high risk of recurrence remains the main cause of reoperation because of elevated intracranial pressure (ICP) after endoscopic surgery and absence of postoperative ICP management. A shunting procedure may stop CSF leakage or relieve symptoms in complex cases, and this is presently well-known as the last-line therapy for CSF liquorrhea. We describe a 29-year-old woman with spontaneous CSF rhinorrhea and neuroendocrine alterations due to IIH, and with no previous history of trauma, tumor, or nasal surgery. The bone defect in the skull base became implicated when the site of the leak was detected by cranial magnetic resonance imaging and computed tomography (CT). The patient was successfully managed via ventriculoperitoneal shunt (VPS) alone without endoscopic repair, and neuroendocrine alterations resolved after the shunting procedure.
format Online
Article
Text
id pubmed-8866819
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-88668192022-02-25 Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review Peng, Deqing Yang, Kaichuang Wu, Cheng Gao, Faliang Sun, Weijun Lu, Gang Front Neurol Neurology Spontaneous skull base cerebrospinal fluid (CSF) leaks due to idiopathic intracranial hypertension (IIH) are a rare entity. Patients often present with CSF rhinorrhea, recurrent meningitis, chronic headache, and visual defects, while few patients have been reported to present with neuroendocrine alterations. Endonasal endoscopic repair is the first-line treatment for these leaks at present. However, the relatively high risk of recurrence remains the main cause of reoperation because of elevated intracranial pressure (ICP) after endoscopic surgery and absence of postoperative ICP management. A shunting procedure may stop CSF leakage or relieve symptoms in complex cases, and this is presently well-known as the last-line therapy for CSF liquorrhea. We describe a 29-year-old woman with spontaneous CSF rhinorrhea and neuroendocrine alterations due to IIH, and with no previous history of trauma, tumor, or nasal surgery. The bone defect in the skull base became implicated when the site of the leak was detected by cranial magnetic resonance imaging and computed tomography (CT). The patient was successfully managed via ventriculoperitoneal shunt (VPS) alone without endoscopic repair, and neuroendocrine alterations resolved after the shunting procedure. Frontiers Media S.A. 2022-02-10 /pmc/articles/PMC8866819/ /pubmed/35222246 http://dx.doi.org/10.3389/fneur.2022.809224 Text en Copyright © 2022 Peng, Yang, Wu, Gao, Sun and Lu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Peng, Deqing
Yang, Kaichuang
Wu, Cheng
Gao, Faliang
Sun, Weijun
Lu, Gang
Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review
title Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review
title_full Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review
title_fullStr Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review
title_full_unstemmed Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review
title_short Ventriculoperitoneal Shunt Alone for Cerebrospinal Fluid Rhinorrhea With Neuroendocrine Alterations in Idiopathic Intracranial Hypertension: A Case Report and Literature Review
title_sort ventriculoperitoneal shunt alone for cerebrospinal fluid rhinorrhea with neuroendocrine alterations in idiopathic intracranial hypertension: a case report and literature review
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8866819/
https://www.ncbi.nlm.nih.gov/pubmed/35222246
http://dx.doi.org/10.3389/fneur.2022.809224
work_keys_str_mv AT pengdeqing ventriculoperitonealshuntaloneforcerebrospinalfluidrhinorrheawithneuroendocrinealterationsinidiopathicintracranialhypertensionacasereportandliteraturereview
AT yangkaichuang ventriculoperitonealshuntaloneforcerebrospinalfluidrhinorrheawithneuroendocrinealterationsinidiopathicintracranialhypertensionacasereportandliteraturereview
AT wucheng ventriculoperitonealshuntaloneforcerebrospinalfluidrhinorrheawithneuroendocrinealterationsinidiopathicintracranialhypertensionacasereportandliteraturereview
AT gaofaliang ventriculoperitonealshuntaloneforcerebrospinalfluidrhinorrheawithneuroendocrinealterationsinidiopathicintracranialhypertensionacasereportandliteraturereview
AT sunweijun ventriculoperitonealshuntaloneforcerebrospinalfluidrhinorrheawithneuroendocrinealterationsinidiopathicintracranialhypertensionacasereportandliteraturereview
AT lugang ventriculoperitonealshuntaloneforcerebrospinalfluidrhinorrheawithneuroendocrinealterationsinidiopathicintracranialhypertensionacasereportandliteraturereview