![]() “We have developed non-targeted treatments for patients where no leak can be detected, but as our study shows, these treatments are much less effective than targeted, surgical correction of the leak,” he adds. “Great efforts need to be made to improve the detection rate of CSF leak in these patients,” says Dr. However, the treatment relieved the symptoms of only three of these patients. They treated the remaining 12 patients, whose leaks could not be located, with therapies designed to relieve brain sagging, such as infusions of CSF into the spine. Surgery to close up the fistula reversed the brain sagging in all nine subjects and reversed their dementia symptoms. They discovered a CSF-venous fistula in nine (42.8%) patients. This method involves injecting a fluorescent material into the CSF and tracking its movement.įor the new study, the researchers used DSM to image the spinal cords of 21 patients with bvFTD due to brain sagging. To detect these leaks, known as CSF-venous fistulas, requires a more specialized CT scan called a digital subtraction myelogram or DSM. Schievink, but doctors often mistake it for a condition known as a Chiari brain malformation, in which brain tissue protrudes into the spinal canal.Įven if a neurologist correctly identifies brain sagging, finding the source of the CSF leak can be challenging.Īn imaging technique called a CT myelogram can pinpoint a tear or cyst in the membrane that encloses the CSF.īut Schievink and his colleagues recently discovered that CSF could also leak from the spine into a vein through a hole or “fistula,” which is almost invisible on an ordinary CT myelogram. Some telltale signs of CSF leakage include severe headaches that improve when the patient lies down and significant daytime sleepiness even after a good night’s sleep.Īn MRI (magnetic resonance imaging) brain scan can reveal brain sagging, says Dr. ![]() If the fluid leaks, the pressure falls inside the skull, and the brain sags, disrupting its operation. Normally, cerebrospinal fluid (CSF) provides buoyancy to the brain and acts as a shock absorber. “But our study shows that patients with cerebrospinal fluid leaks can be cured if we can find the source of the leak,” he added. ![]() “If they have behavioral-variant frontotemporal dementia with an unknown cause, then no treatment is available,” said Dr. Wouter Schievink, director of the Cerebrospinal Fluid Leak and Microvascular Neurosurgery Program and professor of neurosurgery at Cedars-Sinai. ![]() “Many of these patients experience cognitive, behavioral, and personality changes so severe that they are arrested or placed in nursing homes,” said Dr. The good news from the study is that a specialist imaging technique can often identify the source of the leaks, which surgeons can then fix, effecting a complete cure of patients’ symptoms. The memory problems that usually characterize dementia only occur later in the course of bvFTD.Ī new study by researchers at Cedars Sinai Medical Center in Los Angeles, CA, adds to evidence that cerebrospinal fluid leakage can cause the symptoms of bvFTD. Damage to neurons in the frontal and temporal lobes of the brain can result in early-onset dementia, known as frontotemporal dementia or FTD.įTD is relatively rare in older people compared with other types of dementia but is the most common cause of the condition in people aged up to 60.Ī subset of patients have behavioral FTD or bvFTD, which involves progressive changes in behavior, personality, and thinking skills.įor example, people with bvFTD often fail to empathize with others and can lose their former inhibitions, which can result in inappropriate behavior. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |