Liquorverlustsyndrom mit intrakraniellen Komplikationen. Wann muss man daran denken?

Christian T. Ulrich; C. Marvin Jesse; Levin Häni; Jens Fichtner; Eike Piechowiak; Tomas Dobrocky; Andreas Raabe; Jürgen Beck

doi:10.1055/a-0902-6443

Die Wirbelsäule, Table of Contents

Die Wirbelsäule 2019; 03(04): 266-274
DOI: 10.1055/a-0902-6443

Übersicht

Liquorverlustsyndrom mit intrakraniellen Komplikationen. Wann muss man daran denken?

Cerebrospinal Fluid Loss with Intracranial Complications. When to think about it?

Christian T. Ulrich

¹Klinik für Neurochirurgie, Inselspital, Universitätsklinik Bern, Schweiz

,

C. Marvin Jesse

¹Klinik für Neurochirurgie, Inselspital, Universitätsklinik Bern, Schweiz

,

Levin Häni

¹Klinik für Neurochirurgie, Inselspital, Universitätsklinik Bern, Schweiz

,

Jens Fichtner

¹Klinik für Neurochirurgie, Inselspital, Universitätsklinik Bern, Schweiz

,

Eike Piechowiak

²Institut für Neuroradiologie, Inselspital, Universitätsklinik Bern, Schweiz

,

Tomas Dobrocky

²Institut für Neuroradiologie, Inselspital, Universitätsklinik Bern, Schweiz

,

Andreas Raabe

¹Klinik für Neurochirurgie, Inselspital, Universitätsklinik Bern, Schweiz

,

Jürgen Beck

¹Klinik für Neurochirurgie, Inselspital, Universitätsklinik Bern, Schweiz

³Klinik für Neurochirurgie, Universitätsklinikum Freiburg, Deutschland

› Author Affiliations

Abstract

Zusammenfassung

Das Liquorverlustsyndrom kann nach spinalen Interventionen, wie zum Beispiel Operationen und Punktionen, oder spontan (ohne erkennbare Ursache) auftreten. Durch ein vermindertes Liquorvolumen können intrakranielle Komplikationen entstehen, deren Spektrum von lageabhängigen (orthostatischen) Kopfschmerzen bis hin zu intrakraniellen Blutungen mit lebensbedrohlichen Zuständen reicht. Deshalb ist es wichtig, das Liquorverlussyndrom klinisch richtig einzuordnen, eine gezielte Diagnostik durchzuführen und die adäquate Therapie einzuleiten. Anhand der verschiedenen Ätiologien der Liquorverlustsyndrome und der Schwere der Befunde wird das diagnostische und therapeutische Management dargelegt.

Abstract

Cerebrospinal fluid (CSF) loss can occur after spinal interventions, such as operations or punctures, or spontaneously (without a known cause). The reduced CSF volume can trigger intracranial complications, ranging from position-dependent (orthostatic) headaches to intracranial bleeding with life-threatening conditions. Therefore, it is important to verify the CSF loss syndrome clinically correctly, carry out a proper diagnosis and initiate the appropriate therapy. Depending on the different etiology of the CSF loss syndromes and the severity of the clinical findings, the diagnostic and therapeutic management is described.

Schlüsselwörter

Liquorverlustsyndrom - intrakranielle Komplikationen - spontane Intrakranielle Hypotension - postoperative Liquorfistel - postpunktionelle Kopfschmerzen

Key words

CSF hypovolemia - intracranial complications - spontaneous intracranial hypotension - post surgery CSF leak - post puncture headache

Full Text

References

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