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BMC Pregnancy and Childbirth

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Open Access 01-12-2023 | Spinal Anesthesia | Case report

Spontaneous skull base cerebrospinal fluid leak during pregnancy: a case report and review of the literature

Authors: Lauren Michelle, Rebecca J. Post, Edward C. Kuan, Michael P. Nageotte

Published in: BMC Pregnancy and Childbirth | Issue 1/2023

Abstract

Background

Idiopathic intracranial hypertension can lead to dural defects and spontaneous leakage of cerebrospinal fluid (CSF) from the skull base. Skull base CSF leaks are rarely reported in pregnancy but pose unique challenges for obstetricians and anesthesiologists.

Case presentation

A 31-year-old G4P1021 at 14 weeks developed debilitating headaches and CSF rhinorrhea. Brain imaging revealed a bony defect of the sphenoid sinus with a meningoencephalocele and a partially empty sella, consistent with CSF leakage from a skull base defect. The patient was neurologically stable without signs of meningitis; thus, management was focused on symptomatic alleviation. A planned cesarean section was performed at 38 weeks under spinal anesthesia. The patient had spontaneous marked improvement of her symptoms postpartum.

Conclusion

Pregnancy may exacerbate skull base CSF leaks, requiring careful management with a multidisciplinary team. Neuraxial anesthesia can safely be performed in pregnant individuals with spontaneous skull base CSF leakage, but further studies are needed to determine the safest mode of delivery in these patients.

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Title: Spontaneous skull base cerebrospinal fluid leak during pregnancy: a case report and review of the literature
Authors: Lauren Michelle
Rebecca J. Post
Edward C. Kuan
Michael P. Nageotte
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Spinal Anesthesia
Idiopathic Intracranial Hypertension
Intracranial Hypertension
Meningitis
Sectio Ceasarea
Headache
Sectio Caesarea
Published in: BMC Pregnancy and Childbirth / Issue 1/2023
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-023-05460-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Spontaneous skull base cerebrospinal fluid leak during pregnancy: a case report and review of the literature

Abstract

Background

Case presentation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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