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1000 Titel
  • Don’t delay, but don’t despair: symptom duration, comorbidity and outcome after closure of spinal cerebrospinal fluid leaks
1000 Autor/in
  1. Volz, Florian |
  2. El Rahal, Amir |
  3. Fung, Christian |
  4. Shah, Mukesch |
  5. Lützen, Niklas |
  6. Urbach, Horst |
  7. Beck, Jürgen |
  8. Wolf, Katharina |
1000 Verlag Springer Berlin Heidelberg
1000 Erscheinungsjahr 2024
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2024-02-26
1000 Erschienen in
1000 Quellenangabe
  • 271(5):2776-2786
1000 Copyrightjahr
  • 2024
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00415-024-12242-2 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055789/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • <jats:title>Abstract</jats:title><jats:sec> <jats:title>Objective</jats:title> <jats:p>Microsurgical sealing of spinal cerebrospinal fluid (CSF) leaks is a viable treatment option in spontaneous intracranial hypotension (SIH). Several factors may influence the outcome, with symptom duration probably the most modifiable variable.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Patients with closure of spinal CSF leaks between September 2020 and March 2023 and a follow-up period of 6 months were included in this retrospective single-center study. Pre- and postoperative scores for impact of headaches (Headache Impact Test, HIT-6) and quality of life (QoL, EQ-5D-5L) were systematically collected. Multiple regression modelling and subgroup analyses for different symptom durations and comorbidities were performed for these outcomes.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>One hundred patients (61% female, median age 43.5 years) were included. Six months postoperatively, there was significant improvement in headache impact (HIT-6: 66 (IQR 62–69) to 52 (IQR 40–61, <jats:italic>p</jats:italic> &lt; 0.001) and QoL (EQ-5D-5L VAS: 40 (IQR 30–60) to 79 (IQR 60–90); EQ-5D-5L Index: 0.67 (IQR 0.35–0.8) to 0.91 (IQR 0.8–0.94, <jats:italic>p</jats:italic> &lt; 0.001, respectively). Subgroup analysis for a symptom duration above (74%) and below 90 days (26%) and comorbidity, as well as multiple regression analysis, revealed a trend in favor of early treatment and lower comorbidity. However, even after a prolonged symptom duration, improvements were significant.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>As patients with shorter symptom duration show a trend for a better outcome, our results promote a timely diagnosis and treatment in SIH patients. However, a significant postoperative improvement can still be expected even after a prolonged symptom duration.</jats:p> </jats:sec>
1000 Sacherschließung
lokal Female [MeSH]
lokal Follow-Up Studies [MeSH]
lokal Adult [MeSH]
lokal Humans [MeSH]
lokal Treatment Outcome [MeSH]
lokal Spinal cerebrospinal fluid leak
lokal Retrospective Studies [MeSH]
lokal Middle Aged [MeSH]
lokal Neurosurgical Procedures [MeSH]
lokal Time Factors [MeSH]
lokal Headache [MeSH]
lokal Intracranial Hypotension [MeSH]
lokal Spontaneous intracranial hypotension
lokal Symptom duration
lokal Cerebrospinal Fluid Leak/surgery [MeSH]
lokal Quality of life
lokal Male [MeSH]
lokal Quality of Life [MeSH]
lokal Comorbidity [MeSH]
lokal Comorbidity
lokal Original Communication
lokal Microsurgery [MeSH]
lokal Orthostatic headache
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/Vm9seiwgRmxvcmlhbg==|https://frl.publisso.de/adhoc/uri/RWwgUmFoYWwsIEFtaXI=|https://frl.publisso.de/adhoc/uri/RnVuZywgQ2hyaXN0aWFu|https://frl.publisso.de/adhoc/uri/U2hhaCwgTXVrZXNjaA==|https://frl.publisso.de/adhoc/uri/TMO8dHplbiwgTmlrbGFz|https://frl.publisso.de/adhoc/uri/VXJiYWNoLCBIb3JzdA==|https://orcid.org/0000-0002-7687-6098|https://frl.publisso.de/adhoc/uri/V29sZiwgS2F0aGFyaW5h
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1000 Label
1000 Förderer
  1. Universitätsklinikum Freiburg |
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    1000 Förderer Universitätsklinikum Freiburg |
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