Evidence map›Paper›PMID 32349710›Full record

ArticleBMC neurology2020

Spinal cerebrospinal fluid leak in the context of pars interarticularis fracture.

Tommy Lik Hang Chan, Robert Cowan, Nada Hindiyeh, Syed Hashmi, Bryan Lanzman, Ian Carroll

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 55% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Tommy Lik Hang ChanDivision of Headache and Facial Pain, Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA. tlhchan@stanford.edu.ORCID http://orcid.org/0000-0003-0252-7757
Robert CowanDivision of Headache and Facial Pain, Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA.
Nada HindiyehDivision of Headache and Facial Pain, Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA.
Syed HashmiDepartment of Rad/Neuroimaging and Neurointervention, Stanford University, Palo Alto, CA, USA.
Bryan LanzmanDepartment of Rad/Neuroimaging and Neurointervention, Stanford University, Palo Alto, CA, USA.
Ian CarrollDepartment of Anesthesia, Stanford University, Palo Alto, CA, USA.
Stanford University · USPalo Alto University · USStanford Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSpinal cerebrospinal fluid (CSF) leak can lead to intracranial hypotension and is an important differential diagnosis to consider in patients with sudden-onset chronic daily headaches. Pars interarticularis (PI) fracture is a potential rare cause of suspected spinal CSF leak.

methodsThis is a retrospective case series of 6 patients with suspected spinal CSF leak evaluated between January 2016 and September 2019. All patients received a magnetic resonance imaging (MRI) of the brain with and without gadolinium, MRI whole spine and full spine computed tomography (CT) myelogram. Targeted epidural patches with fibrin sealant were performed. Treatment response at return visit (3 months post-patch) was documented.

resultsSix patients (4 females, 2 males) were diagnosed with a suspected spinal CSF leak and PI fracture. Mean age at the time of headache onset was 39 years old, and a range from 32 to 50 years old. Mean time to targeted epidural patches with fibrin sealant was 4.5 years. All 6 patients had PI fractures identified on CT myelogram and received targeted epidural patches with fibrin sealant at the site of the PI fracture. All patients had significant improvement in their headache intensity.

conclusionOur study highlights: 1) the importance of PI fracture as a possible culprit of suspected spinal CSF leak in patients with intracranial hypotension; 2) the added benefit of CT imaging for detecting bony abnormalities such as fractures in patients with intracranial hypotension; and 3) the successful treatment of suspected spinal CSF leak when targeting the fracture site.

Indexed as

AdultCerebrospinal Fluid LeakFemaleFibrin Tissue AdhesiveGadoliniumHeadacheHumansMagnetic Resonance ImagingMaleMiddle AgedMyelographyRetrospective StudiesSpinal FracturesTomography, X-Ray ComputedYoung AdultFibrin Tissue AdhesiveGadoliniumIntracranial hypotensionPars interarticularis fractureSpinal cerebrospinal fluid leakSpinal CSF leak

Identifiers

PMID32349710
PMCPMC7191704
OpenAlexW3020969632

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.