The authors review a prospectively accrued database of consecutive patients to assess the effectiveness of the off‐label routine use of intrathecal fluorescein to detect an intraoperative cerebrospinal fluid (CSF) leak during endoscopic endonasal skull base surgery. Patients were pretreated with intravenous dexamethasone and diphenhydramine prior to administration of 25 mg of fluorescein inject...

An 18-year-old woman was diagnosed with idiopathic intracranial hypertension (IIH) and bilateral transverse sinus stenoses (TSS), after presenting with papilledema and decreased visual acuity. Lumbar puncture revealed an opening pressure of >60 cm H2O. MRI showed bilateral TSS believed to be associated with the IIH. Initial treatment consisted of symptom relief by a temporary lumbar drain for c...

BACKGROUND Cerebral hyperperfusion syndrome is a rare complication of indirect revascularization due to moyamoya disease, but has not been reported previously in the pediatric population. We present a case of an 18-month-old girl with moyamoya disease that was treated with bilateral pial synangiosis and had complications consistent with cerebral hyperperfusion syndrome. This case report discuss...

A pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured directed PCoA imposes significantly extra challenge as surgeon undergoes dissection through tight brain. Even with measures commonly used to attain brain relaxation like lu...

We determined the pharmacokinetics of efavirenz in plasma and cerebrospinal fluid (CSF) over a 24-h dosing interval in a patient who had undergone a lumbar drain because of cryptococcal meningitis. Drug concentrations were determined by high-performance liquid chromatography-tandem mass spectrometry in paired CSF (n = 24) and plasma (n = 25) samples. The median plasma efavirenz concentration wa...

Background: While dysphagia after anterior cervical spine surgery is common, a dural tear rare complication. Airway compromise resulting from cerebrospinal fluid collection an even rarer complication that has only been described to occur in the first few days postoperatively. Case Report: A 55-year-old male presented with progressive and respiratory 3 weeks discectomy fu...