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Vol. 28. Issue 2.
Pages 93-96 (March - April 2017)
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Vol. 28. Issue 2.
Pages 93-96 (March - April 2017)
Caso clínico
Hipertensión intracraneal idiopática y fístula espontánea de líquido cefalorraquídeo. Utilidad de la monitorización de la presión intracraneal
Idiopathic intracranial hypertension and spontaneous cerebrospinal fluid fistula. Usefulness of intracranial pressure monitoring
Angel Horcajadas Almansaa,
Corresponding author
angel.horcajadas@gmail.com

Autor para correspondencia.
, Ana Román Cutillasa, Ana Jorques Infantea, José Ruiz Gómezb, Heriberto Busquierc
a Servicio de Neurocirugía, Hospital Vithas La Salud, Granada, España
b Servicio de Otorrinolaringología, Hospital Vithas La Salud, Granada, España
c Servicio de Neurorradiología, Hospital Vithas La Salud, Granada, España
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Resumen

Las fístulas espontáneas de líquido cefalorraquídeo (LCR) constituyen una entidad clínica relativamente frecuente en la práctica neuroquirúrgica. El tratamiento quirúrgico va encaminado al cierre del defecto y el porcentaje de recurrencias no es bajo. La asociación de fístula espontánea de LCR e hipertensión intracraneal idiopática (HII) es frecuente y posiblemente sea la causa de esta baja tasa de éxito. La semiología clínica de la HII asociada a la fístula espontánea de LCR no es típica, lo que hace que su diagnóstico pase a menudo desapercibido. La monitorización continua de la presión intracraneal permite diagnosticar situaciones de hipertensión intracraneal crónica en estos pacientes, por lo que su utilización es de extraordinaria utilidad a la hora de plantear alternativas terapéuticas.

Palabras clave:
Fístula espontánea de líquido cefalorraquídeo
Hipertensión intracraneal idiopática
Monitorización de presión intracraneal
Abstract

Spontaneous cerebrospinal fluid (CSF) fistulas are rather common in daily practice. The aim of the surgical treatment is closure of the leak, but recurrences are quite frequent. The association between spontaneous CSF fistulas and idiopathic intracranial hypertension (IIH) is not uncommon, and this is probably the cause of the low rate of success of the surgical treatment. Symptoms of IIH associated with spontaneous CSF fistula are atypical, and diagnosis is often missed. Continuous intracranial pressure monitoring is very useful in the diagnosis of chronic IIH and in patients with spontaneous CSF fistula, as it helps in making decisions on the treatment of these patients.

Keywords:
Spontaneous cerebrospinal fistula
Idiopathic intracranial hypertension
Continuous intracranial pressure monitoring

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