{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:45:41Z","timestamp":1783773941867,"version":"3.55.0"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1978,9]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The authors review 39 patients with cerebrospinal fluid (CSF) leaks originating from the middle or posterior fossa. They evaluate the usefulness of preoperative investigative procedures, including cisternal radionuclide scanning and the deliberate increase of intracranial pressure. The results in this series emphasize the important role that abnormal CSF dynamics play in the recurrence of problematic cases of rhinorrhea or otorrhea. The following guidelines are recommended by the authors on the basis of their recent experience: 1) if hydrocephalus is present, if the cisternogram is abnormal, or if the CSF leak is intermittent and slight, the initial treatment should be insertion of a lumboperitoneal shunt; 2) if the leak is localized in the sellar or parasellar area, a transsphenoidal approach to obliterate the leak is advised; 3) if the CSF leak originates through a dural opening into the middle ear, an intracranial repair is indicated.<\/jats:p>","DOI":"10.3171\/jns.1978.49.3.0393","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:25:00Z","timestamp":1241709900000},"page":"393-397","source":"Crossref","is-referenced-by-count":69,"title":["Management of recurrent CSF rhinorrhea of the middle and posterior fossa"],"prefix":"10.3171","volume":"49","author":[{"given":"Robert F.","family":"Spetzler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles B.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3171\/jns.1967.26.1part1.0057","article-title":"Treatment of skull fractures with and without cerebrospinal fluid fistulae.","volume":"26","author":"Brawley","year":"1967"},{"key":"b2","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1148\/122.2.379","article-title":"Acquired spontaneous, nontraumatic normal-pressure cerebrospinal fluid fistulas originating from the middle fossa.","volume":"122","author":"Kaufman","year":"1977"},{"key":"b3","series-title":"Surg Neurol","first-page":"111","article-title":"Antimicrobial prophylaxis in patients with rhinorrhea or otorrhea: a double-blind study.","volume":"6","author":"Klastersky","year":"1976"},{"key":"b4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"312","DOI":"10.3171\/jns.1970.33.3.0312","article-title":"Meningitis following acute traumatic cerebrospinal fluid fistula.","volume":"33","author":"MacGee","year":"1970"},{"key":"b5","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1097\/00005373-196609000-00007","article-title":"Posttraumatic cerebrospinal fluid fistula of the frontal fossa.","volume":"6","author":"Mincy","year":"1966"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3171\/jns.1965.22.4.0326","article-title":"The importance of the lateral extensions of the sphenoidal sinus in post-traumatic cerebrospinal rhinorrhea and meningitis. Clinical and radiological aspects.","volume":"22","author":"Morley","year":"1965"},{"key":"b7","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1212\/WNL.14.2.106","article-title":"Cerebrospinal fluid rhinorrhea.","volume":"14","author":"Ommaya","year":"1964"},{"key":"b8","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1136\/jnnp.31.3.214","article-title":"Non-traumatic cerebrospinal fluid rhinorrhoea.","volume":"31","author":"Ommaya","year":"1968"},{"key":"b9","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1001\/archsurg.1967.01330160118017","article-title":"Post-traumatic cerebrospinal fluid leaks.","volume":"95","author":"Raaf","year":"1967"},{"key":"b10","article-title":"Management of recurrent CSF rhinorrhea.","author":"Spetzler"},{"key":"b11","series-title":"Surg Neurol","first-page":"25","article-title":"Simplified percutaneous lumboperitoneal shunting.","volume":"7","author":"Spetzler","year":"1977"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/49\/3\/article-p393.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/49\/3\/article-p393.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/49\/3\/article-p393.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T18:11:58Z","timestamp":1660500718000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/49\/3\/article-p393.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1978,9]]},"references-count":11,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/jns.1978.49.3.0393","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1978,9]]}}}