A Cedars-Sinai study suggests physicians treating dementia should look for cerebrospinal fluid leak—a treatable cause of an otherwise incurable condition. Wouter Schievink, MD, director of the Cerebrospinal Fluid Leak and Microvascular Neurosurgery Program, said many patients with brain sagging—w
A recent Cedars-Sinai study indicates that some patients diagnosed with behavioral-variant frontotemporal dementia, an incurable condition causing loss of behavior control and daily living abilities, may actually have a treatable cerebrospinal fluid leak instead.
A new Cedars-Sinai study suggests that some patients diagnosed with behavioral-variant frontotemporal dementia —an incurable condition that robs patients of the ability to control their behavior and cope with daily living—may instead have a cerebrospinal fluid leak, which is often treatable.
“A knowledgeable radiologist, neurosurgeon or neurologist should check the patient’s MRI again to make sure there is no evidence for brain sagging,” Schievink said.Clinicians can also ask about a history of severe headaches that improve when the patient lies down, significant sleepiness even after adequate nighttime sleep, and whether the patient has ever been diagnosed with a Chiari brain malformation, a condition in which brain tissue extends into the spinal canal.
In this study, investigators used this imaging technique on 21 patients with brain sagging and symptoms of bvFTD, and they discovered CSF-venous fistulas in nine of those patients. All nine patients had their fistulas surgically closed, and their brain sagging and accompanying symptoms were completely reversed.
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