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In three patients with postoperative CSF leaks,symptoms resolved after treatment.Despite imaging evidence of successful plug deployment,two other patients still had severe symptoms,and they underwent surgery after 2 and 18 hours,respectively.One patient had a continued CSF leak and a headache after 12 hours;follow-up surgery repaired an unsuspected dural tear just distal to the site of original surgery underneath the lamina and not covered by the fibrin glue.After one of the successful procedures,the patient had a fever and a headache,probably because of aseptic meningitis, which resolved after 2 days.Percutaneous CT-guided placement of fibrin glue may provide nonsurgical treatment for postoperative CSF leaks, potentially avoiding a major and technically difficult surgical procedure. |
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