title: Spontaneous cerebrospinal fluid fistula through the clivus: report of two cases.
abstract: There have been no previous reports of a spontaneous cerebrospinal fluid fistula through the clivus. We present two such cases, describe their management, and propose a physiopathological explanation. The pulsating effect of the basilar artery in Patient 1 and brisk increases in intracranial pressure through repeated Valsalva maneuvers, acting on a congenitally thin bone in Patient 2, seem to be the plausible causes for the clival leakage.
authors.affiliation: Department of Neurosurgery, University of Lisbon, Hospital de Santa Maria, Portugal.
authors.forename: D
authors.initials: D
authors.lastname: Coiteiro
authors.forename: L
authors.initials: L
authors.lastname: Távora
authors.forename: J L
authors.initials: JL
authors.lastname: Antunes
mesh_terms: D000328:Adult; D002555:Cerebrospinal Fluid; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007427:Intracranial Pressure; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013101:Sphenoid Sinus / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed