Dear Sir or Madam, You have been invited to participate in a clinical study whose aim is to compare the effectiveness of two different approaches to the treatment of cerebrospinal fluid (CSF) pseudomeningocele - conservative management and interventional treatment (surgical or drainage procedures). CSF pseudomeningocele is a complication that may occur after brain surgery and is characterized by an accumulation of cerebrospinal fluid beneath the skin. At present, there is no clear consensus regarding the optimal treatment approach. How the study will be conducted After enrollment in the study, you will be randomly assigned (by chance) to one of two groups: Conservative management: no surgical intervention, regular follow-up, and wound care. Interventional treatment: simple aspiration/puncture, insertion of a lumbar drain, or reoperation. During the study, you will be followed for a period of 1 year. Follow-up examinations will include clinical assessment and brain imaging (CT or MRI) at 4 months and 12 months after enrollment. Risks associated with the interventional group Simple cyst aspiration/puncture: infection, bleeding into the pseudomeningocele. Lumbar drainage: infection, meningitis, bleeding at the insertion site, cerebrospinal fluid leakage, nerve root irritation, headaches. Reoperation: bleeding, infection, complications related to general anesthesia. Expected duration of participation in the study 12 months Expected total number of participants enrolled in the study 20 participants Benefit of the study The aim of the study is to compare the effect of surgical intervention with conservative management. Compensation for participation Participation in this study is not associated with any financial compensation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Insertion of Lumbar drain
aspiration of the CSF fluid with injection
after aspiration of the CSF a fibrin glue is injected into the pseudomeningocele
Revision surgery in order to prevent future pseudomeninogocele formation
Military University Hospital Prague
Prague, Prague, Czechia
RECRUITINGCSF Leakage or Tension pseudomeningocoele
New-onset wound CSF leakage requiring revision surgery, or pseudomeningocele associated with severe headaches not responsive to analgesics.
Time frame: 12 months
Infection
To compare the infection rate between the two treatment groups.
Time frame: 12 months
Glasgow Outcome Scale Extended (GOSE)
To assess functional recovery using the Glasgow Outcome Scale-Extended (GOSE) at 1 year post-surgery.
Time frame: 12 months
Absorption of the Pseudomeningocoele
Absorption of pseudomendingocoele at 4 months and 1 year post-surgery assessed by CT or MRI
Time frame: 12 months
Pain
Persistence of headache after the surgery - Pain Scale 0-10 (VAS)
Time frame: 12 months
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