Abstract
Accurately identifying patients with CSF-venous fistulas (CVF), one cause of spontaneous intracranial hypotension (SIH), is a diagnostic dilemma. This conundrum underscores the need for a CVF biomarker to help select who should undergo an invasive myelogram for further diagnostic workup. Beta trace protein (BTP) is the most abundant CNS derived protein in the CSF and therefore is a potential venous biomarker for CVF detection. The purpose of our study was to measure venous BTP levels as a potential CVF biomarker. We prospectively enrolled 14 patients with CVF and measured BTP in venous blood samples from the paraspinal veins near the CVF and compared those levels to the peripheral blood. Myelograms used initially to identify the CVF were evaluated for modality, CVF laterality, CVF level, and venous drainage pattern. Patient sex, patient age, and symptom duration were also collected. Brain MR images were reviewed for Bern scores. We also measured the peripheral blood BTP levels in 20 normal controls. In patients with CVF, the mean BTP level near the CVF was 54.5% higher (0.760 [SD 0.673] vs 0.492 [SD 0.095] mg/L; p = 0.069) compared to peripheral blood. Nine (64.3%) patients with CVF had a higher paraspinal BTP level than peripheral BTP level. The 20 control patients had a higher the mean peripheral BTP level 0.720 (SD 0.191) mg/L compared to patients with CVF (p<0.001). We found that venous blood at the site of CVF had higher BTP values compared to peripheral blood in the majority, but not all patients with CVF. This may reflect the intermittent leaking nature of CVF. Additionally, we found that patients with CVF had a lower peripheral blood BTP level compared to normal controls. BTP requires further evaluation as a potential CVF biomarker. SIH = Spontaneous Intracranial Hypotension; CVF = CSF-Venous Fistula; CTM = CT myelogram; DSM = Digital Subtraction Myelography; BTP = Beta Trace Protein.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Similar Papers
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.