CSF leak (Cerebrospinal fluid leak) care at Mayo Clinic. Were you questioning whether this might be the case with you? Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. Information on this site is provided in good faith and is intended to inform, facilitate discussion and support research. Powered by BROADCASTMED What is likely causing my symptoms or condition? Based on work at Mayo Clinic, it now appears that the core pathogenic factor in SIH is decreased CSF volume rather than decreased CSF opening pressure. Mayo Clinic does not endorse any of the third party products and services advertised. 2006; doi: 10.1001/jama.295.19.2286. "And so we began researching and publishing.". Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. "The outcome can be dramatic for most of these patients," says David G. Piepgras, M.D., a consultant in Neurologic Surgery at Mayo Clinic in Rochester, Minnesota. Thus, 7.2.3 Headache attributed to spontaneous . 2019; doi:10.1016/j.nic.2019.01.002. Steve Grinstead, A cheeseburgers role in one mans stroke recovery, Mobile technology collaboration with EMS aims to improve outcomes for stroke. The spinal cord and CSF are surrounded by three layers of membranes. 90210 Surgery Medical Center 450 N Roxbury Dr #600. Having constant draining in your nostril and ear has got to really make it tough to do day-to-day tasks, much less vertigo. Then, my sense of taste," Steve says of the symptoms that surfaced in 2012. Learn more about Mayo Clinic's neurosurgery and neurology departments' expertise and rankings. 3 Targeted treatment with epidural patching or surgery is important in refractory cases but requires . This content does not have an English version. We are not a medical facility, and we do not treat . Bullock has been my salvation. Accessed July 20, 2021. I then rest for three hours in his office without moving to allow the blood to begin to coagulate in patches along the epidural space. Mayo Clinic does not endorse companies or products. All appointments are prioritized on the basis of medical need. "Dr. Marsh was excellent. 310-423-3277. Mayo Clinic; 2021. Mayo Clinic does not endorse companies or products. Less than a week after surgery, Steve left the hospital. All Rights Reserved. These are the first-ever reported cases of this treatment for CSF-venous fistulas. Headaches resolved. Mayo Clinic is a not-for-profit organization. Some CSF leaks may heal with conservative treatments such as bed rest. Mayo Clinic uses lateral decubitus digital subtraction myelography (DSM), a state-of-the-art imaging tool that makes it much easier to locate spinal CSF leaks. Thank you! Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. E and F. Bilateral papilledema was found. "Going to Mayo Clinic turned out to be the best decision of my life," he says. consultation, imaging, procedure, etc). I have these other health conditions. 13400 E Shea Blvd, Scottsdale AZ 85259. Mayo Clinic has one of the largest and most experienced practices in the United States, with campuses in Arizona, Florida and Minnesota. Even if there are no auto-suggestions within the search field, hit "Search" anyway, as you may still get results. 1 Department of Radiology, Mayo Clinic, Rochester (MN), USA; . These communications may occur spontaneously or result from trauma or prior sinonasal surgery. of blood or as much as I can tolerate since it is very painful and I have to be awake (though slightly sedated). Patients seeking care with suspected spinal CSF leak, or an orthostatic headache, should email contato@drmarcionattan.com.br. A cerebrospinal fluid leak (CSF) is when you're leaking the fluid that surrounds your brain and spinal cord. Meet the Team AskMayoExpert. Patients are often referred by a physician, but self-referrals are allowed. Patients should be prepared to submit prior medical records, including imaging, related to their suspected spinal CSF leak prior to their initial consultation. Accessed July 28, 2021. Contact: Emily Griffing (office manager) at egriffing@mississippimigrainecenter.com Once you email the office manager, she will reply with a CSF leak workup packet. However, SIH has a broad spectrum of clinical and imaging manifestations, and atypical cases are increasingly seen. "I was terrified," Taylor says. Tests to diagnose a cranial CSF leak may include: Our caring team of Mayo Clinic experts can help you with your csf leak (cerebrospinal fluid leak)-related health concerns Head MRI sagittal view shows descent of the cerebellar tonsils, flattened anterior pons, obliteration of pre-pontine cistern and crowded posterior fossa. He is affiliated with medical facilities such as Mayo Clinic Hospital and Roper Hospital. The nursing staff was absolutely superb, too.". A CSF leak occurs when there is a hole or tear in the outermost layer of these membranes (dura mater), which allows some of the fluid to escape. The objective of this study is to evaluate the efficacy of epidural blood patch (EBP) in spontaneous CSF leaks. Because headache is a common symptom, patients are often misdiagnosed or mistreated for migraines. To that end, we have curated a list of physicians who have agreed to share their information on our site. Correspondence: . He was very humane, considerate and compassionate," Steve says. All rights reserved. HOURS. How can I best manage them together? @johnbishop may also have some insights for you. The head ache continues and feels like a bruise below the skull behind left ear. Spontaneous intracranial hypotension: Pathophysiology, clinical features and diagnosis. After a series of tests including one called an ultrafast dynamic CT myelogram the team discovered that the site of the leak in Steve's spine was at a different level than previously suspected. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your csf leak (cerebrospinal fluid leak)-related health concerns Start Here MRI Treatment Some CSF leaks improve with bed rest alone. 3 weeks now. Find a doctor Back Find a Doctor. Privacy Policy|Advertising Policy|Privacy Preferences Center|Do Not Sell My Personal Information. Elsevier; 2022. https://www.clinicalkey.com. Complete your request online or contact us by phone. A coordinator will follow up to see if Mayo Clinic is right for you. Hoping they may have some thoughts for you on your dizziness plus ear and nose continual drainage, plus metallic taste in your mouth. A medical history of complex headaches in patients with potential CSF . Softspoken with a gentle nature, [], "Mayo had the expertise to solve the problem. "I have been having constant draining of right nostril and ear. of the Mayo Clinic wrote about "headaches associated with decreased intracranial pressure" stating that "occasionally an occipital or frontal headache comes on only when the patient is up and about and leaves when the patient lies down. This content does not have an English version. https://www.uptodate.com/contents/search. The headache might be throbbing, but often is not, and pain can range from dull to severe. I feel very sick with", "Hi, @bellagirl. Always consult a medical provider for diagnosis and treatment. Location: Sydney, AustraliaScope of practice: Diagnosis, Treatment (Non-invasive), Treatment (Percutaneous), Treatment (Surgical)Ages: 0+Physicians: Marcus Stoodley, PhD, FRACS (Neurosurgery); Ann Bacsi, PhD, FRACP, MRCP (Headache Neurology); Shinuo Liu, PhD, FRACS (Neurosurgery); Geoff Parker, BMBS, FRANZCR (Radiology); John Magnussen, PhD (Radiology), Please call or email to schedule. Phone: +61 2 98123900 Fax: +61 2 98123898 Email: admin@mqneurosurgery.com, Additional information: About Macquarie Neurosurgery, Location: Perth, Western AustraliaScope of practice: Diagnosis, Treatment (Percutaneous)Ages: 18+Physicians: Scott Davies, MB, BCh, FCRAD(DIAG)SA, FRANZCR (Neuroradiology), Patients: Preferably referred by a neurologist or neurosurgeon. Risk factors for spinal CSF leaks include: Risk factors for cranial CSF leaks include: Possible complications of a cranial CSF leak that is left untreated include meningitis and air entering the spaces surrounding the brain (tension pneumocephalus). Cerebrospinal fluid (CSF) is a watery fluid that the nervous system produces to nourish and protect the brain and spine. Cedar Sinai vs Duke vs Mayo in MN. Elsevier; 2017. https://www.clinicalkey.com. I was shocked and pleasantly surprised that they honored that request. When an area of the skull is damaged, becomes thin, or cracks, the dura (the tissue that holds cerebrospinal fluid and surrounds the brain and spine) is exposed and can easily tear. Spinal cerebrospinal fluid leak. Additional information: Mayo Clinic: CSF leaks, Location: Ridgeland, MSScope of practice: DiagnosisAges: 2+Physicians: Christina Treppendahl, FNP-BC, AQH, MHD (Headache certification). JAMA. Additional information: About Dr. Chazen, Location: ManhattanScope of practice: Diagnosis, Treatment (Non-invasive), Treatment (Percutaneous), Treatment SurgicalAges: 0+Physicians: Gayle Salama, MD (Neuroradiology); John Park, MD PhD (Neurosurgery);Jeffrey Greenfield, MD PhD (Neurosurgery);Matthew Robbins, MD (Headache Neurology). Headache and other craniofacial pain. We understand how challenging it can be to find care from experienced medical professionals. This is done under a flourescope so that he does not hit a nerve (which happened with other Dr.) He injects up to 20 cc. Within days, patients at Mayo Clinic can see multiple specialists, have required diagnostic testing and meet with a neurosurgeon if needed a process that may take weeks somewhere else. This space is located just outside the dura mater, which is a tough, fibrous membrane that keeps cerebrospinal fluid (CSF) contained. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. All rights reserved. A leak that occurs at the cranial level, rather than the spine, doesn't result in the same drop in volume and pressure of fluid in the skull. About the Spinal CSF Leak Foundation Physician directory Spinal CSF Leak Foundation is a 501 (c) (3) nonprofit health foundation focused on raising awareness, providing education, and funding research for spinal CSF leaks. About this community. https://www.uptodate.com/contents/search. 45 related questions found. Surgery is considered if these less invasive treatments fail, and the source of the CSF leak is located. I've been diagnosed with what appears to be a slow or intermittent CSF leak back in January 2021 at MGH in Boston. This content does not have an English version. 1216 2nd St SW, Rochester MN 55902. Interested in more discussions like this? It's so easy to do that when talking with a doctor and nice to have a piece of paper to help you remember. Other CSF leaks may need treatment. In collaboration with Mayo Clinic's Department of Neurosurgery, the Memory Disorders Laboratory established a database of over 400 cases with normal pressure hydrocephalus (NPH).Research based on this data shows that when the lumbar puncture pressure is much lower than the opening pressure on the shunt valve, over drainage complications such as subdural . In Steve's case, doctors suspected the iron deposits were a result of a cerebrospinal fluid leak. Then, he scheduled an appointment at Mayo Clinic's Rochester campus. A cranial CSF leak results in a runny nose and carries a high risk of meningitis, an inflammation of the membrane around the brain and spinal cord, which can be fatal and requires emergency attention. Please note that this is not a list of all medical professionals capable of treating patients with spinal CSF leak, and that some of the doctors on this list may be better qualified than others to treat certain conditions. This content does not have an Arabic version. Hes been doing this for the past ten years. Headache and other craniofacial pain. CSF leaks can happen in two main areas: the skull (also called the cranium) and the spinal cord. So when he was facing a different type of threat a health scare that left him with a constellation of troubling symptoms it's no surprise that he confronted it head on. 2014;54:1358. Mayo Clinic neuroradiologists have experience with CT myelogram and MRI with gadolinium contrast in these cases. Mayo Clinic; 2021. Skip navigation. These are spinal CSF leaks and cranial CSF leaks. Help Millions of people find the right doctor and care they need, Get immediate care and visit with providers from the comfort of your home, or anywhere, Urgent care centers can be faster and cheaper for situations that are not life threatening, Doctors and patients discuss the latest medical treatments and health tips, Search prescription drugs for why theyre used, side effects and more, Back and Neck Surgery (Except Spinal Fusion). "He showed great concern about me and had an excellent bedside manner. Contact Name: Dr. Manjit Matharu (Headache Neurology) Phone: +44 (0)7595 900535 Email: drmanjitmatharu@gmail.com Patients can either email or call. Spinal CSF Leak Foundation is a 501(c)(3) nonprofit health foundation focused on raising awareness, providing education, and funding research for spinal CSF leaks. Braswell-Pickering B. Allscripts EPSi. All patients see a collaborative care team and follow an individualized treatment plan that is developed using high-quality imaging and advanced technology. This content does not have an English version. Tinnitus, change in hearing and dizziness, Trouble with memory or cognitive function, Movement disorders, such as chorea or parkinsonism. What happens if CSF leak is not treated? 2006; doi: 10.1001/jama.295.19.2286. In: Youmans and Winn Neurological Surgery. He met with a team that included neurologist Neeraj Kumar, M.D., neuroradiologist Felix Diehn, M.D., and neurosurgeons David Piepgras, M.D., and Richard Marsh, M.D. A lumbar puncture did not indicate high pressure, but the leak is probably keeping the pressure down, Prior to the first leak I did not have the common symptoms, which makes me wonder. Spontaneous intracranial hypotension (SIH) is a condition caused by spinal CSF leaks, either into the epidural space or into an adjacent vein, known as a CSF venous fistula (CVF). Advertising and sponsorship policy CSF leak occurred overall in five patients (5.1 %). In most cases doctors are willing to do this. Medical records research uses . . My pain begins behind right ear. Leaks sometimes occur spontaneously. AskMayoExpert. Surgical expertise. Primary contact by e-mail is preferred, so your case can be evaluated by a physician who will guide you for the best course of action (e.g. Dr. Matthew Neal, MD is a Neurosurgery Specialist in Phoenix, AZ. CSF leaks can often cause severe symptoms, but this condition is very treatable, and up to 98% of people with it will recover. I feel very sick with this. The content on the Spinal CSF Leak Foundation website is provided for general informational and educational purposes only. About 5 months after the fall was the first sypmtoms of a severe headache and I went to the emergency room. While there is a clear postural component in most cases of 7.2.3 Headache attributed to spontaneous intracranial hypotension, it may not be as dramatic or immediate as in 7.2.1 Post-dural puncture headache. Often, your insurer's customer service number is printed on the back of your insurance card. Elsevier; 2022. https://www.clinicalkey.com. Though I can't say with certainty for any individual, often patients who enter Mayo Clinic with a host of symptoms and no diagnosis yet start with a provider in Internal Medicine to determine a diagnosis first, and then they may be sent on to a specialist, as needed. ", "I'm a Jehovah's Witness, so I can't take blood transfusions," he says. "The hypertension usually settles down in a matter of months," Dr. Mokri says. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Evaluate the Safety and Efficacy of Dura Sealant Patch in Reducing CSF Leakage Following Elective Cranial Surgery (ENCASE II), A Study to Assess for Changes in Optic Nerve Structure and Function due to Changes in Cerebrospinal Fluid Pressure, Efficacy of Epidural Blood Patch in Spontaneous Intracranial Hypotension (CSF Leak), A Study to Assess Sinus Stenting to Manage Cerebrospinal Fluid Leak, Advertising and sponsorship opportunities. I had tingling and numbness around my eye after the fall. If you are coming from abroad, apart from the cost of CSF leak . Initially, it wasn't uncommon for patients to be referred after misdiagnosis and treatment for conditions such as migraine or tension headache. Patient Information. Symptoms vary between spinal and cranial CSF leaks. I am sorry to hear you are feeling very". We understand how challenging it can be to find care from experienced medical professionals. Connection & Conversation: Open for the holidays. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. However, the patient reported vague visual symptoms. The head ache persists, although it is less severe right now. What happens if a CSF leak is not treated? There are two distinct types of CSF leaks with different symptoms, causes and treatments. Terms and Conditions His office accepts new patients and telehealth appointments. Back home, Steve attends physical therapy twice a week to help him regain strength and improve his balance. Mayo Clinic is a not-for-profit organization. Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. I would make a list of all your symptoms before your appointment so that you don't forget. 2019; doi:10.1016/j.nic.2019.01.002. Location: New York, NYScope of practice: Diagnosis, Treatment (Percutaneous)Ages: 16+Physicians: J. Levi Chazen, MD (Neuroradiology). Neuroimaging Clinics of North America. The headache is often but not always bilateral, and can be frontal, fronto-occipital, holocephalic or occipital. Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. Mayo Clinic. SC046319) promoting awareness of cerebrospinal fluid (CSF) leaks, with a particular focus on spinal CSF leaks. Researchers at Mayo Clinic conduct studies that improve current diagnostic tests and treatments for people with CSF leaks. Other CSF leaks may need treatment. Mokri B. Spontaneous CSF leaks: Low CSF volume syndromes. Providing this directory of medical professionals who treat spinal CSF leaks does not constitute a recommendation, endorsement, or certification of these physicians. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. "Dr. Marsh was excellent. Mayo Clinic's experienced neurosurgeons are trained to provide a number of different surgical treatment options, depending on the cause of your CSF leak. Spontaneous CSF leaks: Low CSF volume syndromes. It came back with a vengence in December 2011 and at that point was diagnosed as possible CFS leak and I recently had a blood patch. C. Spine MRI (heavily T2-weighted axial image) shows a meningeal diverticulum. Spontaneous intracranial hypotension: Pathophysiology, clinical features and diagnosis. Mayo Clinic is a not-for-profit organization. A cranial CSF leak occurs in the skull. Connect with thousands of patients and caregivers for support and answers. Contact: Tracey Jacobs (Medical Secretary) Phone: 01223 216911 Email: cuh.sih.cambridge@nhs.net A referral by GP or neurologist is required. Explore our 400+ programs. She had joint hypermobility and a family history of joint hypermobility, CSF leaks, and aortic aneurysms and dissection. This fluid flows around the brain and spinal cord and cushions, or floats . He also discusses lateral decubitus digital subtraction myelogram, the novel approach for treatment identified at Mayo Clinic. What websites do you recommend? A single copy of these materials may be reprinted for noncommercial personal use only. CSF leaks occur through a communication between the lining of the brain and the nose. 8th ed. JAMA. Privacy Policy Apparently the logic is that something must be causing the leaks and high intracranial pressure is the most logical cause. Are you currently taking any medication or have seen a doctor concerning your symptoms? Dr. Varun Kshettry, MD Advertising revenue supports our not-for-profit mission. The most common symptom of a spinal CSF leak is a headache, while a cranial CSF leak causes symptoms such as clear fluid leaking from the nose or ear. Mark Gregory Luciano, M.D., Ph.D. Abhay Rajeshwar Moghekar, M.B.B.S. Mayo Clinic offers a multidisciplinary, specialized team of CSF experts including neurologists, neurosurgeons, ear nose and throat (ENT) specialists, imaging specialists (radiologists), and other specialty professionals who work together to provide exactly the care you need. Mayo Clinic neurologist Jeremy K. Cutsforth-Gregory, M.D., discusses the different types of cerebral spinal fluid (CSF) leaks and the treatment options at Mayo Clinic. Cerebral spinal fluid (CSF) leaks at Mayo Clinic.Mayo Clinic neurologists, Jeremy Cutsforth-Gregory, MD, the different types of cerebral spinal fluid (CSF) l. When this fluid volume is reduced, there is less fluid available to cushion the brain inside the skull. In the meantime, I'd like to focus on your symptom of dizziness and bring in some members who have talked about this symptom, like @scruffy1 @hydrang3a @burt @gailfaith @livetheday and @roman. I would like to add my welcome to Connect along with Lisa. 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Chan SM, et al. Mokri B. A spinal CSF leak occurs anywhere in the spinal column. This has gone on for 16 years. The purpose of this study is to determine whether transverse/sigmoid sinus junction stenting reduces the risk of recurrent cerebrospinal fluid (CSF) leak in patients with idiopathic intracranial hypertension presenting with CSF leak. "I woke up, and there were a bunch of tubes coming out [], Alex Kraatz is a creative, determined optimist who loves playing the guitar, taking photos, and spending time with his family. It was surgically removed, and the small orifice of its connection to the dura was sutured. May 25, 2021 8:06 PM. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Over the past 25 years, Dr. Mokri and Dr. Piepgras have seen an estimated 700 patients with SIH. Additional information: About Hospital Srio-Libans. A single copy of these materials may be reprinted for noncommercial personal use only. A single copy of these materials may be reprinted for noncommercial personal use only. We find this the most helpful test in evaluating the possible location of a CSF leak. Imaging of a middle-aged man presenting with orthostatic headaches, dizziness, nausea, and bowel and bladder incontinence. For the most part, cranial and spinal CSF leaks have unique causes and treatments. The team found a 5/16-inch diameter leak, which was stitched up with silk thread. Mayo Clinic . 2014;34:1134. The research is multifaceted, ranging from basic science discovery to clinical applications. BroadcastMed Privacy Policy. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Los Angeles, CA 90048 View Interactive Medical Center Map. Are there brochures or other printed material that I can have? The flexibility of your joints also may be checked. Insurance Details. 7th ed. Spinal cerebrospinal fluid leak. It involves this type of fluid escaping through a tear in the dura mater. You may be asked to lean forward to check for any nasal discharge, which may be collected and sent to a lab for testing. The Mayo Clinic Health System has dozens of locations in several states. Dr. Carlton Jones cannot accept direct referrals or review patients imaging without a clinical referral to the MDT meeting as detailed above. He's eager for that to happen, and for other parts of his life to get back in balance, too. Click here to see if your insurance plan is accepted. SPECIAL DISCOUNT: On the final screen when you enter your credit card information, use promo code SCSFLF15 to automatically apply a $15 discount toward your monthly, quarterly, or annual membership fee once your trial period ends. After you begin your trial, you will be directed to download their mobile app, which will allow you to see available video appointment times in the coming days (appointments incur an additional charge above the membership fee) and reserve a time slot for an initial video visit with a neurologist specializing in CSF leak. If you have additional questions and are interested in joining Neura Health for an evaluation with one of their headache neurologists, please email apickard@spinalcsfleak.org to be provided with additional information. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. Dr. Carlton Jones cannot accept direct referrals or review patients imaging without a clinical referral to the MDT meeting as detailed above. I have had bad metallic taste in mouth. Steve Grinstead knows how to handle dangerous situations. For patients where Neura does not have licensure, including Canada and international patients: Neura Health is not currently licensed to prescribe medication, order lab tests, or order imaging in your state. Spinal CSF Leak Foundation does not have ownership or direct financial interest in any of the specific doctors or clinics listed here. Have your symptoms been continuous or occasional? B and C. CT myelography shows a fairly large meningeal diverticulum (arrows) in the left L2 neural foramen, which was surgically repaired. He was very humane, considerate and compassionate," Steve says. Does anyone out there have similar continuous headaches that get better when you lay down and increase when up or later in the day? Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Mayo Clinic Q&A podcast: Cerebrospinal fluid leaks are commonly misdiagnosed. For patients where Neura is licensed: Patients instates/geographic locations where Neura is licensed can be directly prescribed medical treatment by Neura and have the option for medications to be delivered to their doorstep or called into a local pharmacy. Mayo Clinic College of Medicine and Science Team science Read how researchers are working together to speed discovery. Once considered rare, spontaneous intracranial hypotension (SIH) is now more commonly diagnosed and recognized as an important cause of headaches. The team that performed the procedure and cared for him afterward, Steve recalls, went above and beyond to make him comfortable. A CT with contrast and MRI without contrast have showed nothing. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Mayo Clinic Q&A podcast: Cerebrospinal fluid leaks are commonly misdiagnosed. This test is used to rapidly detect the nucleic acid of 14 of the most common pathogens that cause encephalitis or meningitis. I had many patches at Mayo that were unsuccessful. Please have your referring physician or their assistant email Mea Moore at Mea.Moore@Jefferson.edu Please make sure the referral includes patient contact information, demographics, and insurance information. This site complies with the HONcode standard for trustworthy health information: verify here. Primary Contact: Mesha Martinez, MD meshmart@iu.edu Phone: 317-650-6654 Fax: 317-968-1419, Secondary Contact: Silvia Ruiz, Administrative Assistant NIRteam@iuhealth.org Phone: 317-650-6654 Fax: 317-968-1419, Location: Louisville, KYScope of practice: Treatment (Surgical)Ages: 18+Physicians: Dale Ding, MD; Isaac Josh Abecasssis, MD; Brian Williams, MD, Primary Contact: Dale Ding, MD dale.ding@uoflhealth.org Phone: 502-588-2160 Fax: 502-588-8772, Secondary Contact: Kimberly S. Meyer, CNRN, APRN, PhD kim.meyer@uoflhealth.org Phone: 502-588-2160 Fax: 502-588-8772, Scope of practice: Treatment (Surgical)Ages: 14+ (Neurosurgery), 0+ (Diagnostics and Percutaneous treatment)Physicians: Vinay Deshmukh, MD (Neurosurgery); Anousheh Sayah, MD (Interventional Neuro-radiology); Carrie Dougherty, MD (Neurology); Katherine Hamilton, MD (Neurology); Amanda Tinsley, MD (Neurology); Benjamin Osborne, MD (Neuro-ophthalmology), Location: Ann Arbor, MIScope of practice: Diagnosis, Treatment (percutaneous)Ages: 0+Physicians: Joseph J. Gemmete, MD, Appointments: Phone: 734-936-9766 Fax a Referral: 734-615-5111. Additional information: CSF leak treatment at Cedars-Sinai CSF leak patient guide, Location: Santa Clara, CAScope of practice: Diagnosis, Treatment (Non-invasive), Treatment (Percutaneous), Treatment (Surgical)Ages: 0+Physicians: Mark Mamlouk, MD (Neuroradiology); Peter Shen, MD (Neuroradiology); Peter Jun, MD (Neuroradiology); Brian Dahlin, MD (Neuro Interventional Radiology); Mark Sedrak, MD (Neurosurgery), PATIENTS MUST HAVE KAISER INSURANCE Please be referred by a physician and/or contact the admin. Admin Name: Camille Yanogacio Admin Phone: 408-851-5267 Admin Email: camela.a.yanogacio@kp.org, Additional information: Kaiser Permanente Spinal CSF Leak Program, Location: Palo Alto, CAScope of practice: Diagnosis, Treatment (Non-invasive), Treatment (Percutaneous)Ages: 18+*Physicians: Ian Carroll, MD, Please call the Stanford Headache Clinic at Hoover Primary Phone for Hoover Clinic: 650-723-6469 Primary Fax for Hoover Clinic: 650-725-0390, *Pediatric cases are handled by the Pediatric Pain Clinic in collaboration with Dr. Ian Carroll, Dr. Elliot Krane, and Dr. Genevieve DSouza, Location: San Francisco, CAScope of practice: Diagnosis, Treatment (Non-Invasive), Treatment (Percutaneous), Treatment (Surgical)Ages: 0+Physicians: Vinil Shah, MD (Neuroradiology); William Dillon, MD (Neuroradiology); Maggie Waung (Headache Neurology); Leslie West (Neurology), Call or email Dr. Vinil Shah (neuroradiology) Referral by physician REQUIRED Primary Phone: 415-514-5654 Primary Email: vinil.shah@ucsf.edu Primary Fax: 415-353-7299, Additional information: UCSF Department of Radiology and Biomedical Imaging, Location: Aurora, COScope of practice: Diagnosis, Treatment (Non-invasive), Treatment (Percutaneous), Treatment (Surgical)Ages: 0+Physicians: Andrew L Callen, MD (Neuroradiology); Ashesh Thaker, MD (Neuroradiology); Vincent Timpone, MD (Neuroradiology); Marius Birlea, MD (Headache Neurology); Fabio Grassia, MD (Neurosurgery); Adam Schwertner, MD (Interventional Radiology), Primary Contact: Pam Michelli (Nurse Coordinator) Primary Email: Pamela.Michelli@uchealth.org Primary Phone: 720-848-7237, Location: Washington, D.C.Scope of practice: Treatment (Surgical)Ages: 14+ (Neurosurgery), 0+ (Diagnostics and Percutaneous treatment)Physicians: Vinay Deshmukh, MD (Neurosurgery); Anousheh Sayah, MD (Interventional Neuro-radiology); Carrie Dougherty, MD (Neurology); Katherine Hamilton, MD (Neurology); Amanda Tinsley, MD (Neurology); Benjamin Osborne, MD (Neuro-ophthalmology), Contact Phone: 202-444-8993 Contact Fax: 202-444-7333, Location: Indianapolis, INScope of practice: Diagnosis and Treatment (non-invasive and percutaneous)Ages: 0+Physicians: Mesha Martinez, MD. ? The FilmArray Meningitis/Encephalitis panel is a m ultiplex PCR test capable of qualitatively detecting DNA or RNA of 14 pathogens (bacteria, viruses, and yeast) in approximately 1 hour from spinal fluid.. Patients can be self-referred or referred by a physician. Additional information: About Hospital Samaritano, Location: So Paulo, BrazilScope of Practice: Diagnosis, Treatment (Percutaneous)Ages: 0+Physicians: Diogo Edelmuth, MD (Radiology), Paulo Helito, MD (Radiology), Hugo Costa, MD (Radiology), Primary Contact: Diogo Edelmuth, MD (Radiology)Email: diogo.gleal@hsl.org.brPhone: +55 (11) 3394-3724Fax: +55 (11) 3394-3724.