Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2007
Case ReportsSubarachnoid-pleural fistula in an infant treated with mechanical positive-pressure ventilation.
To report a pediatric case of subarachnoid-pleural fistula, its diagnosis, and its treatment. ⋯ We used beta2-transferrin to confirm the diagnosis of clinically suspected subarachnoid-pleural fistula. High-resolution computed tomographic and magnetic resonance cisternography are the best techniques to localize the fistula. The currently recommended treatment is surgery; we suggest that bilevel positive-pressure ventilation, especially with noninvasive techniques, could be a treatment alternative, reducing the flow of cerebral spinal fluid through the fistula and allowing spontaneous closure.