Cerebrospinal fluid leak management in anterior basal skull fractures secondary to head trauma. (3rd October 2022)

• Record Type: Journal Article
• Authors: Liao, Jian-Cheng; Liang, Buqing; Wang, Xiang-Yu; Huang, Jason H.
• Is Part Of: Neurological research. Volume 44:Number 10(2022)
• Page Start: 888
• Page End: 893
• Publication Date: 2022-10-03
• Subjects: CSF leak -- skull base fracture -- craniotomy -- endoscopic endonasal; Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8005
• DOI: 10.1080/01616412.2022.2066783
• Languages: English
• ISSNs: 0161-6412

Abstract

ABSTRACT: Objective: To summarize the presentation, diagnosis, and management of cerebrospinal fluid (CSF) leaks in the setting of traumatic anterior skull base fracture. Methods: Wide literature research has been performed as well as the authors' own clinical experience has been summarized. Results: Articles from the most recent 30 years have been reviewed and a typical case of our own has been presented. Based on the most updated evidence, a treatment algorithm for CSF leaks has been proposed. Conclusion: Anterior skull base fracture accounts for about 4% of all head injuries and CSF leaks is a complication that commonly presents with clear fluid emanating from the nasal passage. A positive beta-2-transferrin study is highly specific for diagnosis, while thin-slice CT scanning and MRI cisternography are also useful tools. The majority of the CSF leaks tend to be resolved spontaneously, and conservative management is attempted first with or without the augmentation of a lumbar drain. Surgical management mainly includes open surgery and endoscopic surgery, which have their own pros and cons.