RT Journal Article
SR Electronic
T1 The Effect of lumbar drains on spontaneous cerebrospinal fluid leak repair
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 281
OP 285
DO 10.17712/nsj.2018.4.20180116
VO 23
IS 4
A1 Aseel O. Doubi
A1 Dana S. Aljomah
A1 Alanood O. Alhargan
A1 Fahad S. Alfawwaz
YR 2018
UL http://nsj.org.sa/content/23/4/281.abstract
AB Objectives: To address the factors affecting recurrence after endoscopic surgical repairs of spontaneous cerebrospinal fluid leak, specifically the influence of using lumbar drains.Methods: This study involved a retrospective data analysis, including a chart review of all spontaneous cerebrospinal fluid (CSF) leak cases who underwent endoscopic anterior skull base repair from 2012-2017 in King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.Results: Thirteen patients with spontaneous CSF leaks were identified and evaluated. The majority were females (92.3%) with an average body mass index of 34.9. All patients underwent endoscopic repair with intra-operative lumbar drain placement. Patients continued having post-operative lumbar drain for an average of 6.4 days. Four patients (30.8%) developed recurrence; however, only one of those had a documented high opening pressure.Conclusion: Spontaneous CSF leak repairs are at a higher failure risk and may have an underlying pathology involving CSF circulation. The use of lumbar drains and intracranial pressure lowering agents are controversial and seems to be reserved only for high risk patients; however, the higher risk of recurrence in this group may be better managed by proper pre-operative evaluation and selective, patient-specific management protocols.