![]() The decision of whether to observe or to surgically intervene is most likely to be dependent on the cause, site of leak, and timing of the leak. Thus, early detection of CSF leaks is important as it determines the outcome of the patient. ![]() 12) The traditional treatment involves intravenous antibiotics treatment as well as primary repair of dural defect if the definite injury is suspected. Except the cases with spontaneous diseases, traumatic CSF leak can be potentially detrimental with various complications such as bacterial meningitis if not self-resolved. 22 28) The risk of meningitis from the traumatic CSF leak can present with high morbidity and even mortality depending on the cause and site of CSF leak. Post-traumatic CSF leaks are seen 1% to 3% of all closed traumatic brain injuries (TBI) in adults and 80% to 90% of all the causes of CSF leaks in adult patients are due to head injuries. After severe craniomaxillofacial trauma, the destruction of the meningeal structure may lead to the CSF leak from the subarachnoid space. It is produced at choroid plexus and a total volume of 140 mL are actively circulating and turned over daily. Complications, such as meningitis, can arise if the condition is inadequately addressed.Cerebrospinal fluid (CSF) is a physiologic fluid for protecting brain and maintaining intracranial pressure (ICP). This approach involves performing a craniotomy, a procedure in which a section of skull is temporarily removed, so that the neurosurgeon can access the brain and repair the leak.Īlthough surgery is rarely needed, a proper diagnosis and expert management of nonsurgical treatment are essential. Sometimes traditional open surgery is best for the patient and therefore performed instead. Using an endoscope, the surgeon repairs the CSF leak without making any visible incisions. ![]() Many patients are good candidates for endoscopic neurosurgery through the nose or mouth, which is a minimally invasive technique. If the condition does not heal without further intervention, surgery to repair the leak is necessary. If intracranial pressure is high, patients may have a lumbar drain placed in the lumbar area of the spine, allowing small amounts of CSF to drip out and preventing further injury to any damaged tissues. Medications such as pain relievers, steroids, or antibiotics may also be prescribed. Patients are simply instructed to get a week or two of bed rest and drink plenty of fluids, particularly caffeinated beverages because caffeine stimulates the production of CSF. Our neurosurgeons take a conservative, noninvasive treatment approach first because most CSF conditions heal on their own without surgical intervention.
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