The Effect of lumbar drains on spontaneous cerebrospinal fluid leak repair
| Autor: | Fahad Alfawwaz, Alanood O. Alhargan, Dana S. Aljomah, Aseel O. Doubi |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Leak medicine.medical_specialty Intracranial Pressure Spontaneous cerebrospinal fluid leak 03 medical and health sciences Postoperative Complications 0302 clinical medicine Cerebrospinal fluid Lumbar medicine Humans Failure risk 030223 otorhinolaryngology Intracranial pressure Surgical repair Cerebrospinal Fluid Leak business.industry Lumbosacral Region Middle Aged medicine.disease Surgery Psychiatry and Mental health 030228 respiratory system Drainage Female Original Article Neurology (clinical) business Body mass index |
| Zdroj: | Neurosciences |
| ISSN: | 1658-3183 |
| DOI: | 10.17712/nsj.2018.4.20180116 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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