Minim Invasive Neurosurg 2008; 51(3): 154-157
DOI: 10.1055/s-2008-1042437
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

An Effective and Less Invasive Treatment of Post-Traumatic Cerebrospinal Fluid Fistula: Closed Lumbar Drainage System

A. Dalgic 1 , H. O. Okay 1 , A. R. Gezici 2 , E. Daglioglu 1 , R. Akdag 1 , M. F. Ergungor 1
  • 12nd Neurosurgery Clinic, Ankara Numune Research and Training Hospital, Ankara, Turkey
  • 2Department of Neurosurgery, Izzet Baysal Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
Further Information

Publication History

Publication Date:
02 June 2008 (online)


Cerebrospinal fluid (CSF) leakage may develop when a defect is formed in dural layers by traumatic or iatrogenic processes. Traumatic CSF leakage was encountered in 2% of head injuries. CSF leakage is an associated feature of 12-30% of skull base fractures. Numerous treatment modalities are proposed for the management of CSF leaks. A closed lumbar drainage system (CLDS) is recommended as an alternative method to surgery for preventing complications related to leakage. In the present study, we report the clinical details of 46 patients who suffered from rhinorrhea/otorrhea (R/O), three of whom were urgently operated due to other causes like subdural hematoma and tension pneumocephalus. Leakage spontaneously ceased in 26 (60.4%) patients whereas CLDS insertion was found to be necessary in 17 patients. A prophylactic antibiotic regimen was started in the CLDS group and these patients were followed with daily CSF cell counts. Fifteen patients (88.2%) were successfully treated by CLDS, however meningitis developed in 2 patients (11.7%). Severe complications like meningitis could be avoided by a simple daily microbiological analysis of CSF.



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