Post-traumatic CSF fistulae, the case for surgical repair.
The management of acute post-traumatic CSF fistulae is still a matter of controversy. A long-term analysis of 160 patients with acute post-traumatic non-iatrogenic dural fistulae was undertaken to establish the value of surgical dural repair. One hundred and forty-nine patients underwent dural repairs following traumatic CSF rhinorrhoea. The risk of meningitis following surgical dural repair was 4%. The operative mortality was 1.3% (2/151), as was the negative exploration rate. The first dural repair was successful in 90% and a second dural repair was required in 10%. These results are in favour of surgical dural repair which can be undertaken with a low morbidity and mortality and is highly successful in preventing meningitis following traumatic CSF rhinorrhoea.
Eljamel
M S
MS
Mersey Regional Department of Neurosciences, Walton Hospital, Liverpool, UK.
Foy
P M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications / Q000601:surgery*; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence