<abstract xmlns="http://www.w3.org/1999/xhtml"><p> A cerebrospinal fluid (CSF) leak occurs when there appears a fistula between the dura and the skull base and it is usually characterized by discharge of cerebrospinal fluid from the nose. Cerebrospinal fluid leaks may have many etiologies, the most common being trauma. The most common site of dural lesion is the cribriform plate of the ethmoid. Diagnosis can be achieved by a multitude of techniques, high-resolution computed tomography being the modality of choice and it may be completed with magnetic resonance imaging or cisternography. Treatment may be either conservative, either surgical, related to the cause, the site and the duration of CSF leak. Conservative treatment usually includes strict bed rest, elevated bed head and no straining, nose blowing or stretching, with resolution of the majority of traumatic CSF leaks in seven days. Surgical treatment consists of a variety of approaches (intracranial/extracranial, open/endoscopic). The future trend is represented by minimally invasive endoscopic approaches, with a success rate of almost 90%; however, open transcranial or extracranial interventions still have indications in the surgical management. CSF leaks must be correctly diagnosed and treated, because the risk of intracranial complications increases 10-fold when the leakage persists.</p></abstract>

A cerebrospinal fluid (CSF) leak occurs when there appears a fistula between the dura and the skull base and it is usually characterized by discharge of cerebrospinal fluid from the nose. Cerebrospinal fluid leaks may have many etiologies, the most common being trauma. The most common site of dural lesion is the cribriform plate of the ethmoid. Diagnosis can be achieved by a multitude of techniques, high-resolution computed tomography being the modality of choice and it may be completed with magnetic resonance imaging or cisternography. Treatment may be either conservative, either surgical, related to the cause, the site and the duration of CSF leak. Conservative treatment usually includes strict bed rest, elevated bed head and no straining, nose blowing or stretching, with resolution of the majority of traumatic CSF leaks in seven days. Surgical treatment consists of a variety of approaches (intracranial/extracranial, open/endoscopic). The future trend is represented by minimally invasive endoscopic approaches, with a success rate of almost 90%; however, open transcranial or extracranial interventions still have indications in the surgical management. CSF leaks must be correctly diagnosed and treated, because the risk of intracranial complications increases 10-fold when the leakage persists.

Current insights in CSF leaks: a literature review of mechanisms, pathophysiology and treatment options

Romanian Journal of Rhinology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

A cerebrospinal fluid (CSF) leak occurs when there appears a fistula between the dura and the skull base and it is usually characterized by discharge of...

Current insights in CSF leaks: a literature review of mechanisms, pathophysiology and treatment options

Article Category: Literature Review

Published Online: Sep 01, 2017

Page range: 143 - 151

DOI: https://doi.org/10.1515/rjr-2017-0016

Keywords
cerebrospinal fluid, rhinorrhea, endoscopic, intracranial, grafting

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Current insights in CSF leaks: a literature review of mechanisms, pathophysiology and treatment options

Article Category: Literature Review

Published Online: Sep 01, 2017

Page range: 143 - 151

DOI: https://doi.org/10.1515/rjr-2017-0016

Keywordscerebrospinal fluid, rhinorrhea, endoscopic, intracranial, grafting

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
cerebrospinal fluid, rhinorrhea, endoscopic, intracranial, grafting