Management of traumatic cerebrospinal fluid fistula

Cerebrospinal fluid fistulae present a common management problem for the surgeon managing craniofacial trauma. Controversies exist concerning various aspects of treatment. These controversial management issues include cerebrospinal fluid drainage, antibiotic prophylaxis, timing of surgical intervention, and techniques of repair. Although most cerebrospinal fluid fistulae cease spontaneously, some fistulae persist, resulting in the potential for life-threatening complications. A review of these issues is presented, together with a suggested management protocol.