An Endoscopic Endonasal Repair of Spontaneous Skull Base Cerebrospinal Fluid Leak

Area of Science:

• Neurology
• Neurosurgery
• Otolaryngology

Background:

• Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure.
• IIH can predispose individuals to spontaneous cerebrospinal fluid (CSF) leaks, particularly at the skull base.
• CSF leaks can present insidiously, complicating diagnosis and management.

Observation:

• A young female presented with clear rhinorrhea, a symptom of a spontaneous CSF leak.
• The underlying cause was diagnosed as undiagnosed idiopathic intracranial hypertension.
• Computerized tomography (CT) identified a defect in the skull base.

Findings:

• The skull base defect was successfully repaired using an endoscopic endonasal approach.
• A lumboperitoneal shunt was placed as an adjuvant treatment.
• The case demonstrates a specific sequence of surgical repair and postoperative care.

Implications:

• Endoscopic endonasal repair is a safe and effective treatment for spontaneous CSF leaks secondary to IIH.
• This approach minimizes invasiveness compared to traditional open surgeries.
• Prompt diagnosis and appropriate management are crucial for preventing complications associated with IIH and CSF leaks.