Continuous Lumbar Drainage for the Prevention and Management of Perioperative Cerebrospinal Fluid Leakage

Cerebrospinal fluid (CSF) leak is an unfortunate, yet well-recognized complication of skull base fractures, skull base surgeries, and variety of spinal procedures. Continuous lumbar drainage (CLD) of leaking CSF has shown a high success rate with minimal morbidities in handling CSF leak in these patients. Therefore, we conducted this study to illustrate the efficacy of CLD as a prophylactic and therapeutic method for CSF leakage with the assessment of clinical outcome and early postoperative sequel.

In the period from January to December 2017, patients with traumatic or postoperative CSF leak and those susceptible for postoperative CSF leak as skull base and spinal intradural surgeries at the Neurosurgery Department, Fayoum University, were included in our study.

A total of 20 eligible patients were included in the study. All patients showed successful cessation of CSF leakage at different durations of CLD. Fifteen patients showed excellent results; four showed good results; and one showed fair results. Besides a minimal pneumocephalus, headache was the most common presenting complication in our population, which occurred to all patients. Six patients had vomiting beside headache, whereas two patients experienced vomiting and nausea in addition to headache. There were neither mortalities nor life-threatening complications noted; however, a superficial wound infection occurred in a single case.

CLD is a simple, safe, and efficient method in the management of CSF leakage at operative sites, CSF rhinorrhea, and CSF otorrhea of various etiologies.