Clinical Presentation and Epidemiology of Traumatic and Iatrogenic Cerebrospinal Fluid Leaks

Cerebrospinal fluid (CSF) leaks occur when the skull base and dura are breached, allowing CSF to escape into sinonasal or tympanomastoid cavities. Traumatic leaks, historically documented to comprise the majority of CSF leaks, happen due to blunt (e.g., motor vehicle accident) or penetrating injuries. Penetrating injuries carry higher morbidity and infection risks. Iatrogenic leaks stem from medical or surgical interventions such as endoscopic sinus surgery, pituitary, and lateral skull base surgeries, or even certain medications. Both types of leaks can lead to serious complications like meningitis, pneumocephalus, and prolonged hospitalization, emphasizing the need for high clinical suspicion and prompt management.