Related Experiment Video
Updated: May 16, 2026
08:18
Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model
Published on: February 8, 2022
Spontaneous Middle Cranial Fossa Cerebrospinal Fluid Leaks and Intracranial Hypertension: Systematic Review With
Georgios Vavoulis1, Dimitrios Spinos2,3, Panagiotis Varoutis4
1Department of Neurosurgery General Attica Hospital "KAT" Kifissia Greece.
Laryngoscope Investigative Otolaryngology
|May 15, 2026
Summary
Perioperative lumbar puncture or drain use for spontaneous cerebrospinal fluid leaks does not impact recurrence rates. However, management protocols for intracranial pressure and treatment methods are inconsistently applied and assessed in current literature.
Area of Science:
- Neurosurgery
- Otolaryngology
- Neurology
Background:
- Spontaneous cerebrospinal fluid leaks (sCSFL) in the lateral skull base present complex perioperative management challenges.
- Current literature lacks consensus on optimal cranial pressure assessment and relief strategies for sCSFL.
Purpose of the Study:
- To systematically review and evaluate perioperative cranial pressure assessment protocols and relief methods for lateral skull base sCSFL.
- To synthesize current evidence on the efficacy of medical and invasive interventions for sCSFL management.
Main Methods:
- Systematic literature search of MEDLINE, EMBASE, and Cochrane Library.
- Data extraction included study and patient characteristics, and outcomes related to sCSFL recurrence and management.
- Analysis of 2039 operations, with specific focus on perioperative interventions like lumbar puncture (LP), drain (LD), acetazolamide, and ventriculoperitoneal shunt (VPS).
Main Results:
- Perioperative LP or LD use showed similar recurrence/persistence rates (10.1% vs. 8.9%) compared to non-use.
- Idiopathic intracranial hypertension (IIH) was diagnosed in 14.3% of patients where intracranial pressure was assessed.
- Acetazolamide and VPS were inconsistently utilized across the studied cases (17.7% and 11.2%, respectively).
Conclusions:
- Systematic perioperative LP or LD does not alter sCSFL recurrence or persistence rates.
- Decision-making regarding LP/LD, acetazolamide, and VPS is inconsistently reported, indicating a need for standardized protocols.
- Standardized assessment of intracranial hypertension is frequently neglected in the perioperative management of sCSFL.
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