Chronic Post-craniotomy Fistula Persisting for Seven Years in a Patient With Neurofibromatosis Type 2

Chronic post-craniotomy draining fistulas are rare complications, particularly in patients who have received prior antibiotic therapy. Individuals with neurofibromatosis type 2 (NF2) may face heightened risk due to repeated cranial interventions, impaired wound healing, radiation exposure, and tumor burden. Persistent fistulas in this population are infrequently reported. We describe an unusual case of a chronic post-craniotomy draining fistula persisting for more than seven years in a patient with NF2 who had undergone multiple cranial surgeries and prior radiation therapy for tumor management, along with an antibiotic course for osteomyelitis in the past. Despite intermittent antibiotic treatment and conservative wound care, the draining sinus tract remained unresolved. This case underscores the importance of maintaining a high index of suspicion for chronic fistula formation in complex neurosurgical patients, even years after the index procedure. Early recognition and multidisciplinary management are essential to prevent prolonged morbidity and optimize surgical outcomes.