Risk factors for pseudomeningocele development following craniotomy: a single-center experience from Greece

A pseudomeningocele is a subcutaneous collection of cerebrospinal fluid due to a defect in the dura that occurs after surgery or trauma. Postoperative pseudomeningocele can lead to wound breakdown, intracranial hypotension and meningitis, thus increasing the length of hospitalization and morbidity. Although several clinical and operative variables have been proposed as potential risk factors for this complication, relevant prospective, large-scale studies to investigate these associations are missing. The purpose of this study is therefore to explore the potential correlation between various patient-related, as well as surgical factors, and the development of pseudomeningocele.

A single-center prospective cohort study was performed at the University General Hospital of Alexandroupolis over a 3-year period and included consecutive patients undergoing craniotomy. Patient-related and operative factors, such as craniectomy and the use of synthetic dural graft, were evaluated and statistically analyzed.

Overall, 183 craniotomies were performed and the incidence of postoperative pseudomeningocele was 19%. Among patient-related variables, univariate analyses showed a significant association between obesity and the development of this complication, but the association was not significant on multivariate analysis. The remaining patient-related and surgical factors were not statistically associated with the complication.

Our study presents our institution's experience regarding the risk factors of one of the most commonneurosurgical complications. Future studies should aim at identifying additional risk-factors for pseudomeningocele development in order to improve craniotomy's safety and surgical outcomes.