Cerebrospinal fluid leakage complicating skull base fractures: analysis of 81 cases

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dc.contributor.buuauthorYılmazlar, Selçuk
dc.contributor.buuauthorArslan, Erhan
dc.contributor.buuauthorKocaeli, Hasan
dc.contributor.buuauthorDoğan, Şeref
dc.contributor.buuauthorAksoy, Kaya
dc.contributor.buuauthorKorfalı, Ender
dc.contributor.buuauthorDoygum, Muammer
dc.contributor.departmentUludağ Üniversitesi/Tıp Fakültesi/Nöroşirürji Anabilim Dalı.tr_TR
dc.contributor.orcid0000-0003-3633-7919tr_TR
dc.contributor.researcheridAAH-5070-2021tr_TR
dc.date.accessioned2021-08-24T05:25:38Z
dc.date.available2021-08-24T05:25:38Z
dc.date.issued2006
dc.description.abstractThe aim of this study was to evaluate the results of conservative and surgical management options for traumatic cerebrospinal fluid (CSF) leakage complicating skull base fractures. The subjects were 81 patients who were treated between 1996 and 2003 for CSF leaks that had persisted for 24 h or longer after head injury. For each case the medical records were reviewed, and the data collected were as follows: demographic features, clinical and radiological findings, management options, complications and outcome scores. Analysis was done with patients grouped according to Glasgow coma scale (GCS) score at admission (<= 8 vs >8), and findings for three treatment methods (conservative, CSF drainage, surgery) were evaluated. In 32 cases (39.5%), the CSF leakage resolved spontaneously, and the mean hospital stay for these patients was 14 +/- 11 days. Twenty-four patients (29.6%) were treated by CSF drainage, and seven of these individuals ultimately required surgery to close the leak. Hospital stay was 17 +/- 7 days. Twenty-five patients (30.9%) underwent surgery as the initial treatment step, and the mean hospital stay for these individuals was 15 +/- 9 days. The large majority (74.2%) of patients with admission GCS scores <= 8 had poor outcomes. Compared with this group, a greater proportion of the CSF leaks in the patients with admission GCS scores >8 resolved spontaneously. The factors that had a critical influence on outcome in this series were level of consciousness on admission and presence of additional intracranial pathology associated with CSF leakage within cases of traumatic CSF fistulae due to skull base fractures. Treatment decisions should be dictated by the severity of neurological decline during the emergency period and the presence/absence of associated intracranial lesions. The timing for surgery and CSF drainage procedures must be decided with great care and with a clear strategy. The authors offer a treatment algorithm.en_US
dc.identifier.citationYılmazlar, S. vd. (2006). ''Cerebrospinal fluid leakage complicating skull base fractures: analysis of 81 cases''. Neurosurgical Review, 29(1), 64-71.en_US
dc.identifier.endpage71tr_TR
dc.identifier.issn0344-5607
dc.identifier.issn1437-2320
dc.identifier.issue1tr_TR
dc.identifier.pubmed15937689tr_TR
dc.identifier.scopus2-s2.0-27944489964tr_TR
dc.identifier.startpage64tr_TR
dc.identifier.urihttps://doi.org/10.1007/s10143-005-0396-3
dc.identifier.urihttps://link.springer.com/article/10.1007%2Fs10143-005-0396-3
dc.identifier.urihttp://hdl.handle.net/11452/21538
dc.identifier.volume29tr_TR
dc.identifier.wos000233465600014tr_TR
dc.indexed.pubmedPubmeden_US
dc.indexed.scopusScopusen_US
dc.indexed.wosSCIEen_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.journalNeurosurgical Reviewen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergitr_TR
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectNeurosciences & neurologyen_US
dc.subjectSurgeryen_US
dc.subjectComplicationen_US
dc.subjectSkull base fractureen_US
dc.subjectCerebrospinal fluid leakageen_US
dc.subjectAnterioren_US
dc.subjectDiagnosisen_US
dc.subjectMetaanalysisen_US
dc.subjectFistulasen_US
dc.subjectRhinorrheaen_US
dc.subjectManagementen_US
dc.subjectPhylactic antibioticsen_US
dc.subjectSevere head-injuryproen_US
dc.subjectTemporal bone-fracturesen_US
dc.subject.scopusCerebrospinal Fluid Rhinorrhea; Ethmoid Bone; Encephaloceleen_US
dc.subject.wosClinical neurologyen_US
dc.subject.wosSurgeryen_US
dc.titleCerebrospinal fluid leakage complicating skull base fractures: analysis of 81 casesen_US
dc.typeArticle
dc.wos.quartileQ2 (Surgery)en_US
dc.wos.quartileQ3 (Clinical neurology)en_US

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