Cerebrospinal fluid fistula surgical treatment

If the site of leakage is not identified prior to attempted surgical treatment, 30% develop a recurrent leak post-op, with 5–15% of these developing meningitis before the leak is stopped ¹⁾.

There is currently no most ideal technique among the available options. The choice of which technique to be applied in each case is dependent on each surgeon's cumulative experience as well as a clear understanding of the contributory underlying factors in each patient, the nature and site of the leak, the available facilities and equipment ²⁾.

1. Traumatic Cerebrospinal fluid fistula that persists > 2 weeks in spite of non-surgical measures

2. Nontraumatic cerebrospinal fluid fistula and those of delayed onset following trauma or surgery: usually require surgery because of a high incidence of recurrence

3. leaks complicated by recurrent meningitis

Primary and meticulous dural closure is sine qua non in preventing postoperative cerebrospinal fluid fistula.

Several techniques for duraplasty and different materials for Water-tight dural closure have been described.

A plastic dummy with a balloon was developed to test the efficacy of the Water-tight closure of the dura. The technical notes to reproduce the method have been described.

The described model represents a new, simple, effective and affordable device to be used for neurosurgical training in the procedures of duraplasty and to test the efficacy of Water-tight closures ³⁾.

Duraplasty

see Dural substitute.

Dural sealant

Endoscopic endonasal approach for cerebrospinal fluid fistula.

Spinal Dura Repair.

Ventriculoperitoneal shunt for cerebrospinal fluid fistula treatment.