When repairing a spontaneous cerebrospinal fluid (CSF) leak, the surgeon needs to take extra measures to guard against recurrence, according to a team of investigators at the University of Pennsylvania.
Explore this issue:May 2008
Because such leaks have a higher recurrence rate than those occurring secondary to external events, such as trauma or surgery, the team developed a paradigm for managing spontaneous CSF leaks, which they presented at the 2007 annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS).
-James Palmer, MD
The important steps are to first identify what type of leak the patient has-whether iatrogenic, traumatic, congenital, tumor, or spontaneous-and, second, if it is spontaneous, to determine whether the CSF pressure is normal or elevated, said James Palmer, MD, Director of the Division of Rhinology and A ssociate Professor in the Department of Otorhinolaryngology-Head and Neck Surgery at the University of Pennsylvania. If you can identify the nature of the leak, then you can identify the appropriate mechanism for repairing it.