Management of CSF leak

CSF is an ultra-filtrate of plasma or serum containing electrolytes, glucose, and proteins. Located in the cerebral ventricles and cranial/spinal subarachnoid space, this fluid serves as a physical support and provides buoyancy for the brain and spinal elements. CSF also serves to maintain homeostasis of neural tissues by removing by-products of metabolism and regulating the chemical environment of the brain. CSF leak occurs when the fluid escapes through a small tear or hole in the dura mater that surrounds the brain and spinal cord and holds in the CSF. The loss of CSF causes the previously cushioned brain to sag inside the skull, which results in a headache. CSF leaks can occur in the brain (cranial CSF leak) or at any point along the spinal column (spinal CSF leak).The intracranial approach offers the most predictable repair and should be first-line treatment for patients with large skull base defects or very profuse leaks. The majority of posttraumatic CSF leaks resolve without surgical intervention. Successful management of refractory cases involves a combination of observation and bed rest, CSF diversion,extracranial or intracranial procedures.

Autorentext

O autor é um cirurgião bucomaxilofacial apaixonado pelo campo da medicina e em constante busca por pesquisar e aprender sobre a multiplicidade do mundo vivo.