Post traumatic CSF fistulas – a solved problem?

Abstract

Objective: To find the frequency of post-traumatic fistulas in acquire data in neurosurgery department of District Hospital Rawalpindi. Study Design: Descriptive Retrospective Study. Setting: Department of Neurosurgery in District Hospital Rawalpindi. Period: July 2017 to 2019. Material & Methods: Total 70 Patients presented with CSF leaks from either ear or nose or scalp wound following head trauma. All these patients underwent treatment in the emergency room because the study of patients included only those to who presented to emergency with head trauma, including some who underwent some surgical procedure as well, apart from the standard conservative management for all patients. Mean and standard deviation of quantitative data (age), was recorded. Categorical data like gender, early and late onset of disease, surgical treatment were expressed in frequencies & percentage. Results: 70 patients including 52(74.2%) male and 18(25.7%) female. The mean ages was 38.34­­+13.21 year. CSF leakage was from nose 33(47%) and ear was 37(53%). At the postoperative period, 8(11%) patients had meningitis and 62(89%) patients had no meningitis. Those patients who treated non surgically as 56(80%) as compared to those who underwent some surgical procedures 14(20%). Majority of the patients 59(84%) had early onset < 48 hours of presentation, while 11(16%) had delayed > 48 hours of CSF leakage. Conclusion: CSF fistulas remain a problem after head trauma, with a significant risk of complications and rarely death, hence requiring prompt diagnosis and careful management. Failure of CSF fistula to heal within an average time of 2 weeks of conservative treatment, usually requires surgical treatment.