Display options
Cite
Stoker MA, Forbes JA, Hanif R, et al. Decreased Rate of CSF Leakage Associated with Complete Reconstruction of Suboccipital Cranial Defects. J Neurol Surg B Skull Base. 2012;73(4):281-6doi: 10.1055/s-0032-1312709.
Stoker, M. A., Forbes, J. A., Hanif, R., Cooper, C., Nian, H., Konrad, P. E., & Neimat, J. S. (2012). Decreased Rate of CSF Leakage Associated with Complete Reconstruction of Suboccipital Cranial Defects. Journal of neurological surgery. Part B, Skull base, 73(4), 281-6. https://doi.org/10.1055/s-0032-1312709
Stoker, Michael A, et al. "Decreased Rate of CSF Leakage Associated with Complete Reconstruction of Suboccipital Cranial Defects." Journal of neurological surgery. Part B, Skull base vol. 73,4 (2012): 281-6. doi: https://doi.org/10.1055/s-0032-1312709
Stoker MA, Forbes JA, Hanif R, Cooper C, Nian H, Konrad PE, Neimat JS. Decreased Rate of CSF Leakage Associated with Complete Reconstruction of Suboccipital Cranial Defects. J Neurol Surg B Skull Base. 2012 Aug;73(4):281-6. doi: 10.1055/s-0032-1312709. PMID: 23905005; PMCID: PMC3424035.
Copy Download .nbib Format: NLM
Share it on

J Neurol Surg B Skull Base. 2012 Aug;73(4):281-6. doi: 10.1055/s-0032-1312709.

Decreased Rate of CSF Leakage Associated with Complete Reconstruction of Suboccipital Cranial Defects.

Journal of neurological surgery. Part B, Skull base

Michael A Stoker, Jonathan A Forbes, Rimal Hanif, Calvin Cooper, Hui Nian, Peter E Konrad, Joseph S Neimat

Affiliations

  1. Vanderbilt University School of Medicine, Nashville, Tennessee, United States.

PMID: 23905005 PMCID: PMC3424035 DOI: 10.1055/s-0032-1312709

Abstract

Background Cerebrospinal fluid (CSF) leakage represents a major source of morbidity following microvascular decompression (MVD) surgery. The objective of this study was to retrospectively assess whether complete versus incomplete reconstruction of the suboccipital cranial defect influences the incidence of CSF leakage following MVD. Methods We reviewed the charts of 100 patients who consecutively underwent MVD for trigeminal neuralgia by two attending neurosurgeons between July 2004 and April 2010. Operative variables including incomplete or complete calvarial reconstruction, primary dural closure or dural closure with adjunct, and use of lumbar drainage were recorded. The effect of complete calvarial reconstruction on the incidence of postoperative CSF leakage was examined using a multivariate logistic regression model. Results Of the 36 patients whose wound closure was reconstructed with a complete cranioplasty, 2 (5.6%) patients experienced a postoperative CSF leak. Of the 64 patients whose wound closure was augmented with an incomplete cranioplasty, 15 (23.4%) experienced a postoperative CSF leak. There was suggestive but inconclusive evidence that the risk of CSF leakage following MVD was smaller with complete reconstruction of calvarial defect than with incomplete reconstruction (two-sided p value = 0.059), after accounting for age, dural closure method, use of lumbar drainage, and previous MVD. Conclusion Complete reconstruction of the suboccipital cranial defect decreases the risk of CSF leakage.

Keywords: cerebrospinal fluid leak; craniectomy; microvascular decompression; pseudomeningocele; suboccipital

References

  1. Surg Neurol. 1996 Apr;45(4):336-40 - PubMed
  2. Surg Neurol. 2005 Dec;64(6):490-3, discussion 493-4 - PubMed
  3. Neurosurgery. 2008 May;62(5 Suppl 2):ONSE342-3; discussion ONSE343 - PubMed
  4. J Neurosurg. 1995 Feb;82(2):201-10 - PubMed
  5. Pediatr Neurosurg. 2004 May-Jun;40(3):101-6 - PubMed
  6. Surg Neurol. 2009 Oct;72(4):369-75 - PubMed
  7. J Neurol Neurosurg Psychiatry. 2000 Jan;68(1):59-64 - PubMed
  8. Neurosurg Rev. 2007 Apr;30(2):139-42; discussion 142 - PubMed
  9. Neurosurgery. 2008 Jul;63(1 Suppl 1):ONS182-6; discussion ONS186-7 - PubMed
  10. Skull Base. 2004 May;14(2):77-84 - PubMed
  11. Acta Neurochir (Wien). 2005 Oct;147(10):1019-26; discussion 1026 - PubMed
  12. J Neurosurg. 2008 Dec;109 Suppl:160-72 - PubMed
  13. Childs Nerv Syst. 2007 Feb;23(2):171-4; discussion 175 - PubMed
  14. Neurosurgery. 2003 Dec;53(6):1436-41; discussion 1442-3 - PubMed
  15. J Neurosurg. 1987 May;66(5):681-5 - PubMed
  16. Clin J Pain. 2002 Jan-Feb;18(1):35-41 - PubMed
  17. Head Face Med. 2008 Jul 02;4:11 - PubMed
  18. Neurosurg Focus. 2000;9(1):e4 - PubMed
  19. Minim Invasive Neurosurg. 2005 Dec;48(6):369-72 - PubMed
  20. N Engl J Med. 1996 Apr 25;334(17):1077-83 - PubMed
  21. Minim Invasive Neurosurg. 1999 Jun;42(2):92-6 - PubMed

Publication Types