Surgical Outcome of Transcranial Intradural Repair in Post Traumatic Cerebrospinal Fluid Leak

Objective: To study the outcome of Transcranial repair in post traumatic CSF leak in head injury patients Study Design: Prospectively Study Place and Duration: From May 2013 to May 2015 at Pakistan Institute of Medical Sciences, Islamabad. Materials and Methods: All patients who have CSF leak after head injury were included in this study. All cases were studied prospectively at our center during period of 2 years. Patient’s demographic profiles, symptoms and signs, imaging studies, complications and outcome were assessed prospectively. The mean age of patients was 26.20 years, male /female ratio was 72:20, 76 out of 92 were adult and 16 were children. MRI images were used to identify the accurate site of dural rent which is very essential for successful result. Transcranial intradural repair was done in all patients whom dural rent was confirmed on MR images. Results: A total of 92 cases were studied prospectively, all patients were started on prophylactic antibiotics and observed for 72 hours. Patients mostly presented with loss of consciousness, vomiting, nasal or ear bleed, fits and severe headache. In 44 patients CSF leak stopped spontaneously. In 48 patients MRI brain especially T2 images coronal cuts in prone position was done to define the accurate site of CSF leak. 38 out of 48 patients improved (79.16%), 3 patients died (6.25%) and 5 patients still had leak after repair and lumber drain insertion (10.41%) that were reopened. Conclusion: The Transcranial repair (duraplasty) for post traumatic CSF leak is highly effective with good results.