The study was initiated following the approval of the institutional review board (IRB no.17-215). In This study we aim to address the factors affecting recurrence after repairs of spontaneous cerebrospinal fluid leak, specifically the influence of using lumbar drains.Ī retrospective chart review was carried out with the aim of finding all patients who underwent endoscopic CSF leak repair under the care of one surgeon at King Fahad Medical City, Riyadh, Saudi Arabia. 1, 3 Since it is not a well understood disease entity, and its management lacks a clear evidence base, more studies are needed to properly understand the underlying mechanism and proper management of this disease entity. 1 Excessive pneumatisation of the sinuses is also associated with thinning of the skull base and is well recognized in patients with spontaneous CSF leaks. 3 Erosions of the skull base, specifically in the thinnest areas, are exacerbated by these high pressures. 2 The hypothesis behind IIH ranges from vitamin A metabolic abnormalities, adipose tissues acting as actively secreting endocrine tissues, and cerebral venous anomalies. 1 Obese middle-aged females are more commonly affected by IIH and spontaneous CSF rhinorrhea. 1 They may also have radiographic findings consistent with total or partial empty sella. 1 In the presence of IIH, patients may have other symptoms such as headache, tinnitus, imbalance, and visual disturbances. 1 The classical presentation of spontaneous CSF rhinorrhoea is unilateral intermittent clear watery nasal discharge that may be affected by posture and valsalva manoeuvres.
2 The underlying mechanism of spontaneous CSF leaks is that of circulation which manifests itself via a dehiscence at the skull base. 1 Recent studies have associated the diagnosis of spontaneous CSF leaks with the presence of a raised intracranial pressure (ICP) and an underlying diagnosis of idiopathic intracranial hypertension (IIH). Spontaneous cerebrospinal fluid (CSF) rhinorrhoea is an idiopathic leakage, lacking an identifiable cause such as tumour, trauma, or previous surgery.
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