Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and Complications
Introduction: Cerebrospinal Fluid (CSF) leak is a serious complication in base of skull fractures with high probability of complications like meningitis. Aim: To find out incidence and duration of CSF leak, occurrence of meningitis, type of organism and antibiotic sensitivity and incidence of t...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2021-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/15700/51407_CE[Ra1]_F(SHU)_PF1(SC_SS)_PFA(SC_SHU)_PN(KM).pdf |
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| author | Shinihas Vattaparambil Prakasan Kannoth Shaji Urambath Abu Lijo John Kollannur Binu Areekal |
| author_facet | Shinihas Vattaparambil Prakasan Kannoth Shaji Urambath Abu Lijo John Kollannur Binu Areekal |
| author_sort | Shinihas Vattaparambil |
| collection | DOAJ |
| description | Introduction: Cerebrospinal Fluid (CSF) leak is a serious
complication in base of skull fractures with high probability of
complications like meningitis.
Aim: To find out incidence and duration of CSF leak, occurrence
of meningitis, type of organism and antibiotic sensitivity and
incidence of those requiring surgery among the head injury
patients with base of skull fracture.
Materials and Methods: A prospective cohort study was
conducted in the Neurosurgery and General Surgery Ward,
Government Medical College, Kozhikode, Kerala, India. All
patients with clinically evident CSF leak in base of skull fracture
from 15th April 2017 to 30th November 2018 were included in
the study. Incidence of CSF leak, incidence of meningitis and
patients requiring surgery were noted. Results were expressed
in terms of frequency and percentages.
Results: A total of 167 patients were included in the study. Total
81 (48.49%) patients was between 21-40 age group (years).
The most common mode of injury was road traffic accidents,
accounting to 83.23%. Of the total 167 patients, 35 patients
(20.95%) developed post traumatic CSF leak. Of these 30
(85.71%) had CSF rhinorrhea and 6 (17.14%) had CSF otorrhea.
Duration of CSF leak was 1 day in 18 patients (51.42%), 2-10
days in 10 patients (28.57%), more than 10 days in 7 patients
(20.00%). Meningitis occurred in 9 out of 35 (25.7%) patients.
Most common organism was Streptococcus, found in 2 patients
(22.2%), followed by resistant Klebsiella. Cultures were sterile.
Two Streptococcus infected patients were found to be sensitive
to penicillin. Of the total 35 only 7 patients (20%) needed
surgical interventions.
Conclusion: The incidence of CSF leak in patients with base
of skull fractures is approximately 20%. Most of the cases
resolve spontaneously. With persistent leak, there is significant
morbidity and mortality in the form of meningitis and requirement
of surgery for repair of defect. |
| first_indexed | 2024-12-22T20:00:13Z |
| format | Article |
| id | doaj.art-973022c47ddc4c7b96f500e61bce375d |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-22T20:00:13Z |
| publishDate | 2021-11-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-973022c47ddc4c7b96f500e61bce375d2022-12-21T18:14:17ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-11-011511333610.7860/JCDR/2021/51407.15700Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and ComplicationsShinihas Vattaparambil0Prakasan Kannoth1 Shaji Urambath Abu2Lijo John Kollannur3Binu Areekal4Consultant Neurosurgeon, Department of Neurosurgery, KIMS Al-Shifa Super Speciality Hospital, Perinthalmanna, Malappuram, Kerala, IndiaAssociate Professor, Department of Neurosurgery, Government Medical College, Thrissur, Kerala, India.Associate Professor, Department of Neurosurgery, Government Medical College, Thrissur, Kerala, IndiaAssociate Professor, Department of Neurosurgery, Government Medical College, Thrissur, Kerala, IndiaAdditional Professor, Department of Community Medicine, Government Medical College, Thrissur, Kerala, IndiaIntroduction: Cerebrospinal Fluid (CSF) leak is a serious complication in base of skull fractures with high probability of complications like meningitis. Aim: To find out incidence and duration of CSF leak, occurrence of meningitis, type of organism and antibiotic sensitivity and incidence of those requiring surgery among the head injury patients with base of skull fracture. Materials and Methods: A prospective cohort study was conducted in the Neurosurgery and General Surgery Ward, Government Medical College, Kozhikode, Kerala, India. All patients with clinically evident CSF leak in base of skull fracture from 15th April 2017 to 30th November 2018 were included in the study. Incidence of CSF leak, incidence of meningitis and patients requiring surgery were noted. Results were expressed in terms of frequency and percentages. Results: A total of 167 patients were included in the study. Total 81 (48.49%) patients was between 21-40 age group (years). The most common mode of injury was road traffic accidents, accounting to 83.23%. Of the total 167 patients, 35 patients (20.95%) developed post traumatic CSF leak. Of these 30 (85.71%) had CSF rhinorrhea and 6 (17.14%) had CSF otorrhea. Duration of CSF leak was 1 day in 18 patients (51.42%), 2-10 days in 10 patients (28.57%), more than 10 days in 7 patients (20.00%). Meningitis occurred in 9 out of 35 (25.7%) patients. Most common organism was Streptococcus, found in 2 patients (22.2%), followed by resistant Klebsiella. Cultures were sterile. Two Streptococcus infected patients were found to be sensitive to penicillin. Of the total 35 only 7 patients (20%) needed surgical interventions. Conclusion: The incidence of CSF leak in patients with base of skull fractures is approximately 20%. Most of the cases resolve spontaneously. With persistent leak, there is significant morbidity and mortality in the form of meningitis and requirement of surgery for repair of defect.https://jcdr.net/articles/PDF/15700/51407_CE[Ra1]_F(SHU)_PF1(SC_SS)_PFA(SC_SHU)_PN(KM).pdfanterior cranial fossa repairmeningitisrhinorrhoea |
| spellingShingle | Shinihas Vattaparambil Prakasan Kannoth Shaji Urambath Abu Lijo John Kollannur Binu Areekal Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and Complications Journal of Clinical and Diagnostic Research anterior cranial fossa repair meningitis rhinorrhoea |
| title | Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and Complications |
| title_full | Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and Complications |
| title_fullStr | Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and Complications |
| title_full_unstemmed | Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and Complications |
| title_short | Cerebrospinal Fluid Leak in Base of Skull Fractures- Incidence and Complications |
| title_sort | cerebrospinal fluid leak in base of skull fractures incidence and complications |
| topic | anterior cranial fossa repair meningitis rhinorrhoea |
| url | https://jcdr.net/articles/PDF/15700/51407_CE[Ra1]_F(SHU)_PF1(SC_SS)_PFA(SC_SHU)_PN(KM).pdf |
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