Cerebrospinal Fluid Leak - Prevalence in Traumatic Head Injury at a Tertiary Care Center

Background: Cerebrospinal fluid circulates around the surface of brain and spinal cord and through the brain’s ventricles. CSF leak is a condition that occurs when the CSF leaks through a defect in the dura or skull and out through the ear or nose. The most common causes of CSF leak include head injury, brain and sinus surgery. The objective of this study was to determine the frequencies of post-traumatic cerebrospinal fluid leak in traumatic head injury. Material and Methods: A descriptive case series was carried out in the Department of Neurosurgery, Hayatabad Medical Complex, Peshawar for a period of 1 year, from 1st February 2016 to 31st January 2017. A total of 422 patients presenting within 48 hours of acute trauma to the head were included in a consecutive manner and followed up till 7th day to determine the CSF leak. Results: The mean age group of our sample was 37.37 + 12.3 years of which 79.6% were male patients and 20.4% female patients. Most of the patients (55.5%) were ≤ 40 years of age. CSF leak was observed in 5.2% of patients, with otorrhea seen in 2.1% patients and rhinorrhea in 3.1% patients, respectively. Conclusion: CSF leak is quite common in our population after acute trauma to the head. The high prevalence may be due to high frequency of accidents in our society with high velocity impact and more commonly seen in the younger age group (≤ 40 years).