Treatment of cerebrospinal fluid fistulas in patients from Las Tunas

Abstract

Background: indications, approach, time of surgery and use of prophylactic antibiotics in cerebrospinal fluid fistulas remain controversial. Further evidence of the therapeutic effectiveness of different treatment modalities is required.Objective: to describe the results of the treatment algorithm for cerebrospinal fluid fistula, used in patients attended to at the Dr. Ernesto Guevara de la Serna General Teaching Hospital of Las Tunas, from January 2013 to September 2016.Methods: a descriptive and prospective observational study was carried out at the hospital and during the period of time herein mentioned. The sample was made up of 46 patients admitted with a diagnosis of cerebrospinal fluid fistula. A database was created for the information processing that was analyzed using descriptive statistics, using the percentage value to report the results.Results: unilateral or bilateral direct rhinorrhea was the most frequent form of presentation, followed by fluid outflow from the surgical incision and accumulation in the soft tissues. Basilar skull fractures, surgery of posterior fossa tumors and microsurgical dissectomies were the most frequent causes. The highest number of patients benefited from the placement of a continuous spinal drainage.Conclusions: for the treatment of cerebrospinal fluid fistulas, continuous spinal drainage is a feasible option.

Keywords

• cerebrospinal fluid
• cerebrospinal fluid rhinorrhea
• meningitis
• skull fracture, basilar