Prevention of Cerebrospinal Fluid Leakage: An Evergreen Neurosurgical Issue

Abstract

G alen was the first, in the 2nd century AD, to describe the leakage of cerebrospinal fluid (CSF) after cranial trauma, postulating that it was released into the nose via pituitary and ethmoid regions, but it was not considered a pathologic process until the mid 17th century (7). Only at the beginning of the last centurywere the first attempts to repair CSF leakage reported. In 1926, Dandy reported the first successful operative repair of a CSF leak (2). Even in contemporary neurosurgery, CSF leaks can be a frustrating complication of skull base procedures, and thus it should be considered an evergreen issue. To confirm the continuing interest in this issue, a Pubmed search using “CSF leak surgery” as keywords revealed 422 articles in the last 5 years.