Treatment of postoperative recurrent cerebrospinal fluid leak with pseudo-meningocele formation using temporary epidural drain

Abstract

Abstract Objective Treatment of cerebrospinal fluid (CSF) leak with pseudo meningocele formation can be challenging; especially when attempts to repair it fail. In this paper the authors present four cases in which the problem was fixed using temporary epidural drain. Patients and methods Four patients were treated with this approach over the last 15 years. One patient had cranio-cervical decompression for Chiari malformation with two attempts to fix the CSF leak after the initial operation; two patients had one attempt at operative repair of the leak after the initial operation; and one patient had an attempt to repair of the leak during the initial procedure. Epidural drains were placed percutaneously under local anesthesia. Results Within 2–3 days the wounds were dry and flat. After one week the drains were removed. None of the patients had recurrence of the leak. There was no complication from the drain placement. Conclusion Placement of the epidural catheter is a simple and minimally invasive procedure that solved a complex problem in these four patients. Considering the simplicity of this procedure it is worthwhile trying it prior to considering reoperation.