The incidence of postoperative cerebrospinal fluid leakage after elective cranial surgery: a systematic review

Cerebrospinal fluid (CSF) leakage is a major complication after elective neurosurgical procedures. The aim of this systematic literature review is to summarize the incidence rates of postoperative cerebrospinal fluid leakage for neurosurgical procedures, classified by surgical approach. The Pubmed,...

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Bibliographic Details
Published in:Neurosurgical review 2022-06, Vol.45 (3), p.1827-1845
Main Authors: Coucke, Birgit, Van Gerven, Laura, De Vleeschouwer, Steven, Van Calenbergh, Frank, van Loon, Johannes, Theys, Tom
Format: Article
Language:English
Subjects:
Cerebrospinal Fluid Leak - epidemiology
Cerebrospinal Fluid Leak - etiology
Cerebrospinal Fluid Leak - surgery
Humans
Incidence
Medicine
Medicine & Public Health
Neurosurgery
Neurosurgical Procedures - adverse effects
Postoperative Complications - etiology
Postoperative Period
Retrospective Studies
Review
Skull Base - surgery
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Summary:Cerebrospinal fluid (CSF) leakage is a major complication after elective neurosurgical procedures. The aim of this systematic literature review is to summarize the incidence rates of postoperative cerebrospinal fluid leakage for neurosurgical procedures, classified by surgical approach. The Pubmed, Cochrane, Embase, and Web of Science databases were searched for studies reporting the outcome of patients undergoing elective neurosurgical procedures. The number of patients, surgical approach, and indication for surgery were recorded for each study. Outcomes related to CSF leakage such as clinical manifestation and treatment were reported as well. One hundred and thirteen studies were included, reporting 94,695 cases. Overall, CSF leaks were present in 3.8% of cases. Skull base surgery had the highest rate of CSF leakage with 6.2%. CSF leakage occurred in 5.9% of anterior skull base procedures, 6.4% of middle fossa, and 5.2% of transpetrosal surgeries. 5.8% of reported infratentorial procedures were complicated by CSF leakage versus 2.9% of supratentorial surgeries. CSF leakage remains a common serious adverse event after cranial surgery. There exists a need for standardized procedures to reduce the incidence of postoperative CSF leakage, as this serious adverse event may lead to increased health care costs.
ISSN:1437-2320
1437-2320
DOI:10.1007/s10143-021-01641-y