Frequency of Post-Operative Cerebrospinal Fluid Leak after Infratentorial Surgery

Abstract

Introduction: The infratentorial space (posterior fossa) is the region of the brain below the tentorium cerebelli and contains structures like of the midbrain, pons, medulla oblongata and the cerebellum. Cerebellopontine angle (CPA); an extra-axial region between the cerebellar hemisphere and the pons and is the site of exit for the cranial nerves 5th to 12th is also located infratentorialy. Primary brain tumors are commonly located in the posterior cranial fossa in children and approximately 54 – 70% of all intracranial tumors in children are infratentorial. Eighty-eight percent of all tumors fall into one of the 4 categories, astrocytoma, medulloblastoma, ependymoma and craniopharyngioma.
Objective: The objective of the study is to determine the frequency of post-operative Cerebro spinal fluid (CSF) leak after infratentorial surgery.
Material and Methods: This study was conducted at Department of Neurosurgery, PGMI Lady Reading Hospital, Peshawar. Duration of the study was six months and the study design was descriptive case series in which a total of 132 patients were observed by using 21.4% CSF leak11, 95% confidence level and 7% margin of error with the help of WHO software for sample size determination. More over consecutive non probability sampling technique was used for sample collection.
Results: In this study 67% patients were in age range < 20 years, 20% patients were in age range 21 – 35 years, 10% patients were in age range 36 – 50 years while 3% patients were 51 – 60`years. Mean age was 22 years with a standard deviation of ±5.71. Fifty three patients were male and 47% patients were female. More over 7% patients had CSF leak.
Conclusion: Our study concludes that the incidence of CSF leak after infratentorial surgery was 7% which give us an insight into our complication rate so that we should modify our surgical technique such as we can use fibrin glue or artificial dura in case our rate is high