Cerebrospinal fluid (CSF) leaks following head injuries are rare complications with significant morbidity and mortality if left untreated. CSF oculorrhea secondary to a cranio-orbital fistula is a rare presentation of this complication. Standard treatment for a CSF leak involves management of intracranial pressure, CSF diversion and surgical repair of any dural defect. Lumbar drains have commonly been inserted to aid in diverting CSF. We describe a case of a 16-year-old male who presented with an open comminuted depressed skull fracture and CSF oculorrhea. Following a bifrontal decompressive craniectomy, he was successfully treated with CSF diversion following a conservative trial using an external ventricular drain. The use of an external ventricular drain for this purpose has not been described in the literature to date. We report this case as a method of demonstrating the use of an external ventricular drain to adequately divert CSF.

BackgroundInterns, or first year junior doctors, have traditionally been used as an adaptable frontline solution to many of the changes in healthcare, utilising their broad skill sets for both direct patient care and administrative burdens. While there are studies that focus on the total hours junior doctors work, there are few that analyse the specific tasks they do and how they dedicate their work time.