In response to in reference to intervention for elevated intracranial pressure improves success rate after repair of spontaneous cerebrospinal fluid leaks

Surgical Management of Spontaneous Cerebrospinal Fluid Rhinorrhea

“…20 These results support routine evaluation and intervention for elevated ICP in sCSF leaks and increase repair success by approximately 10%. 20 Kreatsoulas et al present their series of sCSF leaks, where lumbar drains were used to check CSF opening pressures 24 to 48 hours postoperatively and depending on degree of elevation, patients were advised to start either acetazolamide or CSF diversion. 23 The success rate in this cohort was 96%, with only 2 of 46 patients requiring revision over a 15-month follow-up.…”

“…Patients with obesity have also demonstrated worse outcomes after repair. 20 Weight loss is an effective treatment for IIH and case reports have demonstrated resolution of sCSF rhinorrhea after gastric bypass and weight loss. 1 Patients presenting with obesity should be offered health counseling and referred to a dietician.…”

Spontaneous Cerebrospinal Fluid Leak in a Transgender Man

“…Spontaneous CSF leaks have strong female predilection with an average age at presentation of 50.4 years . Most spontaneous CSF leaks occur in the setting of obesity and idiopathic intracranial hypertension .…”

“…Spontaneous CSF leaks have strong female predilection with an average age at presentation of 50.4 years . Most spontaneous CSF leaks occur in the setting of obesity and idiopathic intracranial hypertension . Idiopathic intracranial hypertension is also associated with polycystic ovarian syndrome in up to 57% of patients, compared with 7% to 18% in the general population.…”

Surgical Management of Spontaneous Cerebrospinal Fluid Rhinorrhea

“…In a prospective case series and systematic review, Teachey et al 20 noted that the most common locations for sCSF leaks were the sphenoid sinus, ethmoid sinus, followed by the frontal sinus. Successful primary repair was performed in 92.82% of patients where ICP evaluation and intervention with acetazolamide or CSF shunting was performed but success rates significantly decreased to 81.87% in patients without active management of ICP.…”