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Management of Intractable Cerebrospinal Fluid Collection after Cerebellar Tumor Resection: A Case Report  

Rha, Eun Young (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Oh, Deuk Young (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Kim, Hye Young (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Lee, Jung Ho (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Moon, Suk Ho (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Seo, Je Won (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Rhie, Jong Won (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Ahn, Sang Tae (Department of Plastic Surgery, College of Medicine, The Catholic University of Korea)
Publication Information
Archives of Craniofacial Surgery / v.11, no.2, 2010 , pp. 95-98 More about this Journal
Abstract
Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.
Keywords
Cerebellar neoplasms; Cerebrospinal fluid leakage; Free latissimus dorsi muscle flap;
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1 Dubey A, Sung WS, Shaya M, Patwardhan R, Willis B, Smith D, Nanda A: Complications of posterior cranial fossa surgery-an institutional experience of 500 patients. Surg Neurol 72: 369, 2009   DOI   ScienceOn
2 Abuzayed B, Kafadar AM, Oğuzoğlu ŞA, Canbaz B, Kaynar MY: Duraplasty using autologous fascia lata reenforced by on-site pedicled muscle flap: Technical note. J Craniofac Surg 20: 435, 2009   DOI   ScienceOn
3 Djalilian HR, Gapany M, Levine SC: Reconstruction of complicated skull base defects utilizing free tissue transfer. Skull Base 12: 209, 2002   DOI   ScienceOn
4 Than KD, Baird CJ, Olivi A: Polyethylene glycol hydrogel dural selant may reduce incisional cerebrospinal fluid leak after posterior fossa surgery. Neurosurgery 63: ONS182, 2008   DOI
5 Steinbok P, Singhal A, Mills J, Cochrane DD, Price AV: Cerebrospinal fluid leak and pseudomeningocele formation after posterior fossa tumor resection in children: a retrospective analysis. Childs Nerv Syst 23: 171, 2007   DOI   ScienceOn
6 Weber SM, Kim JH, Wax MK: Role of free tissue transfer in skull base reconstruction. Otolaryngol Head Neck Surg 136: 914, 2007   DOI   ScienceOn
7 Hyun SJ, Rhim SC, Ra YS: Repair of a cerebrospinal fluid fistula using a muscle pedicle flap: technical case report. Neurosurgery 65: E1214, 2009   DOI   ScienceOn
8 Bullock R, Soares D: Current imaging of cerebrospinal fluid leaks. West Indian Med J 58: 362, 2009