Spontaneous CSF leak
Last week operated a challenging case of spontaneous CSF leak in a 40 yr old young lady. She is an avid Kathak dancer and recently had gone for snorkeling. Severe headache with profuse watery discharge from nose and physicians rightly suspected it to be a case of Meningitis with CSF rhino-rhea [Brain fluid leaking into nasal passage through a defect in skull base].
Thoroughly investigated, done CT cysternogrphy and found the suspicious defect in sphenoid sinus.
I myself with Dr Chandrashekhar an eminent neurosurgeon performed the surgery. It was endoscopic trans nasal surgery, defect was identified in sphenoid clivus as multiple tiny leaks in a localised area c,w some drilling done with diamond bur to make a single defect good enough to be plugged with fat , with overlay fascia lata and glue in a five layer closure. Pack was removed on 7th post op day and pt is discharged . This is a very rewarding minimally invasive surgery for a grave problem.
However this lady will have to refrain from her hobbies of dancing and pressure sports like scuba diving .
Thoroughly investigated, done CT cysternogrphy and found the suspicious defect in sphenoid sinus.
I myself with Dr Chandrashekhar an eminent neurosurgeon performed the surgery. It was endoscopic trans nasal surgery, defect was identified in sphenoid clivus as multiple tiny leaks in a localised area c,w some drilling done with diamond bur to make a single defect good enough to be plugged with fat , with overlay fascia lata and glue in a five layer closure. Pack was removed on 7th post op day and pt is discharged . This is a very rewarding minimally invasive surgery for a grave problem.
However this lady will have to refrain from her hobbies of dancing and pressure sports like scuba diving .
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