Surgical Management of Meningoencephaloceles and CSF Leaks
The occurrence of thinning or dehiscence of the tegmen cortex is fairly common, and a portion of patients with this finding will demonstrate meningoencephaloceles and CSF skull base fistulas. Surgical repair of these defects should address the osseous and dural defects as well as any underlying intracranial hypertension. Assessing the latter and determining which patients will require long-term CSF diversion are difficult in this setting. We have suggested some risk factors that should be considered in making these decisions.
Conclusions
The occurrence of thinning or dehiscence of the tegmen cortex is fairly common, and a portion of patients with this finding will demonstrate meningoencephaloceles and CSF skull base fistulas. Surgical repair of these defects should address the osseous and dural defects as well as any underlying intracranial hypertension. Assessing the latter and determining which patients will require long-term CSF diversion are difficult in this setting. We have suggested some risk factors that should be considered in making these decisions.
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