Cerebrospinal fluid leakage after cranial surgery in the pediatric population-a systematic review and meta-analysis

Emma M H Slot, Kirsten M van Baarsen, Eelco W Hoving, Nicolaas P A Zuithoff, Tristan P C van Doormaal

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)

Abstract

BACKGROUND: Cerebrospinal fluid (CSF) leakage is a common complication after neurosurgical intervention. It is associated with substantial morbidity and increased healthcare costs. The current systematic review and meta-analysis aim to quantify the incidence of cerebrospinal fluid leakage in the pediatric population and identify its risk factors.

METHODS: The authors followed the PRISMA guidelines. The Embase, PubMed, and Cochrane database were searched for studies reporting CSF leakage after intradural cranial surgery in patients up to 18 years old. Meta-analysis of incidences was performed using a generalized linear mixed model.

RESULTS: Twenty-six articles were included in this systematic review. Data were retrieved of 2929 patients who underwent a total of 3034 intradural cranial surgeries. Surprisingly, only four of the included articles reported their definition of CSF leakage. The overall CSF leakage rate was 4.4% (95% CI 2.6 to 7.3%). The odds of CSF leakage were significantly greater for craniectomy as opposed to craniotomy (OR 4.7, 95% CI 1.7 to 13.4) and infratentorial as opposed to supratentorial surgery (OR 5.9, 95% CI 1.7 to 20.6). The odds of CSF leakage were significantly lower for duraplasty use versus no duraplasty (OR 0.41 95% CI 0.2 to 0.9).

CONCLUSION: The overall CSF leakage rate after intradural cranial surgery in the pediatric population is 4.4%. Risk factors are craniectomy and infratentorial surgery. Duraplasty use is negatively associated with CSF leak. We suggest defining a CSF leak as "leakage of CSF through the skin," as an unambiguous definition is fundamental for future research.

Original languageEnglish
Pages (from-to)1439-1447
Number of pages9
JournalChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
Volume37
Issue number5
DOIs
Publication statusPublished - May 2021

Keywords

  • Cerebrospinal Fluid Leak/epidemiology
  • Child
  • Craniotomy/adverse effects
  • Humans
  • Neurosurgical Procedures/adverse effects
  • Postoperative Complications/epidemiology
  • Reconstructive Surgical Procedures
  • Retrospective Studies

Fingerprint

Dive into the research topics of 'Cerebrospinal fluid leakage after cranial surgery in the pediatric population-a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this