How Common Are Cerebrospinal Fluid Leaks After Minor Head Trauma?

Discussion Basilar skulls fractures are relatively common occurring in 4-20% of all skull fractures. Motor vehicle accidents, significant falls from heights and blunt trauma are the most common causes of basilar skull fractures. Basilar skulls fractures are even less common in children than adults. Complications can include meningitis, cerebrospinal fluid (CSF) leaks, cranial nerve injuries or even potentially death. With more significant trauma to the head and body, it is not surprising that complications are more likely. Nasoethmoid facial fractures have similar common mechanisms of injury including motor vehicle accident, falls, and pedestrian struck injuries. A review of the timing for concussion symptom resolution can be found here. Learning Point CSF leaks can present as otorrhea or rhinorrhea with a basilar skull fracture. Most leaks occur within 48 hours of trauma and most stop without specific treatment usually within a couple of days. A study of hospitalized patients with isolated basilar skull fracture using hospital diagnosis data (N=3563 pediatric patients) found that rates were 2.3% for CSF leaks and 0.48% meningitis respectively. In a long-term follow up study of post-traumatic basilar skull fractures in hospitalized children (N=196), 28% had CSF leak with 23% having rhinorrhea, and 89% of those stopped spontaneously. Those that didn’t had complicated presentations and courses. The authors state that for children with normal mentation, neurological ...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news