Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-26T14:16:48.261Z Has data issue: false hasContentIssue false

Chapter 20 - Neurosurgical Complications of Head Injury

Published online by Cambridge University Press:  28 April 2020

Peter C. Whitfield
Affiliation:
Derriford Hospital, Plymouth
Jessie Welbourne
Affiliation:
University Hospitals, Plymouth
Elfyn Thomas
Affiliation:
Derriford Hospital, Plymouth
Fiona Summers
Affiliation:
Aberdeen Royal Infirmary
Maggie Whyte
Affiliation:
Aberdeen Royal Infirmary
Peter J. Hutchinson
Affiliation:
Addenbrooke’s Hospital, Cambridge
Get access

Summary

A traumatic skull base fracture can breach the dura, leading to a communication, or fistula, from the intracranial cavity to the external environment. This leads to a risk of cerebrospinal fluid (CSF) leak in 10%–30% of patients, highest in fractures of the anterior cranial fossa.1 CSF can subsequently leak from the nose (rhinorrhoea) or ear (otorrhoea). Many CSF leaks will seal spontaneously within 1–2 weeks with conservative management, but if CSF leakage is prolonged, then operative repair of the fistula is needed (see Chapter 18 for details on CSF leak diagnosis and management).

Type
Chapter
Information
Traumatic Brain Injury
A Multidisciplinary Approach
, pp. 247 - 257
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Phang, SY, Whitehouse, K, Lee, L, Khalil, H, McArdle, P, Whitfield, PC. Management of CSF leak in base of skull fractures in adults. Br J Neurosurg 2016;30(6):596604.CrossRefGoogle ScholarPubMed
Hegazy, HM, Carrau, RL, Snyderman, CH, Kassam, A, Zweig, J. Transnasal endoscopic repair of cerebrospinal fluid rhinorrhoea: a meta-analysis. Laryngoscopy 2000;110:1166–72.Google Scholar
Solomiichuk, VO, Lebed, VO, Drizhdoz, KI. Posttraumatic delayed subdural tension pneumocephalus. Surg Neurol Int 2013;4:37.Google Scholar
Eljamel, MS. Antibiotic prophylaxis in unrepaired CSF fistulae. Br J Neurosurg 1993;7(5):501–5.Google Scholar
Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy. Antimicrobial prophylaxis in neurosurgery and after head injury: infection. The Lancet 1994;344(8936):1547–51.Google Scholar
Ratilal, BO, Costa, J, Pappamikali, L, Sampaio, C. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Cochrane Database Syst Rev 2015;28(4):CD004884.Google Scholar
Hedberg, AL, Pauksens, K, Enblad, P, et al. Pneumococcal polysaccharide vaccination administered early after neurotrauma or neurosurgery. Vaccine 2017;35(6):909–15.Google Scholar
Bullock, MR, Chesnut, R, Ghaiar, J, et al. Surgical management of depressed cranial fractures. Neurosurgery 2006;58(3 Suppl):S5660.Google Scholar
Bayston, R, de Louvois, J, Brown, EM, Johnston, RA, Lees, P, Pople, IK. Use of antibiotics in penetrating craniocerebral injuries ‘Infection in Neurosurgery’ Working Party of British Society for Antimicrobial Chemotherapy. Lancet 2000;355:1813–17.Google Scholar
Jamjoom, AAB, Joannides, AJ, Poon, MT, et al. Prospective, multicentre study of external ventricular drainage-related infections in the UK and Ireland. J Neurol Neurosurg Psychiatry 2018;89(2):120–6.CrossRefGoogle ScholarPubMed
Cui, Z, Wang, B, Zhong, Z, et al. Impact of antibiotic- and silver-impregnated external ventricular drains on the risk of infections: a systematic review and meta-analysis. Am J Infect Control 2015;43(7):e2332.Google Scholar
Sonabend, AM, Korenfield, Y, Crisman, C, Badjatia, N, Mayer, SA, Connolly, ES Jr. Prevention of ventriculostomy-related infections with prophylactic antibiotics and antibiotic-coated external ventricular drains: a systematic review. Neurosurgery 2011;68(4):9961005.Google Scholar
Carney, N, Totten, AM, O’Reilly, C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017;80(1):615.CrossRefGoogle ScholarPubMed
Annegers, JF, Hauser, A, Coan, SP, Rocca, WA. A population-based study of seizures after traumatic brain injuries. N Engl J Med 1998;338(1):20–4.Google Scholar
Jennett, WB. Predicting epilepsy after blunt head injury. Br Med J 1965;1(5444):1215–16.Google Scholar
Christensen, J, Pedersen, MG, Pdersen, CB, Sidenius, P, Olsen, J, Vestergaard, M. Long-term risk of epilepsy after traumatic brain injury in children and young adults. Lancet 2009;373(9669):1105–10.CrossRefGoogle ScholarPubMed
De Reuck, J. Risk factors for late onset seizures related to cerebral contusions in adults with a moderate traumatic brain injury. Clin Neurol Neurosurg 2011:113(6):469–71.Google Scholar
Englander, J, Bushnik, T, Duong, TT, et al. Analyzing risk factors for late post-traumatic seizures. Arch Phys Med Rehabil 2003;84:365–73.Google Scholar
Temkin, NR, Dikmen, SS, Wilensky, AJ, Keihm, J, Chabal, S, Winn, HR. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. N Engl J Med 1990;323(8):497502.Google Scholar
Thompson, K, Pohlmann-Eden, B, Campbell, LA, Abel, H. Pharmacological treatments for preventing epilepsy following traumatic head injury. Cochrane Database Syst Rev 2015;8:CD009900.Google Scholar
Temkin, NH, Dikmen, SS, Anderson, GD, et al. Valproate therapy for prevention of posttraumatic seizures: a randomized trial. J Neurosurg 1999; 91(4):593600.CrossRefGoogle ScholarPubMed
Fuller, KL, Wang, YY, Cook, MJ, Murphy, MA, D’Souza, WJ. Tolerability, safety and side effects of levetiracetam versus phenytoin in intravenous and total prophylactic regimen among craniotomy patients: a prospective randomized study. Epilepsia. 2013;54(1):4557.Google Scholar
Jones, KE, Puccio, AM, Harshaman, KJ, et al. Levetiracetam versus phenytoin for seizure prophylaxis in severe traumatic brain injury. Neurosurg Focus 2008;25(4):E3.CrossRefGoogle ScholarPubMed
Zafar, SN, Khan, AA, Ghauri, AA, Shamim, MS. Phenytoin versus Leviteracetam for seizure prophylaxis after brain injury – a meta analysis. BMC Neurol 2012;12:30.Google Scholar
Lim, DA, Tarapore, P, Chang, E, et al. Safety and feasibility of switching from phenytoin to levetiracetam monotherapy for glioma-related seizure control following craniotomy: a randomized phase II pilot study. J Neurooncol 2009;93(3):349–54.Google Scholar
Szaflarski, JP, Sangha, KS, Lindsell, CJ, Shutter, LA. Prospective, randomized, single blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis. Neurocrit Care 2010;12(2):165–72.Google Scholar
Ronne-Engstrom, E, Winkler, T. Continuous EEG monitoring in patients with traumatic brain injury reveals a high incidence of epileptiform activity. Acta Neurol Scand 2006;114(1):4753.CrossRefGoogle ScholarPubMed
Santarius, T, Kirkpatrick, PJ, Ganesan, D, et al. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet 2009;374(9695):1067–73.Google Scholar
Edlmann, E, Girogi-Coll, S, Whitfield, PC, Carpenter, KLH, Hutchinson, PJ. Pathophysiology of chronic subdural haematoma: inflammation, angiogenesis and implications for pharmacotherapy. J Neuroinflammation 2017;14(1):108.Google Scholar
Berghauser Pont, LM, Dirven, CM, Dippel, DW, Verweij, BH, Dammers, R. The role of corticosteroids in the management of chronic subdural hematoma: a systematic review. Eur J Neurol 2012;19(11):1397–403.Google Scholar
Emich, S, Richling, B, McCoy, MR, et al. The efficacy of dexamethasone on reduction in the reoperation rate of chronic subdural haematoma – the DRESH study: straightforward study protocol for a randomized controlled trial. Trials. 2014;15(1):6.CrossRefGoogle ScholarPubMed
Bauer, DF, McGwin, G Jr, Melton, SM, George, RL, Markert, JM. Risk factors for conversion to permanent ventricular shunt in patients receiving therapeutic ventriculostomy for traumatic brain injury. Neurosurgery 2001;68(1):85–8.Google Scholar
Murthy, SB, Awad, I, Aldrich, F, et al. Permanent CSF shunting after intraventricular hemorrhage in the CLEAR III trial. Neurology 2017;89(4):355–62.Google Scholar
Marmarou, A, Foda, MA, Bandho, K, et al. Posttraumatic ventriculomegaly: hydrocephalus or atrophy? A new approach for diagnosis using CSF dynamics. J Neurosurg 1996;85(6):1026–35.Google Scholar
Jin, H, Wang, S, Hou, L, et al. Clinical treatment of traumatic brain injury complicated by cranial nerve injury. Injury 2010;41(9):918–23.Google Scholar
Schofield, PW, Moore, TM, Gardner, A. Traumatic brain injury and olfaction: a systematic review. Front Neurol 2014;5:5.Google Scholar
He, Z, Li, Q, Yuan, J, et al. Evaluation of transcranial surgical decompression of the optic canal as a treatment option for traumatic optic neuropathy. Clin Neurol Neurosurg 2015;134:130–5.Google Scholar
Lin, C, Dong, Y, Lv, L, Yu, M, Hou, L. Clinical features and functional recovery of traumatic isolated oculomotor nerve palsy in mild head injury with sphenoid fracture. J Neurosurg 2013;118(2):364–9.Google Scholar
Brodie, HA, Thompson, TC. Management of complications from 820 temporal bone fractures. Am J Otol 1997;18(2):188–97.Google Scholar
Darrouzet, V, Duclos, JY, Liguoro, D, Truilhe, Y, De Bonfils, C, Bebear, JP. Management of facial paralysis resulting from temporal bone fractures: our experience in 115 cases. Otolaryngol Head Neck Surg 2001;125(1):7784.Google Scholar
Finsterer, J, Grisold, W. Disorders of the lower cranial nerves. J Neurosci Rural Pract 2015;6(3):377–91.Google Scholar
deSouza, RM, Crocker, MJ, Haliasos, N, Rennie, A, Saxena, A. Blunt traumatic vertebral artery injury: a clinical review. Eur Spine J 2011;20(9):1405–16.Google Scholar
Alterman, DM, Heidel, RE, Daley, BJ, et al. Contemporary outcomes of vertebral artery injury. J Vasc Surg 2013;57(3):741–6.Google Scholar
Joshi, DK, Singh, DD, Garg, DD, Singh, DH, Tandon, DM. Assessment of clinical improvement in patients undergoing endovascular coiling in traumatic carotid cavernous fistulas. Clin Neurol Neurosurg 2016;149:4654.Google Scholar
Larson, PS, Reisner, A, Morassutti, DJ, Abdulhadi, B, Harpring, JE. Traumatic intracranial aneurysms. Neurosurg Focus 2000;8(1):e4.Google Scholar
McCrory, P, Johnston, K, Meeuwisse, W, et al. Summary and agreement statement of the 2nd International conference on concussion in sport, Prague 2004. Clin J Sport Med 2005;15:4857.Google Scholar
Saunders, RL, Harbaugh, RE. The second impact in catastrophic contact-sports head trauma. JAMA 1984;252(4):538–9.Google Scholar
Gavett, BE, Stern, RA, McKee, AC. Chronic traumatic encephalopathy: a potential late effect of sport-related concussive and subconcussive head trauma. Clin Sports Med 2011;30(1):179–88.Google Scholar
Martland, HS. Punch drunk. JAMA 1928;9a:1103–7.Google Scholar
Millspaugh, JA. Dementia pugilistica. US Naval Bull 1937;35:297302.Google Scholar
Corsellis, JAN. Boxing and the brain. Br Med J 1989;298:105–9.CrossRefGoogle ScholarPubMed
Roberts, AH. Brain damage in boxers: a study of the prevalence of traumatic encephalopathy among ex-professional boxers. London: Pitman; 1969.Google Scholar
Loosemore, M, Knowles, CH, Whyte, GP. Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies. Br Med J 2007;335:809–12.CrossRefGoogle ScholarPubMed
McCrory, P. Boxing and the risk of chronic brain injury. Br Med J 2007;335:781–2.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×