Fístula incisional intratable de líquido cefalorraquídeo después de craneotomías parasagitales. Descripción del espacio romboidal parasagital de las granulaciones aracnoideas

Abstract

The Cerebrospinal fluid leakage is a frequent complication in neurosurgical practice, especially in skull base; supratentorial procedures have a lower risk and the pathogenesis of arachnoid villi granulations is little mentioned; The following are three cases of intractable leaks after parasagittal craniotomies of the cranial vault; the management was complex, the common were: no visualization of cerebrospinal fluid leakage due to a perceptible dural defect, multiple attempts at graft repair, use of cerebrospinal fluid shunts, infection and prolonged hospitalization; The anatomical basis of the parasagittal rhomboid arachnoid space and the critical management points are discussed.