Lumbar–Peritoneal Shunt as A Therapeutic AlternativeAfter A Failed ‎Skull Base Defect Repair in A Pediatric Post-Traumatic CSF Leak: A Case ReportAnd Literature Review

  • Authors

    • Si Ali I‎ University of Mostaganem, CHU Mostaganem, Algeria
    • Berdi FZ University of Mostaganem, CHU Mostaganem, Algeria
    • Habib A University of Mostaganem, CHU Mostaganem, Algeria
    • Badache K‎ University of Mostaganem, CHU Mostaganem, Algeria
    https://doi.org/10.14419/r82dc246

    Received date: January 10, 2026

    Accepted date: February 5, 2026

    Published date: February 8, 2026

  • Skull Base Defect; CSF Leak; Lumbar–Peritoneal Shunt; Post-Traumatic Surgery; Therapeutic ‎Alternative

  • Abstract

    Introduction: Cerebrospinal fluid (CSF) leakage secondary to cranial trauma is a rare but ‎serious complication. Surgical repair of the skull base remains the treatment of choice. In ‎cases of surgical failure, placement of a lumbar–peritoneal shunt (LPS) may represent an ‎effective alternative [1], [5], [8], [10]‎

    Case Report: We report the case of a 10-year-old girl who sustained cranial trauma ‎resulting in a skull base fracture and persistent CSF leakage despite initial surgical repair. ‎Placement of a lumbar–peritoneal shunt resulted in complete resolution of the leak without ‎complications.‎

    Discussion: The LPS reduces CSF pressure, thereby facilitating spontaneous closure of the ‎dural defect. This technique is less invasive than repeat surgery and can be used when the ‎initial repair fails [4–15].‎

    Conclusion: Lumbar–peritoneal shunting is a safe and effective therapeutic option for ‎persistent post-traumatic CSF leaks following failed skull base repair.

  • References

    1. Ommaya AK, et al. Cerebrospinal fluid leaks: Management and outcomes. Neurosurgery. 2019;85:123–131.
    2. Schlosser RJ, et al. Endoscopic repair of cerebrospinal fluid leaks. Laryngoscope. 2006;116:1882–1886. https://doi.org/10.1097/01.MLG.0000217644.74806.8F.
    3. Schroeder HW, et al. Lumbar drainage for CSF leaks: Indications and results. Skull Base. 2008;18:123–129.
    4. Hegazy HM, et al. Management of post-traumatic CSF leaks. Neurosurg Rev. 2000;23:1–6.
    5. Dhooge I, et al. Lumbar subarachnoid drainage in cerebrospinal fluid leaks after lateral skull base surgery. Laryngoscope Investig Otolaryngol. 2011;XX:XXX–XXX.
    6. Bell RR, Dierks EJ, Homer L, Potter BE. Management of cerebrospinal fluid leak associated with craniomaxillofacial trauma. J Oral Maxillofac Surg. 2004;62(6):676–684. https://doi.org/10.1016/j.joms.2003.08.032.
    7. Hosameldin A, Osman AA, Abdel Tawab MG. Role of continuous lumbar drainage in cerebrospinal fluid leak: A prospective study. Med J Cairo Univ. 2019;87(7):4847–4851. https://doi.org/10.21608/mjcu.2019.85227.
    8. Hussein M, Abdellatif M. Continuous lumbar drainage for the prevention and management of perioperative cerebrospinal fluid leakage. Asian J Neu-rosurg. 2019;14(2):473–478. https://doi.org/10.4103/ajns.AJNS_265_18.
    9. Lobo BC, Baumanis M, Nelson RF. Surgical repair of spontaneous cerebrospinal fluid (CSF) leaks: A systematic review. Laryngoscope Investig Oto-laryngol. 2017;2(5):215–224. https://doi.org/10.1002/lio2.75.
    10. Fayad JN, et al. Lumbar drainage in endoscopic skull base surgery: Efficacy and safety. Otolaryngol Head Neck Surg. 2018;158:803–811.
    11. Harvey RJ, et al. Does lumbar drainage reduce postoperative CSF leak after endoscopic endonasal skull base surgery? Laryngoscope. 2018;128:1234–1241.
    12. MSD Manuals. Post-lumbar puncture headache and CSF hypotension. [Online] 2025.
    13. Greenlee JDW, Teo C, Ghahreman A, Kwok B. Lumbar cerebrospinal fluid drainage in skull base surgery. Neurosurg Focus. 2002;12(5):e4.
    14. Zwagerman NT, Wang EW, Shin SS, et al. Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? J Neurosurg. 2018;131(4):1172–1178. https://doi.org/10.3171/2018.4.JNS172447.
    15. Patel PN, Stafford AM, Patrinely JR, et al. The role of cerebrospinal fluid diversion in skull base reconstruction. Otolaryngol Head Neck Surg. 2010;143(4):590–595.
    16. Wang J, Bidari S, Inoue K, Yang H, Rhoton AL Jr. Extensions of the sphenoid sinus: A new classification. Neurosurgery. 2010;66(4):797–816. https://doi.org/10.1227/01.NEU.0000367619.24800.B1.
    17. Prosser JD, Vender JR, Solares CA. Traumatic cerebrospinal fluid leaks. Otolaryngol Clin North Am. 2011;44(4):857–873. https://doi.org/10.1016/j.otc.2011.06.007.
    18. Bernal-Sprekelsen M, Bleda-Vázquez C, Carrau RL. Ascending meningitis secondary to traumatic cerebrospinal fluid leaks. Am J Rhinol. 2000;14(4):257–259. https://doi.org/10.2500/105065800779954473.
    19. Schlosser RJ, Wilensky EM, Grady MS, Bolger WE. Elevated intracranial pressures in spontaneous cerebrospinal fluid leaks. Am J Rhinol. 2003;17(4):191–195. https://doi.org/10.1177/194589240301700403.
    20. Brodie HA. Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae. Neurosurg Clin N Am. 1992;3(2):389–396.
    21. Hammer G, Radberg C. The sphenoid sinus: An anatomical and roentgenologic study. Acta Radiol. 1961;56:401–422. https://doi.org/10.1177/028418516105600601.
    22. Kassam AB, Gardner PA, Snyderman CH, et al. Expanded endonasal approach: Fully endoscopic, completely transnasal approach to the skull base. Neurosurg Focus. 2005;19(1): E6. https://doi.org/10.3171/foc.2005.19.1.7.
    23. Sainte-Rose C, Cinalli G, Roux FE, et al. Management of hydrocephalus in children. Lancet. 2001;358(9287):115–123.
    24. Di Rocco C, Caldarelli M, Massimi L. Shunt-related complications in pediatric neurosurgery. Child's Nerv Syst. 2006;22(8):1029–1038. https://doi.org/10.1007/s00381-006-0149-9.
    25. Reddy GK, Bollam P, Caldito G. Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World Neurosurg. 2014;81(2):404–410. https://doi.org/10.1016/j.wneu.2013.01.096.
    26. Browd SR, Ragel BT, Gottfried ON, Kestle JR. Failure of cerebrospinal fluid shunts: Part I—Obstruction and mechanical failure. Pediatr Neurol. 2006;34(2):83–92. https://doi.org/10.1016/j.pediatrneurol.2005.05.020.

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  • How to Cite

    I‎ , S. A. ., FZ, B. ., A, H. ., & K‎, B. . (2026). Lumbar–Peritoneal Shunt as A Therapeutic AlternativeAfter A Failed ‎Skull Base Defect Repair in A Pediatric Post-Traumatic CSF Leak: A Case ReportAnd Literature Review. International Journal of Medicine, 14(1), 12-16. https://doi.org/10.14419/r82dc246