Open Journal of Modern Neurosurgery, 2020, 10, 114-121 https://www.scirp.org/journal/ojmn ISSN Online: 2163-0585 ISSN Print: 2163-0569 DOI: 10.4236/ojmn.2020.101012 Dec. 18, 2019 114 Open Journal of Modern Neurosurgery Management of Post-Craniotomy Persistent CSF Subgaleal Collection in Skull Base Procedures: Local Experience Hosam Shata, Mahmoud Saad * , Ahmed Nageeb Taha Neurosurgery Department, Mansoura University, Mansoura, Egypt Abstract Background: Post-craniotomy CSF collection is a problem that may cause severe complications as meningitis, wound disruption, prolonged hospitaliza- tion, and additional surgeries. Objective: To evaluate our cases with resistant post-operative subgaleal CSF collection, trying to identify causes and optimal management. Methods: Retrospective review of elective skull base cases dur- ing the period of January 2104 to January 2019 identification of cases with post-operative CSF subgaleal collection, which either managed conservatively or needed a second surgery. Results: 219 patients, 30 of them suffered subga- leal CSF collection, 22 patients improved with non-operative measures, eight patients needed second surgery with pericranial graft augmentation, and ob- literation of subgaleal space resulted in resolution of CSF leak with no mor- bidities. Conclusion: Meticulous tensionless dural closure, obliteration of subgaleal space, tethering of dural grafts to bone edges are useful techniques in preventing post-operative CSF leak. Keywords Subgaleal, CSF, Post-Operative, Dural Repair, Craniotomy 1. Introduction Dural closure is an essential step after intradural neurosurgical procedures to prevent CSF leakage, subcutaneous collections, wound breakdown, intracranial hypotension, neural tissue herniation, meningitis, prolonged hospitalization, and even revision surgery [1]. Primary closure by sutures is the preferred economic technique when feasible. Different factors can make this simple closure impossi- ble, as absent basal dural edges, dural resection due to infiltration by pathologies, How to cite this paper: Shata, H., Saad, M. and Taha, A.N. (2020) Management of Post-Craniotomy Persistent CSF Subgaleal Collection in Skull Base Procedures: Local Experience. Open Journal of Modern Neurosurgery, 10, 114-121. https://doi.org/10.4236/ojmn.2020.101012 Received: November 14, 2019 Accepted: December 15, 2019 Published: December 18, 2019 Copyright © 2020 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access