Evidence map›Paper›PMID 39738756›Full record

SynthesisNeurosurgical review2024

Evidence-based approaches to cranial cerebrospinal fluid leaks in low- and middle-income countries: a systematic review of the literature.

Sean O'Leary, Prashanth Gowda, Akshay Prabhakar, Abigail Jenkins, Kwadwo Darko, Faraaz Azam, Ariadna Robledo, Aaron E Luna, Nancy A Bonsrah, Megan E H Still and 5 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Sean O'LearyDepartment of Neurosurgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA. smoleary@utmb.edu.
Prashanth GowdaDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Akshay PrabhakarDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Abigail JenkinsDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Kwadwo DarkoDepartment of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana.
Faraaz AzamDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Ariadna RobledoDepartment of Neurosurgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.
Aaron E LunaDepartment of Neurosurgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.
Nancy A BonsrahDepartment of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Megan E H StillDepartment of Neurosurgery, University of Florida, Gainesville, FL, USA.
Salah G AounDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Brett A WhittemoreDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Umaru BarrieDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Bruno P BragaDepartment of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Teddy TotimehDepartment of Neurosurgery, Accra Medical Centre, Accra, Ghana.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cerebrospinal fluid (CSF) leaks commonly occur due to trauma or surgical procedures. Here we review CSF leak diagnosis and management in Low- and Middle-Income Countries (LMICs). A systematic review of the CSF leak management in LMICs was conducted using PubMed, Google Scholar, Embase and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eighteen articles with 3,596 patients (mean age = 39.58 years) were analyzed. Of these patients, 31.37% (1,128/3,596) were reported to have developed cranial CSF leaks. The predominant presentation of CSF leak included symptoms of rhinorrhea, headache, meningitis, and visual impairment. The primary etiology of CSF leak was complications from endoscopic surgery (482 patients), followed by spontaneous origin (46 patients), craniotomy (44 cases), and trauma from motor vehicle accidents (43 cases). Computed tomography (CT) scans (10 retrospective, 15 case, and 1 comparative study) and magnetic resonance imaging (MRI) (6 retrospective, 11 case, and 2 comparative studies) were identified as the most utilized diagnostic modalities. The endoscopic endonasal technique emerged as the predominant surgical approach for managing CSF leak (5 retrospective, 13 case, and 1 comparative study). Moreover, both acellular dermal matrix and turbinate flaps demonstrated comparable repair rates in the management of CSF rhinorrhea (95.23% and 96.00%, respectively). Additionally, porcine-derived fibrin sealant exhibited enhanced success rates for repairs in craniotomies, increasing from 49.21% to 97.81%. This study demonstrates progress in the diagnosis, treatment, and management of cerebrospinal fluid (CSF) leaks within LMICs, including the noteworthy advancement from traditional microscope utilization to the endoscopic endonasal technique.

Indexed as

Cerebrospinal Fluid LeakDeveloping CountriesCerebrospinal Fluid RhinorrheaEvidence-Based MedicineHumansCerebrospinal fluidCSFCSF leakGlobal neurosurgeryLMICsLow- and middle-income countries

Identifiers

PMID39738756

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.