Depressed Skull Fracture and Cerebrospinal Fluid Rhinorrhea: A Rare Complication after Gamma Knife Radiosurgery Frame Fixation

Abstract Gamma Knife radiosurgery (GKRS) is a widely used minimally invasive alternative procedure to the traditional microsurgery with negligible major procedure-related complications. The common complications include postprocedure headaches, nausea, and, in rare instances, radiation-induced edema leading to seizures and neurological deficits. We present our experience with a 75-year-old gentleman who experienced an unseen complication of a depressed frontal bone fracture and cerebrospinal fluid leakage during the stereotactic frame fixation for GKRS. Anatomical variations like enlarged frontal sinus, postcraniotomy bony defects, osteoporotic bones, systemic causes like metastatic tumors, hyperparathyroidism, granulomatous diseases, and bony anomalies leading to frontal cortex thinning must be kept in mind during the frame fixation for GKRS.