Frequency of cerebrospinal fluid rhinorrhea in traumatic head injury with pneumocephalus

Background: rain injury from trauma continues to pose a major public health obstacle on a worldwide scale. It stands as the principal cause of disability and death internationally, with lower and middle-income countries experiencing the most severe disease burden. The procedure known as "decompressive craniectomy" involves removing a bone flap after opening the dura mater to control cerebral swelling and alleviate dangerously high intracranial pressure. Decompressive craniectomy has become an established and regularly performed surgical technique in neurosurgical medicine. Objective: To determine the frequency of cerebrospinal fluid rhinorrhea in traumatic head injury with pneumocephalus Setting: This Randomized controlled trial study was conducted at Department of Neurosurgery Bolan Medical College Hospital Quetta. Methodology: Total 144 patients meeting the established inclusion criteria were enrolled in the study. All enrolled patients underwent surgical intervention performed by a single surgical team under general anesthesia, with oversight provided by a research team member. Patients were monitored postoperatively for the development of complications, and statistical analysis was conducted utilizing SPSS version 24.0. Results: The findings demonstrated that the mean patient age was 33.3±7.8 years, with males comprising 73.6% of the cohort. Regarding clinical outcomes, 20.8% of patients achieved a Glasgow Outcome Scale (GOS) score of 5, while 17.4% attained a GOS score of 4. Additionally, 22.9%, 16.0%, and 22.9% of patients demonstrated GOS scores of 1, 2, and 3, respectively. Postoperative complications occurred in 18.1% of patients and included cerebrospinal fluid (CSF) leakage (5.5%), surgical site infections (2.1%), and subgaleal hematoma formation (1.4%). The comparative analysis revealed no statistically significant differences between the decompressive craniectomy group and the observation control group with respect to patient age, gender distribution, and clinical outcome measures. Conclusion: It can be concluded form our study that decompressive craniectomy without watertight duraplasty is generally not associated with high prevalence of complications