Our experience in surgical treatment of frontobasal skull injuries associated with liquorrhea in children

During the latest 25 years we have treated 248 patients with fronto ethmoido-orbital or temporobasal skull injuries manifestated with liquorrhea. Fifty-six patients were children with frontobasal skull injuries. Traffic accidents were responsible for frontobasal skull injuries in 33 cases, streetfights in 8 cases, gunshots in 3 cases, falls in 9 cases and others in 6 cases. Fourty-two patients had an early surgery repairing the bone and the dural defect within 36 hours after injury and 14 had late surgery. Local infection was seen in six children with early surgery, meningitis in two children. We had no case with posttraumatic epilepsy in the first group. Preoperatively, meningitis was seen in 8 cases with late surgery, local infection in 4 cases, abscess of the frontal sinus in 2 children. Postoperative hydrocephalus was seen in 2 cases and posttraumatic epilepsia in 11 cases as a late complication after surgery in the second group. Only one child died 6 months after late surgery before the CT-scan era because of temporal lobe abscess. This child had a late surgical treatment of frontoethmoidal bone and dural injury and he had been admitted in the neurosurgical department after 3 episodes of meningitis. Therefore, we prefer early treatment of frontobasal injuries associated with liquorrhea in children, as soon as possible after initial reanimation, to prevent the major complications like meningitis and epilepsy.