[Restoration of an occipital cerebrospinal fluid fistula following roentgen injury].

After intensive radiation treatment following resection of a cerebellar tumor, necrosis of the occipital bone led to a chronic cerebrospinal fluid fistula. Because of eventual complications (constant loss of cerebrospinal fluid, meningitis, herniation of the brain) the chronic cerebrospinal fluid fistula needs to be treated as soon as possible. The treatment includes radical resection of the necrotic tissue, direct closure of the cerebrospinal leakage and stable soft tissue coverage. In the case presented closure was achieved with a free autologous fascia graft, cover with a myocutaneous trapezius island flap.