Allensworth JJ, et al. - In this retrospective review, researchers outlined the incidence rate of preoperative intracranial complications (ICCs) in patients with spontaneous skull-based defects, ICC-related risk factors, and the effect of surgical repair on ICC incidence rates. This investigation was conducted in two academic tertiary care medical centers of all spontaneous skull base defects undergoing endoscopic skull base reconstruction from 2005 to 2019. According to results, preoperative ICCs occurred in 46 patients with an incidence rate of 22.7 per 100 person-years in 222 spontaneous skull base defects. For life-threatening ICCs, spontaneous skull base defects pose significant risk. The results show considerably increased ICC development odds associated with resolved CSF rhinorrhea, reduced BMI, longer symptom duration, and defect location. Endoscopic repair with low morbidity is highly successful and significantly lowers the incidence rate of intracranial complications.