Allensworth JJ, et al. - In this retrospective review, researchers characterized the incidence rate of preoperative intracranial complications (ICCs) in patients with spontaneous skull base defects, risk factors correlated with ICC development, and the impact of surgical repair on the incidence rate of ICCs. The sample consisted of all spontaneous skull base defects undergoing endoscopic skull base reconstruction from 2005 to 2019 at 2 academic tertiary care medical centers. Preoperative ICCs occurred in 46 individuals with an incidence rate of 22.7 per 100 person-years in 222 spontaneous skull base defects. According to findings, spontaneous skull base defects pose a major risk to life-threatening ICCs. Factors significantly linked to preoperative ICCs included symptom duration, reduced BMI, resolved cerebrospinal fluid rhinorrhea, and location in the frontal or lateral sphenoid sinuses. Endoscopic repair with low morbidity is highly successful and decreases the incidence rate of intracranial complications significantly.