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Any surgical manipulation near the skull base can result in an iatrogenic CSF leak. Skull base injuries can vary from simple cracks in the bony architecture to large (>1 cm) defects with disruption of the dura and potentially brain parenchyma.
UpToDate 18.2 Crack
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A study by Lieberman et al found evidence of a significant incidence of multiple simultaneous skull base defects in cases of spontaneous CSF rhinorrhea, reporting the existence of such defects in eight out of 44 patients (18.2%) in the study. The investigators suggested that intracranial hypertension may put patients at risk for developing these defects. [10]
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