Cerebrospinal Fluid Rhinorrhea 34 Years after Trauma: A Case Report and Review of the Literature

Neurosurgery ◽  
1984 ◽  
Vol 15 (5) ◽  
pp. 705-706 ◽  
Author(s):  
Tom Russell ◽  
Brian H. Cummins
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Head Injury ◽  
17Th Century ◽  
Review Of The Literature ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Intracranial Infection

Abstract Posttraumatic cerebrospinal fluid (CSF) rhinorrhea has been recognized since the 17th century, and its association with intracranial infection has been well documented. However, CSF rhinorrhea usually presents during the 1st month after trauma. Cases presenting more than 3 months after trauma are unusual. The authors report a case of CSF rhinorrhea that presented 34 years after head injury.

scholarly journals Delayed Presentation of Traumatic Cerebrospinal Fluid Rhinorrhea: Case Report and Literature Review

2015 ◽  
Vol 6 (3) ◽  
pp. ar.2015.6.0132 ◽  
Author(s):  
Richard A. Guyer ◽  
Justin H. Turner
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Injury ◽  
Skull Base ◽  
Late Onset ◽  
Closed Head Injury ◽  
Csf Leak ◽  
Delayed Presentation ◽  
Traumatic Head Injury ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea

Cerebrospinal fluid (CSF) leak is one of several complications that can occur after traumatic skull base injury. Although most patients present soon after the injury occurs, some can present years later, with resulting morbidity and the need for additional procedures. We present a case of a patient with a sphenoid sinus CSF leak who presented 12 years after a closed head injury that included a sphenoethmoid skull base fracture. We also reviewed the literature on this topic, with a discussion of previous reports of CSF leaks that occurred months, years, or decades after trauma. A late onset CSF leak appears to be a rare but important complication of traumatic skull base injury. This case highlights the need for clinicians to remain vigilant to the possibility of delayed CSF rhinorrhea, even years after traumatic head injury.

scholarly journals A 17-years-old girl presenting with spontaneous cerebrospinal fluid rhinorrhea diagnosed as aqueductal stenosis: A case report

2016 ◽  
Vol 7 (2) ◽  
pp. 134
Author(s):  
Umma Salma ◽  
Mohammad Abdus Sattar Sarker ◽  
Abed Hossain Khan ◽  
Nahida Zafrin ◽  
M. A. Jalil Chowdhury
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Case Report ◽  
Ventriculoperitoneal Shunt ◽  
Chronic Headache ◽  
Aqueductal Stenosis ◽  
Empty Sella ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
History Of

<p>A 17-year-old girl presented with chronic headache and spontaneous CSF rhinorrhea. She had no history of head trauma. MRI of her brain showed aqueductal stenosis associated with triventriculomegaly with partially empty sella. Following insertion of ventriculoperitoneal shunt, her headache and CSF rhinorrhea completely recovered. Though very uncommon but aqueductal stenosis should be kept as a differential diagnosis for etiology of chronic CSF rhinorrhea.</p>

Is posttraumatic cerebrospinal fluid fistula a predictor of posttraumatic meningitis? A US Nationwide Inpatient Sample database study

2012 ◽  
Vol 32 (6) ◽  
pp. E4 ◽  
Author(s):  
Ashish Sonig ◽  
Jai Deep Thakur ◽  
Prashant Chittiboina ◽  
Imad Saeed Khan ◽  
Anil Nanda
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Injury ◽  
Skull Base ◽  
Nationwide Inpatient Sample ◽  
Neurosurgical Procedures ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Factors Associated ◽  
Hospitalization Cost ◽  
Neurosurgical Intervention

Object Various factors have been reported in literature to be associated with the development of posttraumatic meningitis. There is a paucity of data regarding skull fractures and facial fractures leading to CSF leaks and their association with the development of meningitis. The primary objective of this study was to analyze the US Nationwide Inpatient Sample (NIS) database to elucidate the factors associated with the development of posttraumatic meningitis. A secondary goal was to analyze the overall hospitalization cost related to posttraumatic meningitis and factors associated with that cost. Methods The NIS database was analyzed to identify patients admitted to hospitals with a diagnosis of head injury from 2005 through 2009. This data set was analyzed to assess the relationship of various clinical parameters that may affect the development of posttraumatic meningitis using binary logistic regression models. Additionally, the overall hospitalization cost for the head injury patients who did not undergo any neurosurgical intervention was further categorized into quartile groups, and a regression model was created to analyze various factors responsible for escalating the overall cost of the hospital stay. Results A total of 382,267 inpatient admissions for head injury were analyzed for the 2005–2009 period. Meningitis was reported in 0.2% of these cases (708 cases). Closed skull base fractures, open skull base fractures, cranial vault fractures, and maxillofacial fractures were reported in 20,524 (5.4%), 1089 (0.3%), 5064 (1.3%), and 88,649 (23.2%) patients, respectively. Among these patients with fractures, meningitis was noted in 0.17%, 0.18%, 0.05%, and 0.10% admissions, respectively. Cerebrospinal fluid rhinorrhea was reported in 453 head injury patients (0.1%) and CSF otorrhea in 582 (0.2%). Of the patients reported to have CSF rhinorrhea, 35 (7.7%) developed meningitis, whereas in the cohort with CSF otorrhea, 15 patients (2.6%) developed meningitis. Cerebrospinal fluid rhinorrhea (p < 0.001, OR 22.8, 95% CI 15.6–33.3), CSF otorrhea (p < 0.001, OR 9.2, 95% CI 5.2–16.09), and major neurosurgical procedures (p < 0.001, OR 5.6, 95% CI 4.8–6.5) were independent predictors of meningitis. Further, CSF rhinorrhea (p < 0.001, OR 2.0, 95% CI 1.6–2.7), CSF otorrhea (p < 0.001, OR 2.3, 95% CI 1.9–2.7), and posttraumatic meningitis (p < 0.001, OR 3.1, 95% CI 2.5–3.8) were independent factors responsible for escalating the cost of head injury in cases not requiring any major neurosurgical intervention. Conclusions Cerebrospinal fluid rhinorrhea and CSF otorrhea are independent predictors of posttraumatic meningitis. Furthermore, meningitis and CSF fistulas may independently lead to significantly increased cost of hospitalization in head injury patients not undergoing any major neurosurgical intervention.

Bromocriptine-Induced Cerebrospinal Fluid Rhinorrhea in Invasive Prolactinoma: Case Report and Review of the Literature

1994 ◽  
Vol 14 (1) ◽  
pp. 64-67 ◽  
Author(s):  
Neville A. Russell ◽  
Saad Al-Rajeh ◽  
Naif Al-Fayez ◽  
Andrew J. Joaquin ◽  
Asiru Abu Bakhr
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Review Of The Literature ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Invasive Prolactinoma

scholarly journals Management and outcome of post-traumatic cerebrospinal fluid rhinorrhea

2020 ◽  
Vol 8 (3) ◽  
pp. 937
Author(s):  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Aliyu Muhammad Koko ◽  
Bello Bala Shehu
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Sub Saharan Africa ◽  
Aetiological Factor ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Post Traumatic ◽  
Sub Saharan

Background: Post-traumatic cerebrospinal fluid (CSF) rhinorrhea are relatively uncommon neurosurgical condition that is associated with serious morbidity and life-threatening complications like meningitis. As such, it requires prompt and thorough evaluation and treatment. Is of note that, only few studies discussed CSF rhinorrhea in literature especially in sub-Saharan Africa. This study was designed to report outcomes of management of post-traumatic CSF rhinorrhea seen in our institution.Methods: Relevant data of all patients with post-traumatic CSF rhinorrhea managed from July 2015 to June 2019 were retrospectively reviewed.Results: Out of the total 1942 cases of head injury managed over the study period 20 cases (1%) were diagnosed with CSF rhinorrhea. The mean age of presentation was 30.5 years. All patients were male and road traffic accidents was the only aetiological factor noted. Majority of patients developed rhinorrhea after 48 hours of injury (12/20). Pneumocephalus was the commonest computerised tomographic scan finding and about 2/3rd of the patients required operative treatment by transcranial anterior cranial fossa repair (13/20). The remaining patients were managed non-operatively with acetazolamide, antihistamines, stool softeners and antibiotics. The outcome was generally good with no recurrence noted. The rate of mortality was 10% (2/20) and resulted from meningitis.Conclusions: Posttraumatic CSF rhinorrhea was seen in 1% of cases of head injury in our environment and affects males predominantly. Although, the outcome of treatments was good, 10% mortality caused by meningitis was recorded.

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