Bilateral cerebrospinal fluid rhinorrhoea

2000 ◽  
Vol 114 (2) ◽  
pp. 137-138 ◽  
Author(s):  
James D. Ramsden ◽  
Rogan Corbridge ◽  
Grant Bates
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
Subarachnoid Space ◽  
Complication Rates ◽  
Endoscopic Repair ◽  
Csf Fistula ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea ◽  
Csf Leaks

Cerebrospinal fluid (CSF) rhinorrhoea is leakage of fluid from the subarachnoid space to the frontal, sphenoidal or ethmoidal sinuses, and may occur spontaneously. The authors present the first reported case of bilateral spontaneous CSF rhinorrhoea. Bony defects on both sides of the cribriform plate were identified using endoscopic and radiological techniques, and the CSF fistula was closed endoscopically. The aetiology, diagnosis and contemporary surgical treatment of spontaneous CSF leaks is discussed. Endoscopic repair was successful in this case, and in view of the high success and low reported complication rates this surgical approach should be considered for treatment of spontaneous CSF rhinorrhoea.

The management of massive pneumocephalus and cerebrospinal fluid rhinorrhoea as a consequence of biopsy in a patient with inverted papilloma

1998 ◽  
Vol 112 (7) ◽  
pp. 657-659 ◽  
Author(s):  
U. S. Kale ◽  
S. G. Raje ◽  
R. G. Wight
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Polyps ◽  
Inverted Papilloma ◽  
Successful Outcome ◽  
Csf Leak ◽  
Lateral Rhinotomy ◽  
Endoscopic Repair ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea

AbstractNasal polypectomy is a common ENT operation. Cerebrospinal fluid (CSF) rhinorrhoea and pneumocephalus are rare complications. We present a patient who developed both these complications after biopsy of nasal polyps which subsequently proved to be an inverted papilloma. He had a defect in the ethmoid roof, which was repaired.Whilst endoscopic repair of CSF leak is increasing in popularity, in this patient because of his pathology and difficulty of access a more traditional lateral rhinotomy approach was made with a successful outcome. An overview of the management of these complications is presented.

scholarly journals Cerebrospinal Fluid Rhinorrhoea in Pituitary Tumours

1980 ◽  
Vol 73 (4) ◽  
pp. 244-254 ◽  
Author(s):  
I E Cole ◽  
Malcolm Keene
Keyword(s):  
Cerebrospinal Fluid ◽  
Pituitary Tumours ◽  
Pituitary Fossa ◽  
Muscle Graft ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea

Three cases of CSF rhinorrhoea due to pituitary tumours are reported and the literature reviewed. The treatment of choice appears to be trans-sphenoidal exploration of the pituitary fossa with insertion of a free muscle graft followed by radiotherapy. The probability of the tumour being a prolactin-secreting adenoma is discussed.

Use of protein electrophoresis in the diagnosis of cerebrospinal fluid rhinorrhoea

1992 ◽  
Vol 106 (6) ◽  
pp. 504-506 ◽  
Author(s):  
M. J. Porter ◽  
G. B. Brookes ◽  
A. Z. J. Zeman ◽  
G. Keir
Keyword(s):  
Cerebrospinal Fluid ◽  
Diagnostic Accuracy ◽  
Tau Protein ◽  
Electrophoretic Analysis ◽  
Protein Electrophoresis ◽  
Csf Leak ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea ◽  
Nasal Secretions

AbstractThe diagnosis of CSF rhinorrhoea on clinical grounds alone can be difficult. We describe how the use of noninvasive electrophoretic analysis of nasal secretions for tau protein (asialotransferrin) helped in the management of cases where the existence of a CSF leak was in doubt. Patients were thus saved unnecessary invasive investigations or surgery. A modification of the method of analysis, which improves diagnostic accuracy, is described.

Surgical treatment of spontaneous spinal cerebrospinal fluid leaks

1998 ◽  
Vol 88 (2) ◽  
pp. 243-246 ◽  
Author(s):  
Wouter I. Schievink ◽  
Vittorio M. Morreale ◽  
John L. D. Atkinson ◽  
Fredric B. Meyer ◽  
David G. Piepgras ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Treatment ◽  
Intracranial Hypotension ◽  
Csf Leak ◽  
Preoperative Imaging ◽  
Content Type ◽  
Surgical Exploration ◽  
Fine Print ◽  
Csf Leaks

Object. Spontaneous spinal cerebrospinal fluid (CSF) leaks are an increasingly recognized cause of intracranial hypotension and may require neurosurgical intervention. In the present report the authors review their experience with the surgical management of spontaneous spinal CSF leaks. Methods. Between 1992 and 1997, 10 patients with spontaneous spinal CSF leaks and intracranial hypotension were treated surgically. The mean age of the seven women and three men was 42.3 years (range 22–61 years). Preoperative imaging showed a single meningeal diverticulum in two patients, a complex of diverticula in one patient, and a focal CSF leak alone in seven patients. Surgical exploration in these seven patients demonstrated meningeal diverticula in one patient; no clear source of CSF leakage could be identified in the remaining six patients. Treatment consisted of ligation of the diverticula or packing of the epidural space with muscle or Gelfoam. Multiple simultaneous spinal CSF leaks were identified in three patients. Conclusions. All patients experienced complete relief of their headaches postoperatively. There has been no recurrence of symptoms in any of the patients during a mean follow-up period of 19 months (range 3–58 months; 16 person-years of cumulative follow up). Complications consisted of transient intracranial hypertension in one patient and leg numbness in another patient. Although the disease is often self-limiting, surgical treatment has an important role in the management of spontaneous spinal CSF leaks. Surgery is effective in eliminating the headaches and the morbidity is generally low. Surgical exploration for a focal CSF leak, as demonstrated on radiographic studies, usually does not reveal a clear source of the leak. Some patients may have multiple simultaneous CSF leaks.

scholarly journals Oropharyngeal CSF Leak Secondary to Anterior Cervical Discectomy and Fusion

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Wyatt J. Weinheimer ◽  
Justin G. Rowley ◽  
Randal Otto ◽  
John Floyd ◽  
Philip G. Chen
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Endoscopic Surgery ◽  
Fusion Imaging ◽  
Anterior Cervical Discectomy ◽  
Csf Leak ◽  
Cervical Discectomy ◽  
Csf Fistula ◽  
Second Procedure ◽  
Csf Leaks

We present a case of an oropharyngeal cerebrospinal fluid (CSF) fistula in a patient that presented with headache, rhinorrhea, and pneumocephalus years after an anterior cervical discectomy and fusion. Imaging suggested a defect in the fovea ethmoidalis, but endoscopic surgery revealed the defect in the oropharynx. A second procedure was performed to remove the spinal hardware and repair the leak. This case is not only unique in the literature but also highlights the importance of maintaining a broad differential diagnosis to include rare complications and shows that despite dramatic improvements in imaging, locating CSF leaks still presents a challenge.

Study on spontaneous cerebrospinal fluid rhinorrhoea: its aetiology and management

2005 ◽  
Vol 119 (1) ◽  
pp. 12-15 ◽  
Author(s):  
C J Dunn ◽  
A Alaani ◽  
A P Johnson
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Queen Elizabeth Hospital ◽  
Study Group ◽  
Common Features ◽  
Csf Rhinorrhoea ◽  
The Common ◽  
Csf Leaks

The aim of this study was to identify the common features in a study group of patients with spontaneous cerebrospinal fluid (CSF) rhinorrhoea, to develop a hypothesis to explain the cause of this condition and to investigate the outcome of surgical techniques adopted to repair the leak. In this retrospective study the authors have reviewed all the cases of spontaneous CSF leaks attending and receiving treatment from the otolaryngology department of Queen Elizabeth Hospital, Birmingham, from 1992 to 2002.Of 34 patients with CSF leaks, 15 were spontaneous in nature and formed the study group. Of these 15 patients, 14 were female; with ages ranging from 37 to 70 years and a median age of 50 years. All the female patients were overweight with a body mass index (BMI) >24.9 and, of these, nine were considered obese with a BMI >30. It was attempted to identify common factors in the study group and it was evident that female sex, obesity and age played a key role in this condition.The follow-up period ranged from two to 98 months. Thirteen patients were asymptomatic but two patients remained symptomatic, one of these despite repeated surgical intervention.

scholarly journals The Surgical Treatment of Posttraumatic Skull Base Defects with Cerebrospinal Fluid Leak

2017 ◽  
Vol 79 (02) ◽  
pp. 205-216 ◽  
Author(s):  
Ashish Thapa ◽  
Bing-Xi Lei ◽  
Mei-Guang Zheng ◽  
Zhong-Jun Li ◽  
Zheng-Hao Liu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Treatment ◽  
Skull Base ◽  
Surgical Approach ◽  
Common Factors ◽  
Csf Leak ◽  
Surgical Approaches ◽  
Skull Base Defect ◽  
The Common ◽  
Skull Base Defects

Objectives The objective was to explore further the surgical treatment of posttraumatic skull base defects with cerebrospinal fluid (CSF) leak and to identify the most common factors affecting the surgical treatment of posttraumatic skull base defect with CSF leak retrospectively. Materials and Methods This study included 144 patients with head trauma having skull base defect with CSF leak who had been surgically treated at Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from 1998 to June 2016. There were 113 (78.5%) males and 31 (21.5%) females, with age ranging from 1 to 78 years and mean age of 26.58 ± 14.95 years. We explored the surgical approaches for the treatment of the skull base defect and the graft materials used and also measured the association among surgical approaches; location, size, and type of skull base defects; presence or absence of associated intracranial pathologies; postoperative complications; outcome; age; Glasgow outcome score (GOS) at discharge; and days of hospital stay. Results The location, size, and types of skull base defect and the presence of associated intracranial pathologies were the common factors identified not only for choosing the appropriate surgical approach but also for choosing the materials for defect repair, timing of the surgery, and the method used for the defect as well as leak repair. The statistically significant correlation with p < 0.001 was found in this study. Conclusion From this study, we could conclude that size, location, and types of the defect and the presence of associated intracranial injuries were the common factors that affected the surgical treatment of posttraumatic skull base defect with CSF leak. Hence, the importance of careful evaluation of these factors is essential for proper selection of the surgical approach and for avoiding unnecessary hassles.

Bilateral, spontaneous cerebrospinal fluid rhinorrhoea: endoscopic, uninasal, trans-septal approach for simultaneous closure

2011 ◽  
Vol 125 (11) ◽  
pp. 1185-1188
Author(s):  
M Kurien ◽  
G A Mathew ◽  
S L Abraham ◽  
A Irodi
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
English Language ◽  
Past History ◽  
Cerebrospinal Fluid Leakage ◽  
Endoscopic Repair ◽  
Recent Onset ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Fluid Leakage ◽  
History Of

AbstractBackground:Bilateral, spontaneous cerebrospinal fluid rhinorrhoea is extremely rare, with only one previous case report (this patient developed contralateral cerebrospinal fluid leakage four years after successful endoscopic repair). We present the first English-language report of simultaneous, bilateral, spontaneous cerebrospinal fluid rhinorrhoea.Objective:To recommend a simple alternative endoscopic technique for simultaneous closure of bilateral, spontaneous cerebrospinal fluid rhinorrhoea.Case report:A 47-year-old woman presented with recent onset of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, a recent history suggestive of meningitis, and a past history of pneumococcal meningitis. Bony defects on both sides of the cribriform plate were closed endoscopically in the same anaesthetic session, via a uninasal, trans-septal approach, enabling both leakage sites to be sealed simultaneously.Conclusion:In cases of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, uninasal, trans-septal endoscopic repair is a simple and effective technique for simultaneous closure of cerebrospinal fluid leakage.

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