![]() Usually the fracture involves some portion of the anterior cranial fossa floor with the leaks occurring through the cribriform plate or ethmoid sinus roof into the nose. Other etiologies include: postoperative defect (10 %), spontaneous leak (3-4 %), tumor, and inflammation (8). ![]() The non-traumatic group is associated to brain tumors (intracranial and extracranial tumors, cholesteatoma, or tuberculoma are know to erode the bone directly) (6), skull base congenital defects and meningoceles or meningoencephalocles (7).ĬSF leak most commonly occurs following trauma (80-90 % of cases) and the majority of cases presenting within the first three months. A PUBMED search of the National Library of Medicine was conducted.ĬSF rhinorrhea can be divided in traumatic and non-traumatic: the traumatic group can be divided in accidental and iatrogenic. This article reviewed the causes, diagnosis and treatment of CSF leakage. Pituitary tumors cause erosion of the sella turcica floor and are frequently associated with CSF rhinorrhea (5). Others conditions include paranasal sinuses along with osteomyelitis of the adjacent bone, congenital anomalies of the brain and its coverings such as meningoceles or meningoencephaloceles, and destruction lesions along the skull base (4). CSF leaks have been associated with about a 10% risk of developing meningitis per year (3).ĬSF rhinorrhea commonly occurs following head trauma (fronto-basal skull fractures) or as a result of intracranial surgery. A spinal fluid leak from the intracranial space to the nasal respiratory tract is potentially very serious because of the risk of an ascending infection which could produce fulminant meningitis (2). A CSF rhinorrhoea occurs when there is a fistula between the dura and the skull base and discharge of CSF from the nose. CSF leak is an escape of the fluid that surrounds the brain and spinal cord, from the cavities within the brain or central canal in the spinal cord. Severe head and neck trauma are often connected with fractures of the frontal skull base or nasoethmoido-orbital complex and cerebrospinal fluid (CSF) leakage (1). Surgical management of multiple traumatized patients with head trauma is highly individualized and depends on a number of factors including etiology, intracranial pressure, concomitant injuries, patient age and the possibility of an interdisciplinary procedure. Key words: Liquorrhoea, rhinorrhoea, cerebrospinal fluid, head injury. The timing for surgery and CSF drainage procedures must be decided with great care and with a clear strategy. ![]() Treatment decisions should be dictated by the severity of neurological decline during the emergency period and the presence/absence of associated intracranial lesions. CSF fistulae persisting for > 7 days had a significantly increased risk of developing meningitis. A greater proportion of the CSF leaks in the patients resolved spontaneously. In cases where a confirmatory test is needed, the beta-2 transferrin assay is the test of choice because of its high sensitivity and specificity. In the presence of a skull base fracture on computed tomography and a clinical CSF leak, there is no need for a further confirmatory test. This suggests that patients with head injuries and features of periorbital haematoma are at greater risk of unobserved dural tear and delayed CSF leakage. CSF rhinorrhoea have significantly greater incidence of periorbital haematoma. CSF leak most commonly occurs following trauma and the majority of cases presenting within the first three months. A PUBMED search of the National Library of Medicine was conducted. A spinal fluid leak from the intracranial space to the nasal respiratory tract is potentially very serious because of the risk of an ascending infection which could produce fulminant meningitis. CSF rhinorrhea or liquorrhoea commonly occurs following head trauma (fronto-basal skull fractures), as a result of intracranial surgery, or destruction lesions. Cerebrospinal fluid rhinorrhoea: diagnosis and managementĭDS, Specialist in Dental and Maxillofacial Radiology, Health Division, Joinville City Hall, Joinville, Santa Catarina, BrazilĪ cerebrospinal fluid (CSF) rhinorrhoea occurs when there is a fistula between the dura and the skull base and discharge of CSF from the nose.
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