Cerebrospinal fluid rhinorrhoea: Difference between revisions

From WikiMD's Wellness Encyclopedia

CSV import
 
CSV import
 
(2 intermediate revisions by the same user not shown)
Line 1: Line 1:
{{Infobox medical condition (new)
 
{{Infobox medical condition
| name            = Cerebrospinal fluid rhinorrhoea
| name            = Cerebrospinal fluid rhinorrhoea
| synonyms        =  
| synonyms        = CSF rhinorrhea, CSF leak
| image          =
| field          = [[Neurology]], [[Otolaryngology]]
| alt            =
| symptoms        = [[Clear nasal discharge]], [[headache]], [[meningitis]]
| caption        =
| complications  = [[Meningitis]], [[pneumocephalus]]
| pronounce      =
| onset          = Sudden or gradual
| field          =  
| duration        = Variable
| geneReviewsID  =
| causes          = [[Head trauma]], [[surgical complications]], [[spontaneous]]
| symptoms        =  
| risks          = [[Head injury]], [[sinus surgery]], [[skull base tumors]]
| complications  =  
| diagnosis      = [[Beta-2 transferrin test]], [[CT scan]], [[MRI]]
| onset          =  
| differential    = [[Allergic rhinitis]], [[sinusitis]], [[nasal polyps]]
| duration        =  
| treatment      = [[Bed rest]], [[surgical repair]], [[lumbar drain]]
| types          =
| medication      = [[Antibiotics]] (if [[meningitis]] is present)
| causes          =  
| prognosis      = Generally good with treatment
| risks          =  
| frequency      = Rare
| diagnosis      =  
| differential    =  
| prevention      =
| treatment      =  
| medication      =  
| prognosis      =  
| frequency      =  
| deaths          =
}}
}}
'''CSF rhinorrhoea''' refers to the drainage of [[cerebrospinal fluid]] through the [[Human nose|nose]]. Measures of CSF components such as glucose have been used in the past, but are neither sensitive nor specific; beta-2 transferrin, however, has been shown to have a high [[positive predictive value]].<ref>{{cite journal |doi=10.1016/j.otc.2005.03.011 |pmid=16005720 |title=Cerebrospinal Fluid Rhinorrhea: Diagnosis and Management |journal=Otolaryngologic Clinics of North America |volume=38 |issue=4 |pages=597–611 |year=2005 |last1=Kerr |first1=Julie T. |last2=Chu |first2=Felix W.K. |last3=Bayles |first3=Stephen W. }}</ref> It has also been noted to be characterized by unilateral discharge.<ref name=EMedicine861126>{{EMedicine|article|861126|CSF Rhinorrhea}}</ref>
{{Short description|Leakage of cerebrospinal fluid from the nose}}
 
'''Cerebrospinal fluid rhinorrhoea''' is a condition characterized by the leakage of [[cerebrospinal fluid]] (CSF) from the [[subarachnoid space]] into the [[nasal cavity]]. This occurs due to a defect in the [[skull base]], which allows the fluid to escape through the [[nose]].
It is a sign of a [[basilar skull fracture]]. Management includes [[watchful waiting]] – leaks often stop spontaneously; if this does not occur then neurosurgical closure is necessary to prevent the spread of infection to the meninges.<ref name=EMedicine861126/>
==Pathophysiology==
 
Cerebrospinal fluid rhinorrhoea results from a breach in the [[dura mater]], the outermost membrane surrounding the [[brain]] and [[spinal cord]]. This breach can occur due to [[trauma]], [[surgery]], [[tumors]], or [[congenital]] defects. The defect allows CSF to leak into the [[paranasal sinuses]] and subsequently into the nasal cavity, leading to a persistent watery nasal discharge.
Other signs of a basilar skull fracture includes CSF otorrhoea (drainage of CSF through the ear).  It can have devastating complications in some patients, as the communication between the nasal cavity and the cerebrospinal fluid and CNS can result in bacterial infections of the CNS that can have catastrophic effects on the patient.<ref name=EMedicine861126/>
==Causes==
 
The causes of cerebrospinal fluid rhinorrhoea can be classified into:
CSF rhinorrhoea can also be a symptom of a [[pituitary adenoma]].{{fact|date=May 2015}}
* '''Traumatic''': This is the most common cause and includes [[head injuries]] such as skull fractures.
 
* '''Iatrogenic''': Resulting from [[surgical procedures]] involving the [[sinuses]] or [[brain]].
'''Spontaneous CSF rhinorrhea'''. The most common congenital or acquired defect in the skull base bones (anterior cranial fossa) at the [http://www.minclinic.ru/cns/cns_eng/spontannaya_likvoreya_eng.html spontaneous nasal liquorrhea] localized in following formation:
* '''Spontaneous''': Occurs without any apparent cause, often associated with [[intracranial hypertension]].
* sphenoid sinus (43%)
* '''Congenital''': Due to developmental defects in the skull base.
* ethmoid bone (29%)
==Symptoms==
* cribriform plate (29%)
The primary symptom of cerebrospinal fluid rhinorrhoea is a clear, watery nasal discharge that is often unilateral. Other symptoms may include:
 
* [[Headache]]
==See also==
* [[Meningitis]]
*[[Beta-2 transferrin]]
* [[Visual disturbances]]
*[[Meningitis]]
* [[Tinnitus]]
*[[Traumatic head injury]]
==Diagnosis==
 
Diagnosis of cerebrospinal fluid rhinorrhoea involves:
==References==
* '''Clinical examination''': Observing the characteristics of the nasal discharge.
{{reflist}}
* '''Laboratory tests''': Testing the fluid for [[beta-2 transferrin]], a protein specific to CSF.
== External links ==
* '''Imaging studies''': [[CT scan]] or [[MRI]] to identify the site of the leak.
{{Medical resources
==Treatment==
|  DiseasesDB      =
Treatment options for cerebrospinal fluid rhinorrhoea include:
|  ICD10          =G96.0
* '''Conservative management''': Bed rest, head elevation, and avoidance of activities that increase [[intracranial pressure]].
|  ICD9            = {{ICD9|349.81}}
* '''Surgical repair''': Endoscopic repair of the skull base defect is often required if conservative measures fail.
|  ICDO            =  
==Complications==
|  OMIM            =  
If left untreated, cerebrospinal fluid rhinorrhoea can lead to serious complications such as:
|  MedlinePlus    =
* [[Meningitis]]
|  eMedicineSubj  = article
* [[Brain abscess]]
|  eMedicineTopic  = 861126
* [[Pneumocephalus]]
|  MeshID          =  
==Prognosis==
|  GeneReviewsName =  
With appropriate treatment, the prognosis for cerebrospinal fluid rhinorrhoea is generally good. Surgical repair has a high success rate, and most patients recover without significant complications.
}}
==Related pages==
{{CNS diseases of the nervous system}}
* [[Cerebrospinal fluid]]
 
* [[Meningitis]]
[[Category:Body fluids]]
* [[Skull fracture]]
 
[[Category:Neurology]]
 
[[Category:Otorhinolaryngology]]
{{nervoussystem-disease-stub}}
[[Category:Medical conditions related to the nervous system]]
{{dictionary-stub1}}

Latest revision as of 22:29, 3 April 2025


Cerebrospinal fluid rhinorrhoea
Synonyms CSF rhinorrhea, CSF leak
Pronounce N/A
Specialty N/A
Symptoms Clear nasal discharge, headache, meningitis
Complications Meningitis, pneumocephalus
Onset Sudden or gradual
Duration Variable
Types N/A
Causes Head trauma, surgical complications, spontaneous
Risks Head injury, sinus surgery, skull base tumors
Diagnosis Beta-2 transferrin test, CT scan, MRI
Differential diagnosis Allergic rhinitis, sinusitis, nasal polyps
Prevention N/A
Treatment Bed rest, surgical repair, lumbar drain
Medication Antibiotics (if meningitis is present)
Prognosis Generally good with treatment
Frequency Rare
Deaths N/A


Leakage of cerebrospinal fluid from the nose


Cerebrospinal fluid rhinorrhoea is a condition characterized by the leakage of cerebrospinal fluid (CSF) from the subarachnoid space into the nasal cavity. This occurs due to a defect in the skull base, which allows the fluid to escape through the nose.

Pathophysiology[edit]

Cerebrospinal fluid rhinorrhoea results from a breach in the dura mater, the outermost membrane surrounding the brain and spinal cord. This breach can occur due to trauma, surgery, tumors, or congenital defects. The defect allows CSF to leak into the paranasal sinuses and subsequently into the nasal cavity, leading to a persistent watery nasal discharge.

Causes[edit]

The causes of cerebrospinal fluid rhinorrhoea can be classified into:

Symptoms[edit]

The primary symptom of cerebrospinal fluid rhinorrhoea is a clear, watery nasal discharge that is often unilateral. Other symptoms may include:

Diagnosis[edit]

Diagnosis of cerebrospinal fluid rhinorrhoea involves:

  • Clinical examination: Observing the characteristics of the nasal discharge.
  • Laboratory tests: Testing the fluid for beta-2 transferrin, a protein specific to CSF.
  • Imaging studies: CT scan or MRI to identify the site of the leak.

Treatment[edit]

Treatment options for cerebrospinal fluid rhinorrhoea include:

  • Conservative management: Bed rest, head elevation, and avoidance of activities that increase intracranial pressure.
  • Surgical repair: Endoscopic repair of the skull base defect is often required if conservative measures fail.

Complications[edit]

If left untreated, cerebrospinal fluid rhinorrhoea can lead to serious complications such as:

Prognosis[edit]

With appropriate treatment, the prognosis for cerebrospinal fluid rhinorrhoea is generally good. Surgical repair has a high success rate, and most patients recover without significant complications.

Related pages[edit]