Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Nov 11;18(1):533.
doi: 10.1186/s13256-024-04882-9.

Spontaneous cerebrospinal fluid rhinorrhoea: a case report and literature review

Umashri Sundararaju #  1 , Hamrish Kumar Rajakumar #  2 , Shanmuga Ashok Siva  3 , Aishwarya Prateep  3
Affiliations
Review

Spontaneous cerebrospinal fluid rhinorrhoea: a case report and literature review

Umashri Sundararaju et al. J Med Case Rep. .

Abstract

Background: Cerebrospinal fluid rhinorrhea is a rare condition characterized by the abnormal leakage of cerebrospinal fluid from the intracranial space into the sinonasal cavity. It includes various etiologies, including traumatic, iatrogenic, and spontaneous causes, each with distinct epidemiological and clinical characteristics.

Case presentation: A 40-year-old Asian female presented with a three-month history of watery discharge from her left nostril and dull headaches localized to the left side of her head. Despite the initial diagnosis of allergic rhinitis, symptoms persisted, leading to further evaluation and eventual diagnosis of cerebrospinal fluid rhinorrhea. Detailed history, physical examination, and diagnostic tests including fluid analysis and imaging confirmed the diagnosis. The patient underwent a successful surgical repair after failed conservative management, highlighting the importance of timely intervention.

Conclusion: Cerebrospinal fluid rhinorrhea poses significant risks if left untreated, including meningitis. Prompt recognition, accurate diagnosis, and individualized treatment strategies are crucial in mitigating complications and improving patient outcomes. A multidisciplinary approach, incorporating both conservative and surgical interventions tailored to the underlying cause, is essential for the successful management of cerebrospinal fluid rhinorrhea.

Keywords: Allergic rhinitis; CSF rhinorrhea; Case report; Misdiagnosis; Spontaneous.

PubMed Disclaimer

Conflict of interest statement

Declarations Ethics approval As per our institutional protocol, ethical approval is required to publish a case report. This case was approved by the institutional ethics committee of Government Medical College, Omandurar, Government Estate (Registration Number: ECR/1492/Inst/TN/2021) with approval number 62/IEC/GOMC/2023 dated 5th August 2023. Consent for publication Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests In compliance with the ICMJE uniform disclosure form, the authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
The bony foveal defect depicted by a black arrow in both the surgical photograph and the schematic diagram
Fig. 2
Fig. 2
The septal cartilage depicted by a black arrow in both the surgical photograph and the schematic diagram
Fig. 3
Fig. 3
The closed defect site reinforced with fat, Surgicel, and middle turbinate mucosa, depicted by a black arrow in both the surgical photograph and the schematic diagram
See this image and copyright information in PMC

References

    1. Chen GY, Ma L, Xu ML, Zhang JN, He ZD, He CY, et al. Spontaneous cerebrospinal fluid rhinorrhea: a case report and analysis. Medicine. 2018;97(5): e9758. 10.1097/md.0000000000009758. - PMC - PubMed
    1. Xie M, Zhou K, Kachra S, McHugh T, Sommer DD. Diagnosis and localization of cerebrospinal fluid rhinorrhea: a systematic review. Am J Rhinol Allergy. 2022;36(3):397–406. 10.1177/19458924211060918. - PMC - PubMed
    1. Schmale IL, Fakhri S, Citardi MJ. Clinical Presentation of CSF Rhinorrhea. In: CSF Rhinorrhea. Cham: Springer International Publishing; 2022. p. 27–34.
    1. Martínez-Capoccioni G, Serramito-García R, Martín-Bailón M, García-Allut A, Martín-Martín C. Spontaneous cerebrospinal fluid leaks in the anterior skull base secondary to idiopathic intracranial hypertension. Eur Arch Otorhinolaryngol. 2017;274(5):2175–81. - PubMed
    1. Severson M, Schaurich CG, Strecker-McGraw MK. Cerebrospinal Fluid Leak. StatPearls Publishing; 2023. - PubMed

LinkOut - more resources