CSF Rhinorrhea or Cerebrospinal Fluid Leak is a rare condition in which the fluid that normally surrounds and protects the spinal cord and brain leaks and runs from the nose and sinuses. The fluid may leak continuously or may stop on its own. The main complaint of people affected with CSF Rhinorrhea is a very watery & runny nose.
Traumatic CSF Rhinorrhea: Penetrating and closed-head trauma to the bones of the face and skull causes traumatic CSF Rhinorrhea.
Iatrogenic CSF Rhinorrhea: Iatrogenic causes include the following:
Neurosurgical procedures like craniotomy and trans-sphenoidal pituitary resections
Otolaryngologic approaches to neoplastic disease
Functional endoscopic sinus surgery
Spontaneous/idiopathic: The causes of spontaneous or idiopathic CSF Rhinorrhea are:
Elevations in intracranial pressure (ICP)
Congenital skull base defects
Congenital CSF Rhinorrhea: Any abnormality in the central nervous system or tissue that is present by birth can cause CSF Rhinorrhea.
CSF Rhinorrhea is a risky condition and need immediate medical care. Its symptoms may depend upon the size and severity of the fluid leak. Symptoms of CSF Rhinorrhea may include the following:
Salty taste and a sense of clear and watery drainage in the throat or in only one side of the nose or one ear
Positional headache: a headache that is worse when upright and improved when positioned horizontally
Nausea and vomiting
Neck pain or stiffness
Change in vision or taste
Ringing in the ears
Pain or numbness at various nerve root levels
Worsening of symptoms on bending over, straining or during increased activity
The diagnosis of CSF Rhinorrhea requires complete physical examination of the patient, history of the disease and following tests:
Smell Identification Test
Endoscopy of nose
MRI and / or CT Cisternography
Laboratory test on nasal drainage ( Sugar and B-2 transferrin assay)
Radioactive pledget scanning
Intrathecal flourescein etc.
A Neurosurgeon who is well versed with Endoscopic surgery is the best person to diagnose as well as treat CSF Rhinorrhea. It should be dealt promptly as CSF Rhinorrhea can be a reason to develop meningitis i.e. infection to the lining of the brain. So to avoid the risks and complications of CSF Rhinorrhea, it should be managed properly and timely.
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