ABSTRACT
Nontraumatic cerebrospinal fluid rhinorrhea is a very rare disease that comprises 3-4% of all CSF rhinorrhea cases. The principle treatment for CSF rhinorrhea is surgery because more conservative treatments usually fail. The authors executed extracranial repair of the fistula and sphenoid sinus obliteration with abdominal fat in a 33-year old male diagnosed with nontraumatic CSF rhinorrhea not accompanied by intracranial lesion. The CSF rhinorrhea stopped after the operation, but acute hydrocephalus developed on the postoperative second day, and a ventriculospinal shunt was performed. The authors report a case of acute hydrocephalus occurring after the repair of the CSF rhinorrhea, a development that, to our knowledge, has never been reported in the literature.
Subject(s)
Adult , Humans , Male , Abdominal Fat , Cerebrospinal Fluid Rhinorrhea , Cerebrospinal Fluid , Fistula , Hydrocephalus , Rare Diseases , Sphenoid SinusABSTRACT
We describe a rare case of nontraumatic normal pressure cerebrospinal fluid rhinorrhea. A 33-year-old male was admitted to our hospital due to continuous rhinorrhea but without a history of specific trauma. We performed various radiological evaluations, and on bone-window CT, detected severe bilateral extension of the sphenoid sinus into the greater wing. MRI and CT cisternography revealed that contrast media and cerebrospinal fluid had leaked from the middle cranial fossa to the sphenoid sinus. Transethmoidal sphenoid approach and sphenoid sinus fat obliteration was successfully performed by an otolaryngologist. On postoperative day 2, however, the patient's mental condition deteriorated and CT showed the development of acute obstructive hydrocephalus. Ventriculo-peritoneal shunt was then successfully performed and the patient was discharged. Nontraumatic normal pressure cerebrospinal fluid rhinorrhea involving leakage through the middle cranial fossa is very rare, this report discussed the etiological, anatomical and surgical considerations of this case.