“High-flow” leak indicates a consistent CSF flow observed intraoperatively in the setting of a connection with cisterns or opening of the ventricular system, whereas a few drops of CSF leak occurring as a result of transient increased intracranial pressure while getting up, straining, or coughing is termed as a “low-flow” CSF leak. Spontaneous CSF leak can be categorized into “low-flow” and “high-flow” leaks. Spontaneous CSF rhinorrhea is identified as a separate clinical entity and a diagnosis of exclusion. Congenital skull base bony malformations and anterior skull base tumors are majorly found responsible for the nontraumatic cases of CSF rhinorrhea. Rarely CSF rhinorrhoea may be secondary to several nontraumatic conditions as well. It frequently occurs as a result of trauma to the anterior skull base–accidental (nearly 80%) or iatrogenic (10–15%). Individualized tailored surgical approach depending upon the site, size, and flow-variety of the defect forms the cornerstone of management.Ĭerebrospinal fluid (CSF) rhinorrhea is the leakage of CSF through nasal cavity due to abnormal communication between the arachnoid membrane and nasal mucosa. Spontaneous CSF rhinorrhea occurs secondary to elevated intracranial pressure, with a predilection for obese females in fourth to fifth decade. The overall success rate of primary endoscopic repair in our study was 95.3%. Intrathecal injection of fluorescein dye was used to identify the site of CSF leakage in 15 cases (34.8%). Intraoperatively, 23 (53.5%) patients showed high-flow leak. = 32, 74.4%) and Planum was found to be the least common site (

Most common site of CSF leak was cribriform plate ( Average BMI in males was found lower (28.7) as compared with females (32). Mean age in our study was 36.7 ± 12.3 years (range: 9–62 years). All patients underwent endoscopic repair of the defect depending upon their site of leak. In this study, we present our single center experience of spontaneous CSF rhinorrhea discussing important clinicoradiological aspects in preoperative evaluation and nuances in the endoscopic repair technique.Ī retrospective study conducted for 43 spontaneous CSF rhinorrhea patients admitted between Jan 2011 to Jan 2018 at our tertiary care center. Middle-age (fourth to fifth decade) group, female gender, and obesity (body mass index > 40) are the most commonly reported risk-factors for this rare entity. Cerebrospinal fluid (CSF) rhinorrhea is the leakage of CSF through nasal cavity, due to abnormal communication between the arachnoid membrane and nasal mucosa.

Spontaneous cerebrospinal fluid leak