Cerebrospinal fluid (CSF) rhinorrhoea and/or otorrhoea in patients with head injury

The essence of this study is to investigate the incidence, clinical profile and outcome of conservative treatment of cerebrospinal fluid rhinorrhoea and/or otorrhoea in head injured patients. Records of head injured patients between 1991 and 2000 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria were retrieved and reviewed for demographic data, cause of head injury, incidence of CSF rhinorrhoea and/or otorrhoea and outcome of conservative management. Of the 794 patients, 39 (4.9%): 28 (71.8%) males and 11 (28.2%) females presented with CSF rhinorrhoea and/or otorrhoea. Nineteen (48.7%) of them had rhinorrhoea, 13 (33.3%) otorrhea and 7 (18%) had both. They were aged 1 to 60 years with a mean age of 28. More than 40% of them were aged 10 years or less and about a quarter were in the fourth decade of life. The commonest cause of injury in these patients was road traffic accident, 27 (69.2%). About a quarter sustained their injuries as a result of fall from height. The mortality rate among patients with CSF rhinorrhoea and/or otorrhoea (33.3%) was higher than among the total population of the head injured (23%). All survivors had spontaneous cessation of CSF leakage within two weeks of head injury. In our centre, the incidence of CSF rhinorrhoea and/or otorrhoea following head injury is 4.9%. Though this complication of head injury was associated with increased mortality rate, it does not appear to be a prognostic factor in head injury (P>0.05).