Related Experiment Video

Updated: Jul 10, 2026

Intranasal Administration of CNS Therapeutics to Awake Mice
07:15

Intranasal Administration of CNS Therapeutics to Awake Mice

Published on: April 8, 2013

Cerebrospinal fluid rhinorrhea as a unique cause of hyponatremia

Ashutosh P Jadhav1, Brett D Nelson, Sarah S Kim

  • 1Harvard-Massachusetts Institute of Technology Program in Health, Sciences, and Technology, Harvard Medical School, Boston, Massachusetts, USA.

Pediatric Neurology
|October 24, 2007
PubMed

Insights

Recurrent hyponatremia in children can stem from rare cerebrospinal fluid (CSF) rhinorrhea, leading to significant sodium loss. This case highlights CSF leakage as an unusual cause of electrolyte imbalance in pediatrics.

Area of Science:

  • Pediatric Nephrology
  • Pediatric Endocrinology
  • Neuroscience

Background:

  • Hypovolemic hyponatremia is common in children, often due to gastrointestinal salt loss.
  • Recurrent hyponatremic, hyperkalemic dehydration presents a diagnostic challenge in pediatric patients.

Observation:

  • An 18-month-old boy experienced recurrent dehydration due to excessive salt loss.
  • Evaluation revealed cerebrospinal fluid (CSF) rhinorrhea, confirmed by beta transferrin-2 detection.
  • Head imaging identified a persistent craniopharyngeal canal, indicating a nasopharyngeal-subarachnoid space communication.

Findings:

  • The patient's condition was linked to salt loss via CSF rhinorrhea and inadequate dietary salt intake.
  • Renal and endocrine functions were found to be normal, ruling out common causes.
  • Cerebrospinal fluid (CSF) rhinorrhea was identified as the primary cause of significant sodium depletion.

Implications:

  • Cerebrospinal fluid (CSF) rhinorrhea should be considered in pediatric cases of unexplained hyponatremia.
  • This case underscores the importance of evaluating for rare causes of electrolyte disturbances.
  • Early diagnosis and management of CSF rhinorrhea can prevent severe hyponatremia and associated complications.

More Related Videos

Real-Time Dynamic Collection of Hippocampal Extracellular Fluid from Conscious Rats Using a Microdialysis System05:43

Real-Time Dynamic Collection of Hippocampal Extracellular Fluid from Conscious Rats Using a Microdialysis System

Published on: October 21, 2022

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model09:14

Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model

Published on: June 18, 2021

Related Concept Videos

Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Cerebral Edema l: Introduction01:19

Cerebral Edema l: Introduction

Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Cytotoxic Edema: Pathophysiology01:21

Cytotoxic Edema: Pathophysiology

Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous supply...