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Published on: February 29, 2020
Extraordinarily long-term posttraumatic cerebrospinal fluid fistula
Hyoung Sub Kim1, Jin Woo Hur, Jong Won Lee
1Department of Neurosurgery, Cheongju St. Mary's Hospital, Cheongju, Korea.
Journal of Korean Neurosurgical Society
|December 20, 2008
Summary
A rare case of persistent posttraumatic cerebrospinal fluid (CSF) leakage, presenting as persistent rhinorrhea and otorrhea for five years after a basilar skull fracture, is detailed. Medical treatment improved symptoms, despite diagnostic imaging challenges.
Area of Science:
- Neurosurgery
- Neurology
- Otolaryngology
Background:
- Posttraumatic cerebrospinal fluid (CSF) leakage is a known complication following head injuries.
- CSF otorrhea and rhinorrhea are common initial symptoms, often indicating a basilar skull fracture.
- Persistent CSF fistulas can lead to serious complications like meningitis.
Observation:
- A 38-year-old female patient experienced continuous clear rhinorrhea and otorrhea for five years post-basilar skull fracture.
- Meningitis developed, followed by a CSF fistula.
- Computerized tomography (CT) cisternography failed to detect the dural defect and CSF leakage.
Findings:
- This case highlights a rare instance of a persistent posttraumatic CSF fistula lasting for five years.
- Medical management successfully improved the patient's clinical symptoms.
- Diagnostic limitations of CT cisternography in identifying subtle dural defects were noted.
Implications:
- This case underscores the importance of considering persistent CSF fistulas even with negative initial imaging.
- Effective medical management can resolve symptoms in some complex CSF leak cases.
- Further advancements in diagnostic imaging for subtle CSF leaks may be warranted.
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