Idiopathic Cerebrospinal Fluid Rhinorrhoea (An Uncommon Diagnosis): A case report and a Review of the Literature

Cerebrospinal fluid (CSF) rhinorrhoea is often seen among head injured patients from road traffic crashes or physical assault, and sometimes it is a complication of nasal surgical procedures. Intracranial tumours may also result in CSF leakage. Blood stained rhinorrhoea often occur at the time of initial insult or injury, while CSF rhinorrhea may be a delayed manifestation. However, idiopathic CSF rhinorrhoea is uncommon, and it is regarded as a diagnosis of exclusion. In this communication, we report a 54-year old woman who developed CSF rhinorrhoea with no prior history of head trauma, physical assault, neurosurgical or nasal surgery. Further clinical evaluation revealed an obese woman with a body mass index (BMI) of 31mg/m2, and a blood pressure (BP) of 140/80mmHg. Clinical tests for CSF rhinorrhoea were positive, though; nasal endoscopy and cranial CT-scan were not contributory. Conservative management resulted in remarkable relief of symptoms. However further investigations for confirmation of diagnosis were not possible due to non-availability of reagents in the laboratory as well as financial challenge.