Evaluation of cerebrospinal fluid rhinorrhea by metrizamide computed tomographic cisternography

Seven interesting and instructive cases of cerebrospinal fluid rhinorrhea evaluated by metrizamide computed tomographic cisternography are presented. The rhinorrhea was spontaneous in three patients and was related to previous head trauma or surgical procedures in four patients. The anatomical site and the extent of the fistula were demonstrated precisely by directly showing metrizamide passing through the bony defect. A combination of bone dehiscence and metrizamide within the adjacent paranasal sinuses or the nasal cavity is also useful in localization. Distortion of the interhemispheric fissure, sylvian fissure, or basal sulci indicates the probability of brain herniation through the defect.