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Non-traumatic cerebrospinal fluid rhinorrhea

J M Shugar, P M Som, W Eisman

    The Laryngoscope
    |January 1, 1981
    PubMed
    Summary

    Non-traumatic cerebrospinal fluid (CSF) leaks are uncommon, with most being high pressure. This case highlights a rare normal pressure CSF leak caused by a meningoencephalocele in the frontal sinus, mimicking a mucocele.

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    Area of Science:

    • Neurology
    • Otolaryngology
    • Neurosurgery

    Background:

    • Non-traumatic cerebrospinal fluid (CSF) rhinorrhea is an uncommon condition.
    • Literature review indicates 45% of cases are high-pressure leaks and 55% are normal-pressure leaks.
    • Meningoencephaloceles are exceedingly rare causes of normal-pressure CSF rhinorrhea.

    Observation:

    • This report details the third known case of a meningoencephalocele presenting as a normal-pressure CSF leak.
    • The meningoencephalocele occurred in the frontal sinus.
    • Radiographically, the lesion mimicked a mucocele due to its expansile characteristics.

    Findings:

    • Non-traumatic mucoceles of the paranasal sinuses are not associated with CSF rhinorrhea.
    • Meningoencephaloceles are the only non-osseous, expansile paranasal sinus lesions linked to CSF rhinorrhea.
    • This specific case involved a frontal sinus meningoencephalocele.

    Implications:

    • Accurate diagnosis of CSF leaks is crucial for appropriate management.
    • Distinguishing meningoencephaloceles from mucoceles is vital in cases of normal-pressure CSF rhinorrhea.
    • This case expands the understanding of rare causes of CSF rhinorrhea and their radiological presentation.

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