Cerebrospinal fluid rhinorrhoea (CSF rhinorrhoea) refers to the drainage of cerebrospinal fluid through the nose (rhinorrhoea). It is typically caused by a basilar skull fracture, which presents complications such as infection. It may be diagnosed using brain scans (prompted based on initial symptoms), and by testing to see if discharge from the nose is cerebrospinal fluid. Treatment may be conservative (as many cases resolve spontaneously), but usually involves neurosurgery. CSF rhinorrhoea may be spontaneous, traumatic, or congenital. Traumatic CSF rhinorrhoea is the most common type of CSF rhinorrhoea. It may be due to severe head injury, or from complications from neurosurgery. Spontaneous CSF rhinorrhoea is the most common acquired defect in the skull base bones (anterior cranial fossa) causing spontaneous nasal liquorrhea. Defects are often localized in the sphenoid bone and the ethmoid bone. sphenoid sinus (43%). ethmoid bone (29%). cribriform plate (29%). Congenital CSF rhinorrhoea is the least common type of CSF rhinorrhoea. It may be caused by problems in the embryological development of bones of the skull. CSF rhinorrhoea involves drainage of cerebrospinal fluid through the nose. This appears as a clear, colourless liquid. Aldroubi sign "The liquid in CSF rhinorrhea is thin and clear, and an affected person might notice a sweet or salty taste due to the increased glucose and electrolytes present in cerebrospinal fluid so some affected toddlers and young children tend to lick their nose frequently". CSF rhinorrhoea may be a sign of a basilar skull fracture. Other signs of a basilar skull fracture include CSF otorrhoea (drainage of CSF through the ear). It can have devastating complications in some patients, as the communication between the nasal cavity, the cerebrospinal fluid and the central nervous system can result in severe bacterial infections. CSF rhinorrhoea may be a complication of neurosurgery, such as functional endoscopic sinus surgery, and hypophysectomy (partial or complete removal of the pituitary gland).
Nikolaos Stergiopoulos, Bryn Andrew Martin
Grégoire Courtine, Quentin Barraud, Lili Huang, Xiaomeng Zhang