Cerebrospinal fluid rhinorrhoea and its management

Westmore, G. A.; Whittam, D. E.

doi:10.1002/bjs.1800690821

Cited by 53 publications

(12 citation statements)

References 12 publications

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“…Although meningitis is an indication for surgical repair, late spontaneous healing of rhinorrhea may be seen in some patients [15]. In our case, despite 4 episodes of meningitis, late spontaneous healing was seen 20 months after its occurrence.…”

Section: Discussionmentioning

confidence: 70%

“…The overall incidence of meningitis before surgical dural repair is about 30% [14]. Persistent CSF rhinorrhea following acute trauma or recurrent meningitis requires surgical correction [3,15]. Therefore, it is important to determine the localization of the leakage.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic repair is a promising alternative to traditional repair techniques. Each technique has some advantages and disadvantages depending on the site of the fistula [13,15,[20][21][22]. Thus, in each patient, the preferred surgical method should be evaluated individually.…”

Section: Discussionmentioning

confidence: 99%

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Cerebrospinal Fluid Rhinorrhea and Recurrent Pneumococcal Meningitis after Submucous Resection of the Nasal Septum

Erol¹,

Özkurt²,

Taşyaran³

2001

Otorhinolaryngol Nova

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In an immunologically competent individual, recurrent bacterial meningitis is usually the consequence of a transdural communication between the subarachnoid space and the base of the skull. Cerebrospinal fluid (CSF) rhinorrhea is the most common sign of a CSF fistula. This condition is most commonly caused by trauma, either accidental or iatrogenic. CSF rhinorrhea following a nasal surgical procedure is an unusual condition. We report here the case of CSF rhinorrhea and recurrent bacterial meningitis in a 24-year-old female patient following submucous resection of the nasal septum. We discuss the etiology, diagnosis and clinical course.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Cerebrospinal Fluid Rhinorrhea and Recurrent Pneumococcal Meningitis after Submucous Resection of the Nasal Septum

Erol¹,

Özkurt²,

Taşyaran³

2001

Otorhinolaryngol Nova

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“…Eleven percent occurred in patients who had CSF leaking for less than 7 days while meningitis ensued in 88% of those who continued to leak more than 7 days. Others have noted the incidence of men ingitis with CSF rhinorrhea to be between 25 and 35% [6,7]. The occurrence of posttraumatic meningitis in the presence of CSF otorrhea ranges from 0 to 19% [2,3,7], The patients in our series were critically ill with most requiring ventilatory and circulatory support.…”

Section: Discussionmentioning

confidence: 84%

Posttraumatic Meningitis in Adolescents and Children

Wilson

Copeland²,

Bastian³

1990

Pediatr Neurosurg

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To define the clinical features of posttraumatic meningitis in the pediatric age group, we have reviewed 7 cases presenting to Children’s Hospital – San Diego between 1981 and February 1988. Ages ranged from 3 to 16 years with 4 of the 7 patients being adolescents (> 13 years of age). These 4 adolescents accounted for 25% of the adolescent bacterial meningitis and all cases of nonmeningococcal meningitis in this age group. Six of 7 patients had positive cerebrospinal fluid (CSF) cultures and positive blood cultures. Organisms were Streptococcus pneumoniae (4), group A streptococcus (1), and Haemophilus influenzae (1). Five of the 7 patients required intensive cardiovascular and respiratory support. Four patients had a good neurologic recovery, 2 patients had neurologic sequelae, and 1 suffered sensorineural hearing loss. These data suggest that direct invasion of the CSF by bacteria may cause sepsis and cardiovascular compromise. Further, in adolescents with nonmeningococcal bacterial meningitis, a history of previous head trauma and CSF leakage should be sought and radiographic evaluation for CSF fistula should be considered.

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“…With or without rhinoliquorrhea, there is a persisting risk for meningitis of up to 30% [8,11,23] with a mortality between 0% and 20% [2,11,19]. Therefore, in our opinion operative closure is indicated in any patient showing dura laceration, regardless of whether rhinoliquorrhea is present or not.…”

Section: Discussionmentioning

confidence: 95%

Diagnosis and treatment of frontobasal skull fractures

et al. 1997

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During a five-year-period (January 1990 to December 1994) a total of 67 patients were operated on for frontobasal skull fractures. The indication for surgical treatment was based on the evidence of fractures encroaching paranasal sinuses or the cribriform plate on high-resolution axial or coronal CT scans. The following clinical signs indicating frontobasal trauma were observed: 25 patients (37%) showed rhinoliquorrhea, 14 (21%) had raccoon's eyes, and 2 (3%) had meningitis. Distinct dura laceration was observed intraoperatively in 64 of 67 patients (96%). In our experience, high resolution CT has proven to be a sensitive diagnostic tool for frontobasal skull fractures. With respect to the high coincidence of fractures and dura lacerations, the indication for surgical treatment based on CT findings seems to be justified.

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Cerebrospinal fluid rhinorrhoea and its management

Cited by 53 publications

References 12 publications

Cerebrospinal Fluid Rhinorrhea and Recurrent Pneumococcal Meningitis after Submucous Resection of the Nasal Septum

Cerebrospinal Fluid Rhinorrhea and Recurrent Pneumococcal Meningitis after Submucous Resection of the Nasal Septum

Posttraumatic Meningitis in Adolescents and Children

Diagnosis and treatment of frontobasal skull fractures

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