Late Onset Cerebrospinal Fluid Leakage Associated With Past Head Injury

Kamochi, Haruna; Kusaka, Gen; Ishikawa, Mami; Ishikawa, San‐e; Tanaka, Yuichi

doi:10.2176/nmc.53.217

Cited by 10 publications

(6 citation statements)

References 14 publications

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“…A total of 27 cases of CSF leakage occurred among 1036 cases of closed head injury. 11 In our study, of the 50cases with head injury we observed 2% cases of CSF rhinorrhoea. This is more or less comparable with the studies done by above authors.…”

Section: Resultssupporting

confidence: 46%

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Nasal/maxillofacial manifestations of head and neck injury

Patil

Girish

2017

Int J Otorhinolaryngol Head Neck Surg

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Background: A great deal of work has been directed toward using these symptoms to classify the severity of head injury. Loss of consciousness or coma and posttraumatic amnesia (difficulty in remembering new information after waking up from the coma) are the two most common symptoms used. A mild head injury is one in which the period of unconsciousness is less than twenty minutes and post traumatic amnesia lasts for less than one hour, while a head injury in which the person is unconscious for at least one day and experiences post traumatic amnesia for more than twenty four hours is considered severe. Methods: 50 Cases coming to O.P.D and casualty of Chigateri general hospital and Bapuji hospital attached to JJM Medical College, Davangere were studied. Results: Evidence of C.S.F rhinorrhoea was noticed in 1(2%) case which managed conservatively. Maxillary fracture was noticed in 05 (10%) cases which were managed conservatively. Zygomatic fractures were noticed in 07 (14%) cases which were managed by open reduction and internal fixation with mini plates under general anesthesia. Conclusions: Mandibular fractures were noticed in 10 (20%) of cases which were managed by open reduction and internal fixation with mini plates under general anesthesia.

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Section: Resultssupporting

confidence: 46%

“…The results of those studies show slight differences depending on regional, cultural, social and economic backgrounds. [10][11][12] In the study by Miyazaki et al, in patients with head injury, the total incidence of CSF rhinorrhea was 1-3%, and in almost all cases, CSF rhinorrhea occurred within the first three months after injury. 9…”

Section: Resultsmentioning

confidence: 99%

Nasal/maxillofacial manifestations of head and neck injury

Patil

Girish

2017

Int J Otorhinolaryngol Head Neck Surg

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“…[1] Moreover, it is associated with about a 10% risk of developing meningitis per year. [1,12,15,17,18,[21][22][23] Traumatic CSF rhinorrhea is classified as immediate (within 48 h) or delayed.…”

Section: Discussionmentioning

confidence: 99%

“…[22] Paradoxical CSF rhinorrhea usually manages conservatively with good success in the acute setting, but in the cases of recurrent meningitis or delay CSF rhinorrhea, it seems that surgical repair associated with the best outcome. [23]…”

Section: Table 1: Cases Of Delay Post Traumatic Cerebrospinal Fluid L...mentioning

confidence: 99%

Delay posttraumatic paradoxical cerebrospinal fluid leak with recurrent meningitis

et al. 2019

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Cerebrospinal fluid (CSF) rhinorrhea complicates 2% of all head traumas, and 12%–30% of all basilar skull fractures. Posttraumatic CSF rhinorrhea usually occurs within the first 48 h, and majority of them occur in the first 3 months, whereas delayed CSF leak beyond 3 months is rare. On the other hand, CSF usually leaks through dural tearing associated with fracture of the anterior skull base. CSF leak through fractures of middle cranial fossa to the nose through the eustachian tube is very rare. We present a 52-year-old woman with delayed posttraumatic paradoxical CSF rhinorrhea and recurrent meningitis.

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“…In this case, CSF rhinorrhea began about twenty days after the head trauma. Initially, the fistula might be temporarily blocked by tissues such as the brain, granulation tissue, and sinus mucosa [14] . Sometimes, CSF leakage can occur more than 3 months after head trauma, termed delayed onset of CSF rhinorrhea [15] .…”

Section: Discussionmentioning

confidence: 99%

Post-Traumatic Cerebrospinal Fluid Rhinorrhea Associated with Craniofacial Fibrous Dysplasia: Case Report and Literature Review

Zhou

Yang

Wang

et al. 2016

Translational Neuroscience and Clinics

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Objective Fibrous dysplasia (FD) is an unusual developmental abnormality of the skeleton. When facial and cranial bones are involved in FD, it is termed craniofacial fibrous dysplasia (CFD). Although several reports have reported that CFD has a tendency for spontaneous cerebrospinal fluid (CSF) leakage, there have been no related English-language case reports. We present the first case of post-traumatic CSF rhinorrhea associated with CFD. Methods A 30-year-old man presented with CSF rhinorrhea after a mild head trauma. Computed tomography cisternogram located a defect in the posterior wall of the right frontal sinus. Imaging examination also showed the evident expansion of multiple skull bones, spinal scoliosis, and multiple local enlargements of ribs. Without café-au-lait cutaneous spots and endocrine abnormalities, polyostotic FD was diagnosed instead of McCune-Albright syndrome (MAS). The patient underwent craniotomy fistula repair surgery. The excised bone was contoured to be thinner to increase the cranial cavity. The patient recovered well and CSF leakage did not recur. But during a nineteen-month follow up, sight in the patient's left eye was decreased. MAS was suspected. Unfortunately the patient refused to take the proposed decompression surgery and laboratory tests of serum hormones. Conclusions CFD, if the wall of the paranasal sinus is involved and the cranial cavity is decreased, may increase the risk of CSF rhinorrhea after head trauma. Expectant management is recommended in asymptomatic CFD patients even in the presence of optic nerve compression. As MAS may cause more problems, it should be precluded before polyostotic FD is diagnosed.

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Late Onset Cerebrospinal Fluid Leakage Associated With Past Head Injury

Cited by 10 publications

References 14 publications

Nasal/maxillofacial manifestations of head and neck injury

Nasal/maxillofacial manifestations of head and neck injury

Delay posttraumatic paradoxical cerebrospinal fluid leak with recurrent meningitis

Post-Traumatic Cerebrospinal Fluid Rhinorrhea Associated with Craniofacial Fibrous Dysplasia: Case Report and Literature Review

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