Spontaneous “high pressure CSF rhinorrhoea”. Cerebrospinal fluid leakage caused by long-standing increased intracranial pressure

Schechter, Martin; Rovit, Richard L.; Nelson, Kenneth E.

doi:10.1259/0007-1285-42-500-619

Cited by 14 publications

(4 citation statements)

References 17 publications

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“…Three cases of aqueductal stenosis have been reported manifesting as a fistulous communication between the protruding frontal lobe and the defect in the cribriform plate. 19,28,29) A case of aqueductal stenosis presented with spontaneous CSF rhinorrhea associated with a empty sella syndrome. 13) Three cases of spontaneous CSF rhinorrhea associated with aqueductal stenosis were managed by insertion of a ventriculoperitoneal shunt and resulted in intraventricular tension pneumocephalus.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous CSF rhinorrhea is uncommon as a primary presenting feature of aqueductal stenosis, with only nine reported cases. 3,10,11,13,14,19,[28][29][30] The treatment of these cases has varied widely. We report an adult case of aqueductal stenosis manifesting as spontaneous CSF rhinorrhea probably originating from dehiscence of the cribriform plate following head trauma in childhood.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Cerebrospinal Fluid Rhinorrhea as a Presenting Symptom of Aqueductal Stenosis -Case Report-

Muzumdar

Nadkarni

Goel

2003

Neurol. Med. Chir.(Tokyo)

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A 30-year-old male patient presented with chronic spontaneous cerebrospinal fluid (CSF) rhinorrhea. He had sustained a mild head injury in childhood. Magnetic resonance imaging of the brain showed aqueductal stenosis associated with moderate supratentorial hydrocephalus, and erosion of the cribriform plate. Following insertion of ventriculoperitoneal shunt, the CSF rhinorrhea completely ceased and no direct repair of the CSF fistula was necessary. Long-standing spontaneous CSF rhinorrhea indicates the possibility of concurrent intracranial pathology, such as aqueductal stenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spontaneous Cerebrospinal Fluid Rhinorrhea as a Presenting Symptom of Aqueductal Stenosis -Case Report-

Muzumdar

Nadkarni

Goel

2003

Neurol. Med. Chir.(Tokyo)

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“…Simultaneous use of a large-molecule and a small-molecule tracer allows direct and simultaneous evaluation of any difference in these pathways. 1,7,16,18,19,27,28 Therefore, if the transcerebral fistula (by open operation) is successful in bypassing the basal kaolin block to CSF flow, the perineural CSF olfactory flow should reappear. This method to establish that the CSF fistula is patent involves only minimally invasive techniques and can be repeated.…”

Section: ' 8a5' 2~mentioning

confidence: 99%

Experimental transcerebral fistula

Foltz¹,

Blanks²,

Morton³

1984

Journal of Neurosurgery

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Cerebrospinal fluid dynamics were studied in eight dogs during normal, hydrocephalic, and postoperative phases. Radionuclide-labeled substances introduced into the normal ventricular system flow out of the exits from the fourth ventricle to the convexity subarachnoid spaces superiorly to be absorbed in the sagittal sinus, and basorostrally to the exits from the perineural olfactory sheath into the nose to produce physiological cerebrospinal fluid (CSF) rhinorrhea. Serial radionuclide ventriculography of the head following intraventricular isotope injection of labeled proteins and chelate into the kaolin-induced hydrocephalic system shows a high degree of ventricular stasis with no perineural olfactory nerve flow (rhinorrhea). An operative transcerebral fistula, fashioned from a dilated lateral ventricle to the convexity subarachnoid space, reestablishes perineural olfactory flow of CSF into the nose, as demonstrated by the radionuclide ventriculography studies. This suggests a potential method for treatment of hydrocephalus. Serial imaging studies in this surgically modified system clearly demonstrate radionuclide flow through the patent fistula to distal absorption sites, thereby bypassing the basal obstruction. Moreover, augmented CSF pressures associated with obstructive hydrocephalus can be controlled by such treatment. The application of this method in treating clinical hydrocephalus is discussed with emphasis on fistula arachnoid closure to assure fistula patency.

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“…Occasionally, high-pressure hydrocephalus caused by long-standing increased intracranial pressure (ICP) itself has been the cause of rhinoliquorrhoea in adults [24], presumably secondary to the chronically raised ICP with skull base erosion and meningocele. Aqueductal stenosis has also been involved in the pathophysiology, with moderate supratentorial hydrocephalus and erosion of the cribriform plate [2,14,27].…”

Section: Introductionmentioning

confidence: 99%

Ethmoidal meningoencephalocele and CSF leak after posthaemorrhagic ventricular dilatation in a newborn child

et al. 2015

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Spontaneous “high pressure CSF rhinorrhoea”. Cerebrospinal fluid leakage caused by long-standing increased intracranial pressure

Cited by 14 publications

References 17 publications

Spontaneous Cerebrospinal Fluid Rhinorrhea as a Presenting Symptom of Aqueductal Stenosis -Case Report-

Spontaneous Cerebrospinal Fluid Rhinorrhea as a Presenting Symptom of Aqueductal Stenosis -Case Report-

Experimental transcerebral fistula

Ethmoidal meningoencephalocele and CSF leak after posthaemorrhagic ventricular dilatation in a newborn child

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