Cerebrospinal fluid rhinorrhoea

CSF rhinorrhoea refers to the drainage of cerebrospinal fluid through the nose. Measures of CSF components such as glucose have been used in the past, but are neither sensitive nor specific; beta-2 transferrin, however, has been shown to have a high positive predictive value.[1] It has also been noted to be characterized by unilateral discharge.[2]

Cerebrospinal fluid rhinorrhoea
Specialty	Neurology

It is a sign of a basilar skull fracture. Management includes watchful waiting – leaks often stop spontaneously; if this does not occur then neurosurgical closure is necessary to prevent the spread of infection to the meninges.[2]

Other signs of a basilar skull fracture includes 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 bacterial infections of the latter that can have catastrophic effects on the patient.[2]

CSF rhinorrhoea can also be a symptom of a pituitary adenoma.

Spontaneous CSF rhinorrhea. The most common congenital or acquired defect in the skull base bones (anterior cranial fossa) at the spontaneous nasal liquorrhea localized in following formation:

• sphenoid sinus (43%)
• ethmoid bone (29%)
• cribriform plate (29%)