CSF Rhinorrhoea

CSF rhinorrhoea is the leakage of cerebrospinal fluid (CSF) from the nasal cavity. It occurs when there is a tear or defect in the membrane that surrounds the brain, allowing CSF to escape through the nose.

Causes of CSF Rhinorrhoea

The primary causes of CSF rhinorrhoea include:

Trauma: Head injuries or facial fractures can cause tears in the skull base, leading to CSF leakage.
Surgical Complications: Post-surgical leaks may occur following neurosurgery or sinus surgery.

Spontaneous: Occasionally, leaks can occur without any obvious cause, often due to a weakness in the skull base or increased intracranial pressure.
Tumors: Certain brain tumors or lesions can erode the skull base and cause CSF leaks.

Symptoms of CSF Rhinorrhoea

The primary symptom is a clear, watery nasal discharge, which may be constant or intermittent. This fluid is typically thin and may have a salty taste. Other symptoms can include headache, nasal congestion, and sometimes a post-nasal drip. The discharge may become more pronounced when bending over or lying down.

Diagnosis of CSF Rhinorrhoea

Diagnosis involves a combination of clinical evaluation and diagnostic tests. Key diagnostic methods include:

Beta-2 Transferrin Test: A specialized test of the nasal discharge to confirm the presence of CSF.
Imaging Studies: CT or MRI scans are used to identify the source of the leak and assess for underlying causes.
Rhinomanometry: Measures the amount of fluid leakage and helps in identifying the location of the defect.

Treatment Options for CSF Rhinorrhoea

Treatment depends on the cause and severity of the leak:

Conservative Management: Rest, nasal decongestants, and avoiding activities that increase intracranial pressure (such as heavy lifting) can be effective for minor leaks.
Surgical Intervention: In cases where conservative measures are ineffective or the leak is persistent, surgery may be required to repair the tear in the skull base and seal the leak.

Preventing CSF Rhinorrhoea

Preventive measures include avoiding head trauma, managing conditions that increase intracranial pressure, and ensuring careful surgical techniques if undergoing procedures involving the skull base.