Abstract
Background
Cerebrospinal fluid (CSF) leaks in the form of rhinorrheas and otorrheas are known
entities in case of traumatic brain injuries. However, spontaneous CSF leaks are rare
in incidence. It happens due to a bony defect at the skull base with an associated
breach in the dura and arachnoid layer along with a sinonasal disruption.
Material and Methods
We, at this moment, present the case of a 44-year-old woman with a spontaneous onset
CSF rhinorrhea for 1 month.
Observation
She was evaluated with imaging CT cisternography. However, as the defect was small,
it was difficult to identify the site of CSF rhinorrhea. Therefore, intrathecal fluorescein
dye was administered, and the dye could be visualized with the naked eye under endoscopic
white light as a green color after 20 to 30 minutes. The location was identified and
was plugged with a Hadad flap and fat plug.
Conclusion
The location of the CSF leak needs to be identified with modalities like CT or MR
cisternography, but it becomes challenging if the leak site is small. Hence, the use
of intraoperative modalities to determine the location of a leak needs to be done
meticulously for a successful outcome.
Keywords
CSF rhinorrhea - fluorescein dye - cisternography - intrathecal dye
