Patient Story

Disease : Chronic-CSF Rhinorrhea

Last Updated on : 06 Apr 2024

Case Started on : 18 Nov 2020

Here is the case study of a disease CSF Rhinorrhea, in a 75 Years old lady.
She suffered from leakage of brain fluid (CSF) from her right nostrils for two and a half months.
CSF Rhinorrhea is a clinical condition where the fluid which bathes the brain and spinal cord get leaked through the nose. The most potential point is the skull base, where an area called a cribriform plate (sieve-like). Any factor which increases the CSF pressure can cause a fluid leak.
The cause can be traumatic or non-traumatic
Diagnosis is made by CT cisternography to locate the exact site of the CSF leak. It is performed after injecting contrast into the theca (spine); however, this procedure is highly dependant on patient positioning and timing.
Fluid leaked from the nose may also serve in diagnosis purpose as normal CSF glucose levels lie between 45–80 mg/dL, whereas in average nasal discharge level is 10 mg/dl.
There is another specific lab test for the CSF leak. Beta-2-transferrin is a protein found only in CSF and perilymph. Its absence in other body secretions makes its detection invaluable in diagnosing a CSF leak.

This old lady also had chronic asthma for more than 30 years, gastric trouble and hypothyroidism.
They contacted us from Bhagalpur Bihar, and in the COVID 19 Pandemic, we advised opting for online treatment only. Dr Ravi advised her to go for a CT Cisternography test, and on the test, it says - A small fluid filled tract is seen along right cribiform plate communicating with subarachnoid space – likely CSF fistula.

Her case taking was done meanwhile, and her treatment started on receiving the hair.
Within one week, her CSF leak stopped. Watch out for the story.

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