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    CSF Rhinorrhoea

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    Rohit Chandrasekhar
    This document discusses cerebrospinal fluid (CSF) leaks from the nose. It lists various potential causes including head injuries, sinus surgery, tumors, and congenital skull defects. It describes the clear fluid discharge from the nose and how to diagnose a CSF leak through tests of the fluid, imaging like CT scans and MRI, and intrathecal dye injections. Treatment options include conservative management like bed rest or antibiotics, or surgical repair either endoscopically through the nose or intra-cranially.

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    CSF Rhinorrhoea

    Uploaded by

    Rohit Chandrasekhar
    58 views12 pages
    This document discusses cerebrospinal fluid (CSF) leaks from the nose. It lists various potential causes including head injuries, sinus surgery, tumors, and congenital skull defects. It describes the clear fluid discharge from the nose and how to diagnose a CSF leak through tests of the fluid, imaging like CT scans and MRI, and intrathecal dye injections. Treatment options include conservative management like bed rest or antibiotics, or surgical repair either endoscopically through the nose or intra-cranially.

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    Csf Rhinorrhoea

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    This document discusses cerebrospinal fluid (CSF) leaks from the nose. It lists various potential causes including head injuries, sinus surgery, tumors, and congenital skull defects. It describes the clear fluid discharge from the nose and how to diagnose a CSF leak through tests of the fluid, imaging like CT scans and MRI, and intrathecal dye injections. Treatment options include conservative management like bed rest or antibiotics, or surgical repair either endoscopically through the nose or intra-cranially.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    58 views12 pages

    CSF Rhinorrhoea

    Uploaded by

    Rohit Chandrasekhar
    This document discusses cerebrospinal fluid (CSF) leaks from the nose. It lists various potential causes including head injuries, sinus surgery, tumors, and congenital skull defects. It describes the clear fluid discharge from the nose and how to diagnose a CSF leak through tests of the fluid, imaging like CT scans and MRI, and intrathecal dye injections. Treatment options include conservative management like bed rest or antibiotics, or surgical repair either endoscopically through the nose or intra-cranially.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 12

    MUHSINA U.

    P 51st BATCH

    Presents as flow of clear fluid from nose

    Aetiology
    1)Traumatic: Head injuries Surgery of frontal, ethmoidal or sphenoidal sinus Hypophysectomy As a complication of endoscopic sinus surgery

    2) Tumours Large osteomas of frontoethmoidal region Tumours of pituitary or olfactory bulb 3)Congenital defects in skull Associated with encephalocele 4)Spontaneous type

    Anterior

    cranial fossa
    cribriform plate ethmoid air cells frontal sinus

    Nose

    Middle

    cranial fossa
    sphenoid sinus

    nose Injuries to temporal bone


    eustachian tube

    middle ear

    nose(otorhinorrhoea)

    From history: dribbling of clear watery fluid from nose on bending or straining;uncontrollable and cant be sniffed back. No associated sneezing.

    Lab investigations:
    It will remain clear in a test tube if allowed to stand. Glucose in CSF can be demonstrated by oxidase-peroxidase paper strip or biochemical test.

    Beta 2 transferrin is specific for CSF confirms CSF leak.

    By intrathecal injection of a dye(fluorescein 5%)or a radioisotope And placing pledgets of cotton in theolfactory slit,middle meatus,sphenoethmoidal recess and near eustachian tube

    Then examine the pledgets for dye or radio activity

    Site of leak can be determined by high resolution,thin section coronal cuts with bone window-it can show the area of bony defect

    If this fails tolocalise the defect,a CT cisternogram advised CT scan is combined with injection of a contrast material into intra thecal space via cisterna magna

    A non invasive non ionising technique of MRI with T2 weighted images or MRI cisternography is more useful. In otorhinorrhoea,always examine ear for the presence of fluid and conductive hearing loss. In traumatic CSF leak double ring sign(target sign) will be +ve. ie ,discharge collected on a piece of filter paper shows a central spot of blood while CSF spreads out like a halo around that

    In early cases:conservative management by placing the patient in the semi sitting position,avoiding blowing of nose,sneezing and straining. Prophylactic antibiotics are administered to prevent meningitis. In persistent cases:surgical treatment with nasal endoscopic or intra cranial approach.

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