CSF rhinorrhea is a condition which is caused when the structures supporting the base of the skull get weak or break down. This breakdown of the dura results in the loss of alignment. An undesired connection is formed between the subarachnoid space and the nose. This condition is usually caused due to a trauma. The ablation of a tumor, sinusitis or even surgery can cause this condition.
When the pressure of the cerebrospinal fluid becomes greater than the tensile strength of the arachnoid and the dura, it can cause this disruption. There is also a separation of the fibers of dura and therefore the cerebrospinal fluid begins to leak.
The etiology of CSF rhinorrhea is the same, which ever way it may occur. If the disorder occurs directly, it is through the cranial fossa. In an indirect incidence, both the middle and the posterior fossa or either one of them could be involved. In either case, the pressure is exerted through the Eustachian tube.
CSF rhinorrhea is not very common however, since its complications are extremely severe, it is important to take a CSF test to check for normal CSF. Usually a fistula like this may heal on its own if the condition is managed properly. With conservative management, most fistulas won’t have any complications and may heal on their own. However, if CSF rhinorrhoea presents additional complications like meningitis, hydrocephalus and pneumocephalus, it may be fatal. In about half of untreated cases, meningitis is a possible complication.
In case of csf rhinorrhoea, the cerebrospinal fluid starts to leak through the nose by way of the pituitary gland. Surgical intervention is not recommended in this case.
CSF rhinorrhea is usually classified into two - traumatic or atraumatic. A head injury or a surgery can be cause of a traumatic disorder. Fracture in the base of the skull or head injuries usually result in CSF rhinorrhoea. The disorder may manifest itself as early as 48 hours after the trauma is received. However in most cases, the fistula closes spontaneously if there is no significant loss of the dural tissue. Almost sixteen percent of the cases of CSF rhinorrhoea are caused due to trauma and leaks.
Traumatic or spontaneous leaks are caused due to high pressure of the cerebrospinal fluid or because of spontaneous leaks. Tumors and hydrocephalus usually cause spontaneous pressure leaks. These leaks may be caused due to a long term cranial pressure. If there is increased pressure in the subarachnoid space, the cerebrospinal fluid is forced through a narrower space which causes an increase in the pressure.