Could That Continuous Nasal Discharge Indicate CSF Rhinorrhea?

Posted by Sonam Sinha on May 30th, 2019

Cerebrospinal fluid (CSF) is a colorless, clear, and slightly alkaline fluid produced in the ventricles or hollow spaces of the brain. This fluid is protective in nature and runs down around the spinal cord, serving as a cushion to the brain and the spinal cord. It helps to absorb shocks, maintain appropriate cranial pressure, and acts as a medium of supply of nutrients and removal of waste products. Sometimes, due to causes like head trauma, CSF may find its way from the brain, through the meninges and the bones, into the sinuses and the nose. This results in a highly runny nose that discharges a clear, colorless, and salty fluid. The condition is mostly accompanied by severe headaches and is known as CSF Rhinorrhea. While CSF Rhinorrhea resolves on its own within a day or two, persistence of the symptoms calls for medical and surgical interventions. But how would one know if a runny nose is a CSF issue and whether it would need to be examined by a doctor?

Let’s take a look at CSF leak symptoms, its possible causes, and treatment options to help with better understanding of the condition.

Symptoms:

Symptoms of CSF Rhinorrhea include:

•  Continual watery discharge from the nose, usually from only one side. Discharge may sometimes occur from the ears, too
•  Headaches which are bad in the sitting position and worsen on lying down
•  Vision problems
•  Nausea and stiffness

Causes:

Causes of CSF Rhinorrhea include:

•  Injury to the head
•  Spinal surgery
•  Procedures like lumbar puncture
•  Medications to relieve pain

Prevention:

Since CSF Rhinorrhea is a serious condition, especially in its severe forms, one should always take measures to prevent it from occurring. Some of the preventive measures include:

•  Using very small and thin needles while performing medical procedures on the spinal cord
•  Avoiding stress and anxiety as these may worsen the headaches
•  Consuming a healthy diet every day

Diagnosis:

Diagnosis of the condition involves:

•  A physical examination of the patient
•  Jotting down the medical history of the patient that includes─
•  Information about probable events which might have led to the condition, for instance, head injury or previous surgical procedures
•  Type of nasal discharge
•  Duration of nasal discharge
•  Positions or conditions which cause improvement or deterioration in the condition
•  Confirmation of CSF Rhinorrhea and identification of the route of CSF leak by imaging tests like─
•  Magnetic Resonance Imaging
•  CT Cisternography
•  Isotope Cisternography

Treatment

Once the doctor has confirmed presence of CSF Rhinorrhea, treatment will begin. Treatment mainly aims at stopping the leakage of CSF. This broadly involves two categories as have been discussed below─

•  Conservative treatment: This involves asking the patient to get bed rest of one to two weeks and does not include surgical procedures. It is used in case of spontaneous leaks or head injury.
•  Surgical treatment: This method is chosen when the condition does not resolve with conservative treatment and may involve endoscopic techniques or external incisions to repair the defect in the duramater.

If someone feels they have CSF leak symptoms, they must visit a good hospital to get examined immediately and get treated efficiently.