Abstract
Mohammad Samadian1, Seyed Ali Mousavinejad*1, Hamid Borghei-Razavi2, Guive sharifi1, Kaveh Ebrahimzadeh1, Kristen Almagro PA2 and Omidvar Rezaei1 Author Affiliations 1Departments of Neurosurgery, Loghman Hospital, Tehran, Iran 2Department of Neurosurgery, Pauline Braathen Neurological Center, Weston, Florida, USA Received: December 02, 2020| Published: December 08, 2020 Corresponding author: Seyed Ali Mousavinejad, Departments of Neurosurgery Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran DOI: 10.26717/BJSTR.2020.32.005249
Highlights
Spontaneous or non-traumatic cerebrospinal fluid leaks comprise 5%-10% of all cerebrospinal fluid (CSF) rhinorrhea [1,2]
The exact pathophysiology of CSF clival fistula is debated, excessive pneumatization of sphenoid with other factors such as arterial pulsation and continuous CSF pressure wave were described as potential causes
We found that in cases suspected of clival defect, mid-sagittal MRI with T2-weighted sequences, can help to detect the defect, showed CSF fistula from prepontine cisterna to sphenoid sinus
Summary
Spontaneous cerebrospinal fluid leaks comprise 5-10% of all CSF rhinorrhea. Generally, CSF rhinorrhea occur at cribriform plate, sella, sphenoid sinus and ethmoid air. The second case was a 57-year-old man referred to our department with the complaint of intermittent rhinorrhea starting 6months ago. He had a history of bacterial meningitis one month ago, which was treated in another center. In both cases, testing of the fluid for beta-2 transferrin was positive. Magnetic resonance imaging and computed tomography cistern gram showed CSF leak through clivus into the sphenoid sinus. In both patient’s defect was repaired with abdominal fat, reinforced by fascia late and naso septal flap via “two nostrils-four hands” endoscopic trans nasal, transsphenoidal approach
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