Abstract
Spontaneous cerebrospinal fluid (CSF) rhinorrhea is an uncommon phenomenon. One of the complications associated with CSF rhinorrhea is meningitis, which is associated with high mortality. Therefore, the prompt diagnosis of CSF rhinorrhea is essential. We present a case of a patient, who after zip-lining, developed CSF rhinorrhea. She had no history of trauma and none of the conventional comorbidities associated with spontaneous CSF rhinorrhea. She was diagnosed with the help of radiological studies and biochemical tests. Our case is unique as there are no published case reports of spontaneous CSF rhinorrhea occurring after atraumatic zip-lining.
Highlights
Cerebrospinal fluid (CSF) is a clear fluid that surrounds the brain and spinal cord
We report a case of a patient, with no history of trauma, who presented with right-sided nasal discharge and headache after a zip-lining trip
Many cases of CSF rhinorrhea after documented trauma can be found in published literature
Summary
Cerebrospinal fluid (CSF) is a clear fluid that surrounds the brain and spinal cord. CSF rhinorrhea occurs when there is a fistula between the dura and the skull base and discharge of CSF from the nose. We report a case of a patient, with no history of trauma, who presented with right-sided nasal discharge and headache after a zip-lining trip. A 39-year-old female with no known comorbid was in her usual state of health 10 days back when she suddenly developed nasal discharge from her right nostril after zip-lining in the northern regions of Pakistan. The patient’s neurological examination was normal as well Her body mass index (BMI) was calculated to be 22. She was advised an MRI (fast imaging employing steady-state acquisition [FIESTA] sequence) (Figure 1), which showed an asymmetric accentuated linear tract via the right cribriform plate from the right frontal region into underlying ethmoids. A beta-2-transferrin assay study was performed, which confirmed the diagnosis of CSF rhinorrhea. On her subsequent follow-up visit, the patient's symptoms were resolved completely
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