TY - JOUR
T1 - Chronic subdural haematoma associated with nontraumatic CSF rhinorrhea
T2 - A management challenge
AU - Poonnoose, Santosh Isaac
AU - Manjooran, Raju P.
AU - Mathew, John
AU - Ramachandran, Pranatartiharan
PY - 2007/3
Y1 - 2007/3
N2 - We report an unusual case of chronic subdural haematoma (CSH) associated with cerebrospinal fluid (CSF) rhinorrhoea emphasizing the importance of managing both conditions simultaneously. A 59- year-old man presented with watery discharge from the right nostril, of 2 months duration. MRI of the brain showed a CSH in the left fronto-parietal region with significant mass effect. There was an arachnoidocoele with a defect in the planum sphenoidale. He first underwent a burr hole evacuation of the CSH following which the CSF rhinorrhea did not subside, even with bed rest. Transnasal endoscopic closure of the CSF dural fistula was done. On the first post-operative day, he was disoriented and a CT scan showed a recollection of the subdural haematoma that required repeat evacuation. The patient was asymptomatic at discharge. To our knowledge this is the first reported case of CSF rhinorrhoea associated with CSH. Simultaneous closure of the CSF dural fistula at the time of evacuation of a coexisting CSH would be the optimal management.
AB - We report an unusual case of chronic subdural haematoma (CSH) associated with cerebrospinal fluid (CSF) rhinorrhoea emphasizing the importance of managing both conditions simultaneously. A 59- year-old man presented with watery discharge from the right nostril, of 2 months duration. MRI of the brain showed a CSH in the left fronto-parietal region with significant mass effect. There was an arachnoidocoele with a defect in the planum sphenoidale. He first underwent a burr hole evacuation of the CSH following which the CSF rhinorrhea did not subside, even with bed rest. Transnasal endoscopic closure of the CSF dural fistula was done. On the first post-operative day, he was disoriented and a CT scan showed a recollection of the subdural haematoma that required repeat evacuation. The patient was asymptomatic at discharge. To our knowledge this is the first reported case of CSF rhinorrhoea associated with CSH. Simultaneous closure of the CSF dural fistula at the time of evacuation of a coexisting CSH would be the optimal management.
KW - Chronic subdural haematoma
KW - CSF rhinorrhea
UR - http://www.scopus.com/inward/record.url?scp=33846357785&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2005.11.015
DO - 10.1016/j.jocn.2005.11.015
M3 - Article
C2 - 16510285
AN - SCOPUS:33846357785
SN - 0967-5868
VL - 14
SP - 281
EP - 283
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
IS - 3
ER -