Imaging of Cerebrospinal Fluid Rhinorrhea and Otorrhea

Radiol Clin North Am. 2017 Jan;55(1):167-187. doi: 10.1016/j.rcl.2016.08.005.

Abstract

As the obesity epidemic grows in the United States, rhinorrhea and otorrhea from spontaneous cerebrospinal fluid (CSF) leaks secondary to untreated idiopathic intracranial hypertension are increasing in prevalence. CSF rhinorrhea and otorrhea should also be carefully evaluated in posttraumatic and postsurgical settings, because untreated CSF leaks often have serious consequences. The work-up, diagnosis, and characterization of a CSF leak can be complex, often requiring a multimodality approach to optimize surgical planning. This article reviews the causes of CSF leaks, describes the methodology used to work up a suspected leak, and discusses the challenges of making an accurate diagnosis.

Keywords: CSF leak; Cisternogram; Idiopathic intracranial hypertension (IIH); Skull base fractures.

Publication types

  • Review

MeSH terms

  • Cerebrospinal Fluid / diagnostic imaging*
  • Cerebrospinal Fluid Otorrhea / diagnostic imaging*
  • Cerebrospinal Fluid Otorrhea / etiology
  • Cerebrospinal Fluid Rhinorrhea / diagnostic imaging*
  • Diagnosis, Differential
  • Humans
  • Intracranial Hypertension / complications
  • Intracranial Hypertension / diagnostic imaging*
  • Intracranial Hypertension / etiology
  • Magnetic Resonance Imaging / methods*
  • Neuroimaging / methods
  • Tomography, X-Ray Computed / methods*