CSF rhinorrhea is leaking of the fluid that surrounds the brain into the nose. This is a significant cause for concern, since the CSF fluid can become contaminated with bacteria in the nasal cavity and can result in meningitis.
CSF leaks are often first detected because of dripping of a clear fluid from one side of the nose, especially when bending the head down. Dripping may be accompanied by headaches that are made better by lying down. CSF fluid may taste salty or metallic.
The most common causes of CSF rhinorrhea are trauma and previous sinus or brain surgery. Spontaneous CSF leaks are often associated with a condition called Benign Intracranial Hypertension and can occur without a preceeding event.
Accurate diagnosis of a CSF leak is critical to the correct treatment. Tests of the fluid, such as a Beta 2 transferrin test, nasal endoscopy after intrathecal fluorescein injection and high resolution CT and MRI scans can help make the diagnosis.
Once the diagnosis is made, surgical closure of the leak is the treatment of choice. At the University of Arizona, nearly every case of CSF rhinorrhea is closed with endoscopic techniques, without the need for a cut on the face or a craniotomy. Published research indicates a 95 percent success rate for this approach vs. a 60 percent success rate when done via an open craniotomy.