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Posttraumatic cerebrospinal fluid (CSF) leakage may frequently develop after a skull base fracture. A patient with a 1-month history of intermittent watery rhinorrhea was referred to our department from the Department of Neurosurgery. He had been treated for 8 months due to a skull base fracture after a motor vehicle accident. He had undergone cranial trephination due to brain abscess prior to this presentation. On radiologic examination, a large skull base defect with encephalocele was observed. Using the nasal endoscopic approach, we identified a large protruding mass of soft brain tissue with pulsating CSF in the ethmoid roof. CSF lumbar drainage was performed in order to reduce the protruding mass by decreasing intracranial pressure. After CSF lumbar drainage, the protruding brain tissue was returned to the cranial cavity, and the leak site was successfully repaired with septal cartilage and graft material.
Posttraumatic cerebrospinal fluid (CSF) leakage may frequently develop after a skull base fracture. A patient with a 1-month history of intermittent watery rhinorrhea was referred to our department from the Department of Neurosurgery. He had been treated for 8 months due to a skull base fracture after a motor vehicle accident. He had undergone cranial trephination due to brain abscess prior to this presentation. On radiologic examination, a large skull base defect with encephalocele was observed. Using the nasal endoscopic approach, we identified a large protruding mass of soft brain tissue with pulsating CSF in the ethmoid roof. CSF lumbar drainage was performed in order to reduce the protruding mass by decreasing intracranial pressure. After CSF lumbar drainage, the protruding brain tissue was returned to the cranial cavity, and the leak site was successfully repaired with septal cartilage and graft material.
