CSF leakage in patients with no history of trauma or surgery is called spontaneous or nontraumatic CSF leakage. The most common cause of CSF flow into the nasal cavity through the skull base defect site, resulting in CSF rhinorrhea, is trauma. The upper clivus was not continuous, and appeared to be connected with the suprasellar cistern (Fig. Moreover, a patchy increased density shadow could be observed in the left maxillary sinus and sphenoid sinus, and a patchy low signal shadow with clear boundaries was present in the left ethmoid sinus and sphenoid sinus. A scattered, spot-like, and patchy gas density shadow could be observed in the sellar area, falx cerebri, frontal lobe bilaterally, temporal lobe, and right lateral fissure. The image of the sella turcica showed no obvious abnormality in its size and shape, and no abnormal density was observed on or around it. This study has been approved by the ethics committee of Sino-Japanese Friendship Hospital of Jilin University, and the patient presented signed an informed consent form.Ī head computed tomography (CT) scan of the patient showed abnormal density in the right maxillary sinus, the sphenoidal sinuses bilaterally, and the nasal cavity, combined with intracranial pneumatosis. The clear liquid from the nasal cavity and lumbar CSF were collected and sent for examination the results are presented in Table Table1 1. The bilateral pathological sign was negative. The muscle tension at the extremities was average, and the muscle strength was around grade 4. Bilateral absence of smell, and a transparent fluid discharge from the nasal cavity could be observed. Upon specialist examination, it was determined that the patient's pupils were bilaterally equally large and round with a diameter of 3 mm, and were sensitive to light. The patient had a 3-year history of hypertension, which was sufficiently controlled through self-medication, and there was no history of trauma or related infection. As the symptoms did not improve significantly upon symptomatic treatment by the local hospital, the patient was transferred to our hospital to receive a more extensive neurological assessment. Around 15 days before admission, the same symptoms recurred, accompanied by dizziness and one-time vomiting incidence. The patient was discharged after remission of the symptoms. The local hospital diagnosed him with “CSF rhinorrhea,” and the patient was hospitalized for 1 week, receiving strict bed rest and symptomatic treatment. A 71-year-old man presented with a clear liquid nasal discharge of no obvious cause.
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