Neurosurgery Dr. Stoforou


Rhinorrhoea CSF or Rhinorrhea CSF, i.e. nasal discharge of cerebro-spinal fluid (CSF) is a rare but potentially devastating condition with high rates of morbidity (illness) and mortality (death).


The disruption of natural barriers between the nasal and paranasal cavities and the anterior and middle cranial cavity is the major factor leading to CSF leakage in the nasal cavity. The disruption of the waterproof sealing of the arachnoid meninges as well as the brain’s dura mater of the cranial base area above the nose is the cause of this fluid’s nasal leakage.


Rhinorrhoea CSF or Rhinorrhea CSF can be:


  • Automatic rhinorrhoea CSF: that is, no injury is reported in the area
  • Post-traumatic rhinorrhoea CSF: i.e. after a head injury
  • Iatrogenic rhinorrhoea CSF: after surgery in the area
  • Tumor related rhinorrhoea CSF: relating to a tumor in the area
  • Congenital rhinorrhoea CSF


Rhinorrhoea CSF or Rhinorrhea CSF – Treatment


This communication between the “outside world” and the central nervous system can initiate a number of complications, mainly deriving from infectious agents (microbes) which can lead to a patient’s significant morbidity and potentially destructive long-term complications (meningitis, pneumo-brain (air in the brain), etc.) and thus should always be treated.


Unless there are medical or surgical contraindications, surgical repair is recommended to all patients and iatrogenic CSF leakage in order to avoid meningitis.


Patients with recent head trauma are advised initially to undergo a conservative course of treatment by staying in bed with a lumbar drainage fitting if needed. Nevertheless, if rhinorrhoea CSF persists or if there is a large deficiency in the base of the skull, then surgical restoration is recommended.



Transnasal endoscopic repair of cerebrospinal fluid rhinorrhoea is the appropriate treatment procedure.