Results of Conservative Management of CSF Rhinorrhea in Post Traumatic Patients

Abstract

Objectives: We aimed to see the results of conservative management of CSF rhinorrhea in post-traumatic patients.
 Material and Methods: An observational study was conducted on 50 patients for 3 months from 1st November 2021 to 31th Jan 2022. Patients presented to neurosurgery unit II, PINS. All patients had a history of road traffic accidents (RTA).
 Results: The age range was 10 – 50 years. The mean age was 25 years. All patients were managed conservatively for one week. We advised complete bed rest to all patients for 2 weeks. Head ends of all patients were slightly inclined from 15 – 30 degrees to reduce pressure in basal cisterns. We gave acetazolamide, mannitol, antibiotics, and anti-epileptic medication to all patients. CSF rhinorrhea in our 43 (86%) patients was stopped completely. In our 5 (10%) patients, CSF rhinorrhea was cured completely after doing a lumbar puncture with drainage of CSF and with the placement of a lumbar drain at a rate of 10 ml per hour. In our 2 (4%) patients, CSF rhinorrhea was not cured. We have to do surgery either by trans cranial or endoscopic repair of CSF rhinorrhea.
 Conclusion: CSF rhinorrhea is best cured by conservative management except in 4% of cases.

Role of Conservative Treatment and Outcome of Traumatic CSF Rhinorrhea

“…In cases of a negative initial work-up, Magnetic Resonance Cisternography (MRC) is reserved as a secondary investigation due to its superior testing attributes, albeit at a higher cost. However, it's worth noting that small and intermittent leaks might elude chemical testing due to the unavailability of sufficient specimens for analysis (11,(14)(15)(16)(17). The current study seeks to explore the potential treatment trajectories for individuals with cerebrospinal fluid leakage post-head injury, specifically focusing on how conservative care impacts the course of traumatic CSF rhinorrhea.…”