Late Post-Traumatic Cerebrospinal Rhinorrhoea

Cerebrospinal fluid (CSF) rhinorrhoea results from anatomical breach between the subarachnoid space and air sinus cavities of the skull base and traumatic CSF rhinorrhoea accounts for 80% - 90% of all cases of CSF leaks. We sought to report the case of a 16-year-old patient with a history of head injury following a fall from a tree, who developed a post-traumatic CSF rhinorrhoea after an onset of meningitis. The patient sustained a fall from a 6-meter tree in 2008, and was reviewed by our neurosurgical team in February 2016 for a 1-month history of progressive headaches associated with fever, asthenia and left CSF rhinorrhoea. Clinical examination revealed frank meningism and abundant CSF leak from the left nostril. CT scanning showed fractures of the left frontal bone and sinus wall associated with a massive pneumocephalus. The patient benefited from surgical repair of the tear and post-operative lumbar punctures at day 15. The patient’s guardian was informed that non-identifiable information from the case would be submitted for publication and he provided consent.