Asian Journal of Case Reports in Surgery

Spontaneous Cerebrospinal Fluid Leak and Idiopathic Intracranial Hypertension: A Case Report and Literature Review

F. El Mourabit *

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

C. Rsaissi

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

M. Loudghiri

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

W. Bijou

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

Y. Oukessou

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

S. Rouadi

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

R. Abada

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

M. Roubal

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

M. Mahtar

Department of Otolaryngology-Head and Neck Surgery, University Hospital Ibn Rochd, Casablanca, Morocco.

*Author to whom correspondence should be addressed.

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Abstract

Nowadays, ENT surgeons perform surgical treatment of spontaneous cerebrospinal fluid (CSF) leak, with endonasal endoscopy being preferred to craniotomy as less invasive. Nevertheless, it is frequently the sign of the underlying idiopathic intracranial hypertension, which is outside the conventional domain of competence in ENT. We report a case of a 49-year-old woman presented to the emergency department 9 months ago with spontaneous chronic intermittent left rhinorrhea. Toutefois, surgery is a necessary step, it should not hide the importance of treating the underlying disease. This therapy is complex and requires interdisciplinary collaboration between specialists such as an otolaryngologist, an ophthalmologist, a neurologist, a neurosurgeon, a radiologist, a nutritionist, an endocrinologist and a psychotherapist. Sudden leakage of lower cerebral fluid (CSF) due to idiopathic intracranial hypertension (IIH) is rare. Patients frequently suffer from CSF rhinorrhea, recurrent meningitis, chronic headaches, and visual disturbances. However, few patients have been diagnosed with neuroendocrine disorders. First-line treatment is endonasal endoscopy.

Keywords: Idiopathic intracranial hypertension, CSF rhinorrhea, multidisciplinary management, case report, endonasal endoscopy, neuroendocrine changes, liquor fistula

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