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Pathogenesis of non‐traumatic cerebrospinal fluid rhinorrhea
Author(s) -
Bjerre Per,
Lindholm Jörgen,
Gyldensted Carsten
Publication year - 1982
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1982.tb04515.x
Subject(s) - rhinorrhea , cerebrospinal fluid rhinorrhea , medicine , sella turcica , empty sella syndrome , pituitary adenoma , cerebrospinal fluid , surgery , transsphenoidal surgery , pituitary neoplasm , meningitis , pituitary gland , adenoma , pathology , hormone
15 consecutive patients with non‐traumatic cerebrospinal fluid rhinorrhea were studied. 13 operations were performed on 10 patients. In 8 transcranial operations, an assumed defect in the anterior fossa was plugged with muscle, but only 3 operations were successful. In 4 operations, either transcranial or transsphenoidal, the sella was packed with muscle and rhinorrhea ceased immediately. Based on radiological and operative findings, 3 groups of patients appeared (1) 9 patients had pathology related to the pituitary gland or the sella turcica: enlarged sella, empty sella, pituitary tumour, intrasellar cyst or erosion of the sellar osseous border. (2) 2 patients had rhinorrhea from extrasellar origin. (3) In 4 patients no abnormality could be found. Prior to the rhinorrhea, 6 patients (5 from group 1 and 1 from group 3) had experienced episodes of neurological symptoms, compatible with a pituitary apoplexy. It is suggested that non‐traumatic cerebrospinal fluid rhinorrhea in most cases is the result of a spontaneous necrosis in a pituitary adenoma, which has caused sellar bony erosion.