CSF Fistula
CSF surrounds the brain and spinal cord, which are contained within the dura mater. Any rift in dura can prompt CSF leakage/fistula. Common sites for CSF fistulas are the nose and ears, known as CSF rhinorrhea and CSF otorrhea, respectively. The etiology of CSF fistula includes neurotrauma, cranial as well as spinal surgery, chronic raised intracranial pressure (ICP), and a spontaneously occurring CSF fistula. Diagnosis and evaluation including ‘defect’ localization are the main challenge. CT or MR cisternograms assist in the diagnosis and localization of a CSF fistula. An untreated fistula can cause death and morbidity through meningoencephalitis. Treatment options include conservative and surgical treatment. Surgical treatment depends on the site and size of a fistula, associated pathologies, and the surgeon’s preferences, which can be endoscopy or microsurgery. In this chapter, the etiology, clinical presentation, evaluation, and treatments of CSF fistulae, especially CSF rhinorrhea, CSF otorrhea, and spinal CSF fistula, are discussed briefly.
