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

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.