Diagnosis and management of posttraumatic oculorrhea.
Posttraumatic cranio-orbital cerebrospinal fluid (CSF) fistula is very rare. Diagnosis of these fistulas may be difficult, and it is possible that this complication of craniofacial injury is underdiagnosed. Early recognition and adequate treatment is of paramount importance to prevent hazardous complications. The authors report the case of a 20-year-old woman in whom a CSF leak developed through the medial canthus area of her eye after she sustained a mild sports-related injury. Clinical examination and chemical analysis of the fluid led to the correct diagnosis, and the leak was stopped with conservative treatment. It is proposed that a CSF leak through the eye be termed "oculorrhea" as compared with otorrhea and rhinorrhea. The mechanism of the fistula in this patient is discussed, as is the pertinent radiologically demonstrated anatomy and the mechanism of injury. Management and controversies are also discussed.
Salame
K
K
Department of Neurosurgery, Sourasky Medical Center, Sackler, School of Medicine, Tel Aviv University, Tel Aviv, Israel. salame@tasmc.health.gov.il
Segev
Y
Y
Fliss
D M
DM
Ouaknine
G E
GE
D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006259:Craniocerebral Trauma / Q000150:complications*; D005004:Ethmoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000517:prevention & control; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D009915:Orbit / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D009917:Orbital Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D020205:Skull Fracture, Basilar / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013353:Subdural Effusion / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome