title: [Spontaneous cerebrospinal fluid rhinorrhea associated with long-standing overt ventriculomegaly in adults (LOVA)].
abstract: OBJECTIVE
  Spontaneous cerebrospinal fluid rhinorrhea associated with aqueductal stenosis is rare. CSF diversion is reported to be a failure in the majority of cases. The combination of the repair of the skull base and CSF diversion is reported to be successful. We describe a case successfully treated by intradural repair with ventricular drainage followed by endoscopic third ventriculostomy.
  
  
  METHODS
  A 28-year-old woman presented with rhinorrhea, and occasional attacks of headache, vomiting, and unconsciousness for two years. She had been diagnosed as arrested hydrocephalus for 10 years. Magnetic resonance imaging revealed triventriculomegaly with ballooning of the floor of the third ventricle, tonsilar herniation, right anterior horn herniation into the cribriform plate, and bilateral temporal lobe herniation into the temporal base.
  
  
  METHODS
  A ventricular drain was inserted followed by dissection of the herniated brain and repair of the enlarged cribriform foramen with periosteal flap. Make sure that the bacterial culture negative, endoscopic third ventriculostomy has been performed. There is no recurrence of hydrocephalus and rhinorrhea for two years.
  
  
  CONCLUSIONS
  Direct communication between the lateral ventricle and the nasal/paranasal sinus is a rare complication of aqueductal stenosis and LOVA. Surgical repair of the skull base followed by cerebrospinal fluid diversion with endoscopic third ventriculostomy was a safe and reliable method.
authors.affiliation: Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Matsusaka
authors.forename: Aiko
authors.initials: A
authors.lastname: Terada
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Iwai
authors.forename: Masaki
authors.initials: M
authors.lastname: Komiyama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000473:pathology; D020547:Lateral Ventricles / Q000473:pathology; D008279:Magnetic Resonance Imaging; D019291:Skull Base / Q000473:pathology / Q000601:surgery*; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000009:adverse effects*