THE SPONTANEOUS ESCAPE OF CEREBROSPINAL FLUID THROUGH THE NOSE

Abstract

The patient who, without warning, suddenly develops a discharge of cerebrospinal fluid from the nose should at once be considered a brain tumor suspect. 1 In cerebrospinal rhinorrhea the liquid is usually clear, does not stain the handkerchief, and flows more freely when the head is inclined forward. In the recumbent position, the tasteless fluid may run into the pharynx, the patient being unaware of its presence. The amount of fluid discharged in twenty-four hours varies from 50 to more than 1,000 c.c., and by the usual tests it shows no variations from the fluid obtained by spinal puncture. The discharge may be either continuous or intermittent. When intermittent, the onset of the rhinorrhea may be accompanied by relief from signs and symptoms of intracranial pressure. The patient who, without warning, suddenly develops a discharge of opinion among previous authors concerning the underlying cause of spontaneous cerebrospinal rhinorrhea and concerning