Tohge Rie, Takahashi Makio
Department of Neurology, Osaka Red Cross Hospital, Japan.
Intern Med. 2017;56(14):1911-1914. doi: 10.2169/internalmedicine.56.8186. Epub 2017 Jul 15.
Cases of cerebrospinal fluid (CSF) rhinorrhea due to clival fracture are rare. We present a case of bacterial meningitis with CSF rhinorrhea after a clival fracture. Heavily T2-weighted images showed a bone flap in the thinned clivus and fluid collection in the sphenoid sinus. CSF rhinorrhea developed at 1 month after mild trauma. The fracture may have been caused by the trauma and/or by the pressure gradient between the intracranial CSF space and the sphenoid sinus. A detailed history to identify trauma and an examination to detect bone defects in the skull base are necessary when patients present with bacterial meningitis and persistent rhinorrhea.
因斜坡骨折导致脑脊液鼻漏的病例较为罕见。我们报告一例斜坡骨折后出现细菌性脑膜炎并伴有脑脊液鼻漏的病例。重度T2加权图像显示变薄的斜坡处有骨瓣形成，蝶窦内有液体积聚。轻度外伤后1个月出现脑脊液鼻漏。骨折可能是由外伤和/或颅内脑脊液间隙与蝶窦之间的压力梯度所致。当患者出现细菌性脑膜炎和持续性鼻漏时，详细询问外伤史并检查以发现颅底骨缺损是必要的。
