Neurological Surgery No Shinkei Geka Volume 32, Issue 4 (April 2004)

A Case with Surgical Repair for Delayed Occult Cerebrospinal Fluid Rhinorrhea Presented as Meningitis Fourteen Years After Blunt Head Trauma Hitoshi KAWAMOTO 1 , Haruyoshi TAGUCHI 1 , Osamu YUKAWA 1 , Kazuhiko KUROKI 1 , Junpei OHSHITA 1 , Hirofumi ISHIHARA 2 1Department of Neurosurgery,Hiroshima General Hospital 2Ishihara Noshinkeigeka Hospital Keyword: rhinorrhea , meningitis , occult , hydrocephalus , trauma pp.373-377
Published Date 2004/4/1
  • Abstract
  • Look Inside

 We describe a case of a 34-year-old woman in whom delayed occult cerebrospinal fluid rhinorrhea presented as meningitis. Removal of an implanted shunt system and surgical repair of the fistula were required. The cerebrospinal fluid fistula was located in the left frontoethmoidal region. Fourteen years previously,the patient had been treated successfully for injury to the left internal carotid artery in a motor vehicle collision,by clipping and by implantation of ventriculoperitoneal and subduralperitoneal shunts to reverse the associated hydrocephalus. To prevent the spread of intracranial infection,we immediately removed the implanted shunt system and followed this by placement of lumbar drainage. After complete resolution of meningitis in response to antimicrobial agents,we performed surgical repair of the fistula. Shunt reconstruction was not required. The patient was discharged with good performance status. This case illustrates the point that effective treatment of meningitis is greatly facilitated by timely removal of associated foreign material.

Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.


Neurological Surgery 脳神経外科
32巻4号 (2004年4月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院