Vestibular schwannoma clinically presenting with CSF rhinorrhea: A case report

Abstract

Background: CSF rhinorrhea is leakage of CSF from the intracranial cavity through osseous & dural defects of the skull base into the paranasal sinuses or the nasal cavity. Common causes of this entity are trauma and iatrogenic skull base defects. Rarely, presence of large intracranial tumors may also be associated with CSF rhinorrhea. Case Presentation: A 58-year-old female presented with complaint of intermittent headache and episodes of watery nasal discharge since 6 months. Endoscopy and biochemical examination confirmed the presence of CSF rhinorrhea. CT images of head and paranasal sinuses of this patient showed large right CP angle mass lesion, along with hyperpneumatisation of sphenoid sinuses as well as aberrant arachnoid granulations. MR images confirmed the findings of CT images and additionally showed features of intracranial hypertension and small sphenoid encephalocele.Conclusions: Large intracranial tumours may rarely present with CSF rhinorrhoea, especially in cases, where paranasal sinuses are hyperpneumatised or arachnoid granulations are abnormal large. Hence, in non-traumatic cases of CSF rhinorrhea, imaging of brain should be advised to rule out any space occupying lesion.