JournalLeakSpontaneous cerebrospinal fluid otorrheaFistulaLeakage of cerebrospinal fluidBeta-2 transferrMeningitisHemotympanumSigns of cerebrospinal fluidTegmen tympaniPatients with cerebrospinal fluidIntracranial Pressure in PatientsDischargeTemporalRhinorrhea or otorrheaPostoperativeSymptomsSkull FracturesOtitis mediaCauses of otorrheaEncephaloceleCranial nervesClinicalTraumatic CSF rhinorrheaFistulaeDrainageArachnoidNoseSuggestivePresented with rhinorrheaOccurEndoscopic repairChronic2018InfectionClear colourless fluidTraumaGlucosePersistentAcuteHydrocephalusDefectSpinal fluidIncidenceClinically
- Fraioli, RE , Hirsch, BE & Kassam, AB 2008, ' Fibrin sealant for control of cerebrospinal fluid otorrhea ', American Journal of Otolaryngology - Head and Neck Medicine and Surgery , vol. 29, no. 2, pp. 135-137. (elsevier.com)
- A small defect of 3mm size in the anterior aspect of tegmen tympani with contrast leak in to left middle ear cavity and mastoid air cells with opacification of cotton swab kept in left external ear--Findings are suggestive of CSF otorrhoea. (thefreelibrary.com)
- Fluid leak around the cuff is minimized when the endotracheal tube size is small relative to the size of the trachea. (bioportfolio.com)
- Cerebrospinal fluid (CSF) leak may occur from the nose ( rhinorrhea ), from the external auditory canal ( otorrhea ), or from a traumatic or operative defect in the skull or spine. (medscape.com)
- [ 1 ] The fluid leak is a result of meningeal dural and arachnoid laceration with fistula formation. (medscape.com)
- This coronal magnetic resonance cisternogram demonstrates a left-sided cerebrospinal fluid leak through the cribriform plate (small arrows), which was clinically suspected. (medscape.com)
- The image also shows a right-sided meningocele (large arrow) protruding through the cribriform plate, which was not suspected but was surgically repaired at the same time as the left cribriform cerebrospinal fluid leak site. (medscape.com)
- Drops of fluid from a CSF leak placed on absorbent filter paper may result in the double-ring sign, a central circle of blood and an outer clear ring of CSF. (medscape.com)
- An absorptive sponge pad placed at or near the presumed site of fluid leak can facilitate the collection of the fluid. (medscape.com)
- Cerebrospinal fluid depletion may be caused by a leak, a shunt, inadequate production or too rapid absorption. (dizziness-and-balance.com)
- Thus, beta-2 transferrin in otorrhea would be suggestive of either a CSF leak or a perilymph leak. (wikipedia.org)
- How useful is glucose detection in diagnosing cerebrospinal fluid leak? (wikipedia.org)
- They conclude that CSF leak is a rare complication in IIH, rhinorrhea can be a presenting sign, and both rhinorrhea and otorrhea can be a late sign of the disease. (aao.org)
- Testing for a CSF leak is appropriate in patients with otorrhea or rhinorrhea, particularly following trauma or surgery. (arupconsult.com)
- Testing fluid from the ear or nose for β-2 transferrin is the recommended method to assess patients for a CSF leak because this approach is noninvasive as well as highly sensitive and specific. (arupconsult.com)
- Spontaneous cerebrospinal fluid leak with meningoencephaloceles in sphenoid sinus lateral recess is challenging. (springermedizin.de)
- Seven patients with spontaneous cerebrospinal fluid leak with meningoencephaloceles in the sphenoid sinus lateral recess were included. (springermedizin.de)
- No cerebrospinal fluid leak recurrences were observed during follow-up period that ranged from 37 to 48 months. (springermedizin.de)
- Endoscopic endonasal retrograde trans-sphenoid approach provides a wide, safe, and direct route to the management of sphenoid sinus lateral recess cerebrospinal fluid leak. (springermedizin.de)
- Physical findings of basilar skull fracture, such as hemotympanum , raccoon eyes, Battle's sign, or evidence of a cerebrospinal leak. (thefreedictionary.com)
- If you suffer an injury which causes a tear in the membranes covering the brain and spine, CSF may leak out from either the nose or the ear (rhinorrhoea or otorrhoea). (labtestsonline.org.uk)
- Symptoms include leak of clear fluid through the ear, inflammation of the membranes that cover the brain ( meningitis ), hearing loss , and seizures . (cdc.gov)
- The cause of a spinal fluid leak through the ear is a defect of the bone and meningeal layers covering the brain that separate the subarachnoid space of the brain from the middle ear and mastoid bone (located just behind the ear). (cdc.gov)
- ClinicalTrials.gov lists trials that are related to Cerebrospinal fluid leak. (cdc.gov)
- PubMed is a searchable database of medical literature and lists journal articles that discuss Cerebrospinal fluid leak. (cdc.gov)
- G96.0 is a billable ICD code used to specify a diagnosis of cerebrospinal fluid leak. (icd.codes)
- Spontaneous cerebrospinal fluid leak syndrome (SCSFLS) is a medical condition in which the cerebrospinal fluid (CSF) held in and around a human brain and spinal cord leaks out of the surrounding protective sac, the dura, for no apparent reason. (icd.codes)
- Management of rhinorrhea and otorrhea from CSF leak after trauma is definitely one of those things. (thetraumapro.com)
- A leak in this system, therefore, can be detrimental to brain blood supply and function and can increase the risk of direct trauma to brain parenchyma due to loss of fluid cushion. (statpearls.com)
- A Cerebrospinal fluid leak can occur whenever there is open communication between the subarachnoid space and other spaces via meningeal disruption. (statpearls.com)
- Evaluation of a suspected leak should include testing of rhinorrhea or otorrhea for beta-2 transferrin, a compound found only in CSF and perilymph making it a highly specific and sensitive test. (statpearls.com)
- Ohara K, Terao T, Michishita S, Sato K, Sasaki Y, Murayama Y. Spontaneous cerebrospinal fluid otorrhea and pneumocephalus on the contralateral side of previous cranial surgery. (scientificscholar.in)
- OBJECTIVES/HYPOTHESIS: To determine the prevalence of elevated intracranial hypertension in patients with spontaneous cerebrospinal fluid otorrhea (SCSFO). (noninvasiveicp.com)
- A Case Report of Spontaneous Cerebrospinal Fluid Otorrhea]. (pubfacts.com)
- In the clinical setting of CSF otorrhea or rhinorrhea, the presence of an enlarged labyrinthine facial nerve canal and enlarged geniculate fossa on CT scans and CSF intensity on MR images strongly suggests a CSF fistula through the facial nerve canal. (ajnr.org)
- Spontaneous lateral sphenoid cerebrospinal fluid fistula: MRI diagnosis. (springermedizin.de)
- Shapiro, S & Scully, T 1992, ' Closed continuous drainage of cerebrospinal fluid via a lumbar subarachnoid catheter for treatment or prevention of cranial/spinal cerebrospinal fluid fistula ', Neurosurgery , vol. 30, no. 2, pp. 241-245. (elsevier.com)
- CSF otorrhea, Fistula, Meningitis. (arquivosdeorl.org.br)
- Some of these causes are more serious than others: for example a head injury can result in a leakage of cerebrospinal fluid from the brain. (medic8.com)
- Leakage of cerebrospinal fluid that fails to heal spontaneously requires treatment, drainage, or surgery to avoid increased threat of infection and meningitis. (visualdx.com)
- Cerebrospinal fluid (CSF) otorrhea is the leakage of cerebrospinal fluid (CSF) though the ear. (cdc.gov)
- Confirm or exclude the presence of CSF in leaking fluid by means of an immunoelectrophoretic study of the fluid for beta-2 transferrin (B2Tr) or, where available, beta-trace protein. (medscape.com)
- Beta-2 transferrin is a carbohydrate-free (desialated) isoform of transferrin, which is almost exclusively found in the cerebrospinal fluid. (wikipedia.org)
- They say that initial patient evaluation when serous discharge from the ear or nose is considered to be CSF includes analysis of the fluid discharge for the presence of beta-2 transferrin. (aao.org)
- Meningitis or intracranial abscess is to be expected in any patient with persistent CSF otorrhea. (jamanetwork.com)
- CSF middle ear effusion/otorrhoea can develop in adults without history of meningitis or head trauma or any apparent proximate cause. (thefreelibrary.com)
- Persistent cerebrospinal fluid (CSF) leakage that is refractory to conservative measures usually requires surgical closure to decrease the risk of meningitis. (pocketdentistry.com)
- These are most commonly recurrent meningitis and cerebrospinal fluid (CSF) rhinorrhea. (thefreedictionary.com)
- 2) Cases of CSF otorrhea giving rise to recurrent meningitis have also been described in the literature. (thefreedictionary.com)
- Although patients present with recurrent meningitis , there will be a limited number of inflammatory cells in the cerebrospinal fluid, and this may indicate a less serious course of disease than one might expect. (thefreedictionary.com)
- Az aszcend l bakteri lis fert z s kapcs n kialakult meningitis szan l s t k vet en a beteget megoper lt k, front lis craniotomia ut n b zisrekonstrukci t v geztek. (elitmed.hu)
- There were no complications such as postoperative otorrhoea, meningitis, or epilepsy. (hindawi.com)
- The spinal fluid profiles in bacterial and chemical meningitis are similar. (oup.com)
- No cerebrospinal fluid leakage or meningitis recurrence was reported by the followed up from 1 months to 7 years after operation. (bvsalud.org)
- Other infections like tympanogenic meningitis can also result in purulent otorrhea when the inflammatory cells enter the internal auditory canal. (hxbenefit.com)
- The ear secretes cerebrospinal fluids and it happens in case of meningitis, brain tumors, brain infections, skull fracture, brain injuries or after an ear surgery. (hxbenefit.com)
- 15, suspected open or depressed skull fracture, sign of fracture at the skull base (raccoon eyes, Battle's sign, hemotympanum, cerebrospinal fluid leakage from the ears or nose), post-traumatic seizure, focal neurological deficit, vomiting, amnesia of events. (psychiatryadvisor.com)
- Clinical signs of basilar skull fracture: Retroauricular bruising--Battle's sign (periorbital bruising)--raccoon eyes, hemotympanum , or cerebrospinal fluid otorrhea or rhinorrhea. (thefreedictionary.com)
- There were no signs of cerebrospinal fluid (CSF) rhinorrhoea or otorrhoea. (biomedcentral.com)
- The authors describe a case of spontaneous cerebrospinal fluid otorrhoea occuring in an adult patient with bilateral abscence of the tegmen tympani and review the literature regarding this specific. (ent-review.com)
- Coronal fast spin-echo T2-weighted image demonstrates herniation of meninges and brain tissue (arrows) with adjacent cerebrospinal fluid into the postmastoidectomy tegmen tympani defect. (medscape.com)
- Temporal lobe encephaloceles and cerebrospinal fluid otorrhea from temporal bone defects that involve the tegmen tympani and mastoideum are generally repaired using middle fossa craniotomy, mastoidectomy, or combined approaches. (thejns.org)
- Cerebro-spinal fluid otorrhea and a spontaneous defect of tegmen tympani or antri. (provence-insolite.com)
- BACKGROUND: The aim of this study was to determine the incidence and perioperative management of patients with cerebrospinal fluid (CSF) fistulas during endoscopic sinus surgery (ESS) in New York State. (biomedsearch.com)
- Method:A retrospective analysis of 37 cases of patients with cerebrospinal fluid otorrhea.The clinical symptoms, auxiliary examination, intraoperative findings, surgical methods and postoperative follow-up were analyzed. (bvsalud.org)
- 7) Resistance to Cerebrospinal Fluid Outflow and Intracranial Pressure in Patients with Hydrocephalus after Subarachnoid Haemorrhage. (exlibris.ch)
- Discharge of cerebrospinal fluid through the external auditory meatus or through the eustachian tube into the nasopharynx. (umassmed.edu)
- Although presenting symptoms can be subtle, early suspicion of confirmatory imaging aid in establishing the diagnosis, Galbarriatu and others, (1,2,3) it can be associated with or without skull base defect (4), in the other hand spontaneous CSF otorrhoea is a rare entity, (4) CSF leakage can trickle down through the eustachian tube more details to be presented as CSF oto-rhinorrhoea or nasal discharge. (thefreelibrary.com)
- Otorrhea is discharge from the external part of the ear canal. (rchsd.org)
- The authors say that because most patients do not realize the relationship between a clear fluid discharge from the nose or ear and their IIH, they usually do not provide this information. (aao.org)
- This is the name given to a condition in which the child has a continuous discharge of fluid from the outer and middle ear. (medic8.com)
- The colour and consistency of the ear discharge depends upon what has caused otorrhea. (medic8.com)
- If you (or your child) have acute otorrhea then treatment will involve your GP cleaning your ear of this discharge using a special suction device. (medic8.com)
- If there is a watery discharge from your nose or ear (rhinorrhoea or otorrhoea) after you have suffered a skull fracture or after brain surgery. (labtestsonline.org.uk)
- Otorrhea is drainage or discharge of fluids from the ear along with inflammation and infections. (hxbenefit.com)
- Direct or indirect injury to the ear can result in the discharge of fluids from the ear. (hxbenefit.com)
- Cerebrospinal fluid otorrhoea may occur through the temporal bone both in children and adults. (ent-review.com)
- INTRODUCTION: Spontaneous cerebrospinal fluid otorrhoea or temporal CSF leakage represents a difficult and serious condition to deal with, in terms of its diagnosis, especially with intact ear drum, management and its sequelae if not treated or diagnosed. (thefreelibrary.com)
- We describe an unusual case of craniomaxillofacial injury exhibiting CSF otorrhea because of a temporal bone fracture with a fragment that included the zygomatic arch. (pocketdentistry.com)
- Here we present a case of craniomaxillofacial injuries with CSF otorrhea because of a temporal bone fracture with a fragment that included the zygomatic process. (pocketdentistry.com)
- CSF otorrhea is caused by a defect in the bone surrounding the ear and the temporal bone. (healthtap.com)
- The otologic cerebrospinal fluid leakage was mainly due to acquired factors such as temporal bone fractures and surgeries involving the temporal bone (1). (arquivosdeorl.org.br)
- To the best of our knowledge, clival dysplasia-caused CSF rhinorrhea has never been reported in the neurosurgical field.Conclusion:Spontaneous cerebrospinal fluid rhinorrhea is often treated by surgery, and a transsphenoidal approach repair is the main surgical method used, offering the advantages of less trauma, fewer complications, rapid postoperative recovery, and low recurrence rate. (deepdyve.com)
- There were no major postoperative complications, recurrences of encephaloceles, or cerebrospinal fluid otorrhea in these patients. (thejns.org)
- Spontaneous cerebrospinal fluid otorrhoea in adults may present with dull symptoms such as a blocked ear or short term conductive hearing-loss. (ent-review.com)
- Sur le plan conceptuel, elle se divise en trois composants anatomiques distincts: Compression Stockings helps to relieve symptoms of venous insufficiency. (no-pasaran.mobi)
- Objective:To analyze the etiology and clinical symptoms and to investigate the therapeutic strategies of cerebrospinal fluid otorrhea. (bvsalud.org)
- CSF otorrhoea complicates 6% - 30% of basilar skull fractures [1, (bioline.org.br)
- We included patients with chronic otorrhoea classified as either otitis media or otitis externa, according to our definitions. (scielo.org.za)
- Of 79 patients with otorrhoea, 50 had otitis media, 21 had otitis externa and the condition was not determined in 8 patients. (scielo.org.za)
- We based the diagnosis of otitis media on the presence of a tympanic membrane (TM) perforation with the otorrhoea originating from the middle ear. (scielo.org.za)
- Infection of the inner ear causes fluids to be discharged due to virus or bacteria called otitis media. (hxbenefit.com)
- Minor causes of otorrhea include colds, ear infections and the presence of an object within the ear. (medic8.com)
- Any clear pulsating fluid through myringotomy should arise the suspicion of CSF otorrhoea and encephalocele. (thefreelibrary.com)
- Any clear pulsating fluid through myringotomy should arise the suspicion of CSF otorrhoea and encephalocele which is a protrusion of intracranial contents can include brain matter and meninges through a defect in the cranium or skull base. (thefreelibrary.com)
- The Prevalence of Superior Semicircular Canal Dehiscence in Patients With Mastoid Encephalocele or Cerebrospinal Fluid Otorrhea. (nih.gov)
- It involves more commonly the cranial nerves(CN), makes cerebrospinal fluid(CSF) fistulae and leads to central nervous system(CNS) infections if the CSF fistulae are not detected or treated early and properly. (koreamed.org)
- Patients may experience headache, neuralgia, palsy of the cranial nerves, or cerebrospinal fluid otorrhea. (advancedradteaching.com)
- 2) Quantitative Evaluations of Disturbances in Cerebrospinal Fluid Circulation with Indium-111 Cisternography: A clinical study. (exlibris.ch)
- Although mostly an incidental finding, cerebrospinal fluid rhinorrhea is the characteristic clinical presentation when symptomatic. (radiopaedia.org)
- Five patients were successfully treated for traumatic CSF rhinorrhea/otorrhea without complications. (elsevier.com)
- Management of unexpected cerebrospinal fluid fistulae during endoscopic sinus surgery. (biomedsearch.com)
- Lanza DC, O'Brien DA, Kennedy DW (1996) Endoscopic repair of cerebrospinal fluid fistulae and encephaloceles. (springermedizin.de)
- Drainage from the ear, or otorrhea, is commonly encountered in pediatric practice and can present a diagnostic and therapeutic quandary to the pediatrician. (healio.com)
- Cerebrospinal fluid is a clear, colorless fluid that circulates in the cranial and spinal subarachnoid spaces, located between the pia and arachnoid matters. (bioportfolio.com)
- Head or spine MRI to detect evidence of sinking of the brain, collapse of the superior opthalmic vein, subdural fluid collection, decrease in ventricular size and prominent dural sinuses, extra-arachnoid fluid, meningeal diverticuli, meningeal enhancement, or engorgement of epidural venous plexi. (pietromortini.com)
- Fluid leaking from the nose or external auditory canal must first be positively identified as CSF. (medscape.com)
- Other possible signs include a sensation of ear fullness and difficulty hearing, and the presence of a "halo" or "double ring" sign on bedsheets or on tissue used to collect fluid draining from the nose or ear. (arupconsult.com)
- If the fluid from the nose or ear is indeed CSF, tau protein would be detected when the fluid sample was analysed. (labtestsonline.org.uk)
- Cerebrospinal fluid leakage at ears and nose, which may indicate skull fracture. (nursingcrib.com)
- In the background of head injury, a clear colourless fluid in the ear is suggestive of CSF otorrhoea. (bioline.org.br)
- 3 presented with rhinorrhea and 1 with otorrhea. (noninvasiveicp.com)
- BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leakage may occur in patients with normal or increased intracranial pressure (ICP). (noninvasiveicp.com)
- Thus, cerebrospinal fluid otorrhea can occur. (radiopaedia.org)
- Hao SP (1996) Transnasal endoscopic repair of cerebrospinal fluid rhinorrhoea: an interposition technique. (springermedizin.de)
- Earlier, he was thought to have chronic otitis and in retrospect had had one episode of CSF otorrhea from his right ear and one episode of CSF rhinorrhea from his right nostril. (ajnr.org)
- The authors describe spontaneous cerebrospinal fluid (CSF) leakage as a result of chronic increased intracranial pressure (ICP) in four patients with idiopathic intracranial hypertension (IIH). (aao.org)
- There are two forms of otorrhea: acute or chronic and this can be a symptom of a serious underlying problem. (medic8.com)
- Chronic otorrhea lasts for six weeks or longer. (medic8.com)
- But untreated or chronic ear infections are the most likely cause of otorrhea. (medic8.com)
- Chronic otorrhoea is difficult to treat, with treatment in South Africa (SA) being protocol driven and generally initiated at the primary healthcare level. (scielo.org.za)
- There is a lack of local studies that focus on the bacteriology and antimicrobial sensitivities of chronic otorrhoea, which underpins the management advice offered. (scielo.org.za)
- To determine the microbiological profile and antimicrobial susceptibility of patients with chronic otorrhoea and the validity of the Department of Health's (DoH) current guideline. (scielo.org.za)
- Although treatment is protocol driven, a PubMed search failed to reveal SA studies focusing purely on the bacteriology and antimicrobial sensitivities of chronic otorrhoea underpinning the management advice offered. (scielo.org.za)
- To investigate the microbiology profiles of patients presenting to a tertiary hospital in Cape Town with chronic otorrhoea and to ascertain the validity of the current treatment protocol for chronic otorrhoea outlined by the SA Department of Health (DoH). (scielo.org.za)
- A spectrum of severity of injury occurs which includes chronic tympanic membrane perforation, chronic otorrhoea, facial nerve injury and deafness. (lenus.ie)
- We present a case of drop weld injury to the left tympanic membrane, resulting in chronic middle ear inflammation, otorrhoea and tympanic perforation. (lenus.ie)
- Chronic otorrhea is when the middle ear gets infected and inflamed while the tympanic membrane gets perforated and the condition remains the same for 6 - 12 weeks. (hxbenefit.com)
- Song 2018-02-01 00:00:00 AbstractIntroduction:Spontaneous cerebrospinal fluid leakage is usually caused by developmental abnormalities and is rare, accounting for approximately 5% of the cases of cerebrospinal fluid (CSF) leakage. (deepdyve.com)
- 33%). Otorrhoea had a different microbial spectrum compared with international reports, with methicillin-resistant Staphylococcus aureus infection in a single patient. (scielo.org.za)
- Our exclusion criteria included: patients with cholesteatoma, patients who had previous surgery, anatomical factors predisposing patients to recurrent ear infection, patients with foreign bodies, cerebrospinal fluid otorrhoea and patients who had received systemic or topical antibiotics in the 2 weeks prior to presenting to the hospital. (scielo.org.za)
- He regained consciousness within 24 hours although bloody otorrhoea continued, which later turned to clear, colourless fluid. (bioline.org.br)
- The left ear showed clear colourless fluid, filling the left concha. (bioline.org.br)
- Anatomy) the clear colourless fluid in the spaces inside and around the spinal cord and brain. (thefreedictionary.com)
- Cerebrospinal fluid otorrhea is caused most often by skull fracture, and is looked for routinely in patients who have had trauma to the head. (jamanetwork.com)
- The initial examination performed by a trauma team included X-ray imaging of his thorax and pelvis, that were found normal, as well as ultrasound of his abdomen, which showed no sign of free fluid. (biomedcentral.com)
- This is also possible in case of a trauma to the brain where the cerebral fluid seeps into the passage of the ear and is drained out from there. (hxbenefit.com)
- That it is spinal fluid can be confirmed by any clever physician who thinks to test it for glucose . (healthtap.com)
- Serum glucose, chloride, and total protein tests of the fluid are not specific or conclusive for CSF. (medscape.com)
- However, simple demonstration of glucose in the fluid using glucostix and absence of stickening of the handkerchief may strengthen the diagnosis of CSF [5, 6- (bioline.org.br)
- Cerebrospinal fluid (CSF) is a clear protein- and glucose-rich liquid in the subarachnoid space of the central nervous system. (statpearls.com)
- EIGHT PATIENTS with persistent cerebrospinal fluid (CSF) otorrhea were seen at the Mayo Clinic during the years 1955 through 1965. (jamanetwork.com)
- Blood patches are generally thought to be safe but occasional reports of increased CSF pressure and persistent epidural fluid collections have been reported. (pietromortini.com)
- Acute posttraumatic cerebrospinal fluid rhinorrhea. (medscape.com)
- Acute otorrhea is defined as lasting for up to three weeks. (medic8.com)
- 9) Absence of Hydrocephalus in Spite of Impaired Cerebrospinal Fluid Absorption and Severe Intracranial Hypertension. (exlibris.ch)
- At admission, computed tomography (CT) imaging of the head showed enlargement of the lateral ventricles, a right mastoid fluid collection, and a defect of the superior wall of the right petrous bone. (scientificscholar.in)
- Can ears drain spinal fluid? (healthtap.com)
- Also called spinal fluid . (thefreedictionary.com)
- Radioactive label or a fluorescent dye injected into the spinal fluid to test for the label or dye in the fluid. (pietromortini.com)
- Spinal fluid testing with a beta-trace protein assay. (pietromortini.com)
- Worldwide, there has been a change in the profile of organisms causing otorrhoea and increases have been observed both in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and in resistance to antimicrobials. (scielo.org.za)
- Overall, prophylaxis appears to be effective at reducing the incidence of post-tympanostomy tube otorrhea. (unboundmedicine.com)
- The mean odds ratio was 52%, suggesting that prophylaxis may reduce the incidence of post-tympanostomy tube otorrhea by half. (unboundmedicine.com)
- Lateral 24-hour cranial scintigraphic image from a nuclear medicine cisternographic study in a patient with clinically evident right-sided cerebrospinal fluid rhinorrhea. (medscape.com)