A case of spontaneous middle cranial fossa cerebrospinal fluid leak presenting as recurrent bacterial meningitis

xlomafota13 shared this article with you from Inoreader A case of spontaneous middle cranial fossa cerebrospinal fluid leak presenting as recurrent bacterial meningitis Via leak of cerebrospinal fluid Rinsho Shinkeigaku. 2021 Jul 17. doi: 10.5692/clinicalneurol.cn-001606. Online ahead of print. ABSTRACT A 19-year-old man with a history of Chiari type I malformation was admitted to our hospital two times within a 2-month period because of bacterial meningitis. Cerebrospinal fluid (CSF) analysis showed neutrophilic pleocytosis and hypoglycorrhachia. During the second admission, we became aware of hearing loss on the right since age 15 years. High-resolution temporal bone CT showed soft tissue opacification of the right epitympanum and external auditory canal. Tissue biopsy resulted in CSF otorrhea and pneumocephalus. CT cisternography revealed a temporal bone CSF leak. Brain MRI showed a dural defect localized to the anterior petrous apex. Using a combined middle cranial fossa-transmastoid approach, the dural defect and associated arachnoid granulations were located along the superior side of the greater petrosal nerve and repaired. A CSF le ak without underlying pathology, such as trauma, surgery, or congenital abnormality, is defined as spontaneous. Spontaneous CSF leak should be considered as a cause of recurrent bacterial meningitis even when CSF otorrhea and fluid behind the tympanic membrane are clinically absent. PMID:34275956 | DOI:10.5692/clinicalneurol.cn-001606 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.