Spontaneous cerebrospinal fluid rhinorrhea associated with dysplastic optic discs and a basal encephalocele

Case report

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✓ A 24-year-old man presented with a history of recurrent meningitis secondary to cerebrospinal fluid (CSF) rhinorrhea. The patient had bilateral optic disc dysplasia in association with a basal encephalocele, but had no midline facial anomalies. The syndrome is rare, and this is the first report of a patient with this disorder in the absence of facial or radiographic anomalies. The case serves to emphasize the importance of funduscopic examination in patients with spontaneous CSF rhinorrhea or recurrent meningitis, and stresses the value of Dextrostix examination of nasal secretions in the evaluation of suspected CSF rhinorrhea.

Article Information

Dr. Bullard is a fellow of the National Cancer Institute (1F32 CA 06680-01).

Present address for Dr. Bullard: Division of Neurosurgery, Duke University Medical Center, Durham, North Carolina 27710.

Address reprint requests to: H. Alan Crockard, F.R.C.S., The National Hospital, Queen Square, London WC1E 3BG, England.

© AANS, except where prohibited by US copyright law.

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Figures

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    Left: Fundus of the patient's left eye showing a dysplastic optic disc from which the vessels emerge separately. There is marked peripapillary choroidal and retinal atrophy with clumping of pigment. Right: Fundus of the patient's right eye showing a dysplastic optic disc. There is a large abnormal choroidal vein in relation to the disc and marked peripapillary retinal and choroidal atrophy.

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