Vulvar vestibulitis
Vulvar vestibulitis syndrome (VVS), vestibulodynia, or simply vulvar vestibulitis or "localized (to the vestibule) provoked vulvodynia" refers to pain localized to the vestibular region. It tends to be associated with a highly localized "burning" or "cutting" type of pain. The pain of vulvodynia may extend into the clitoris; this is referred to as clitorodynia.Vulvar vestibulitis syndrome is the most common subtype of vulvodynia that affects premenopausal women – the syndrome has been cited as affecting about 10%–15% of women seeking gynecological care. Causes
A wide variety of possible causes and treatments for vulvodynia are currently being explored. Moreover, there are probably several causes of vulvodynia, and some may be individual to the patient.Possible causes include Sjögren syndrome, the symptoms of which include chronic vaginal dryness. Others include genetic predisposition to inflammation, allergy or other sensitivity (for example: oxalates in the urine), an autoimmune disorder similar to lupus erythematosus or to eczema or to lichen sclerosus, infection (e.g., yeast infections, bacterial vaginosis, HPV, HSV), injury, and neuropathy—including an increased number of nerve endings in the vaginal area. Some cases seem to be negative outcomes of genital surgery, such as a labioplasty. Initiation of hormonal contraceptives that contain low- dose estrogen before the age of 16 could predispose women to vulvar vestibulitis syndrome. A significantly lower pain threshold, especially in the posterior vestibulum, has also been associated with the use of hormonal contraceptives in women without vulvar vestibulitis syndrome. Pelvic floor dysfunction may be the underlying cause of some womens pain.
Cerebrospinal fluid rhinorrhoea (CSF rhinorrhoea) refers to the drainage of cerebrospinal fluid through the nose (rhinorrhoea). It is typically caused by a basilar skull fracture, which presents complications such as infection. It may be diagnosed using brain scans (prompted based on initial symptoms), and by testing to see if discharge from the nose is cerebrospinal fluid. Treatment may be conservative (as many cases resolve spontaneously), but usually involves neurosurgery. Classification
CSF rhinorrhoea may be spontaneous, traumatic, or congenital.Traumatic CSF rhinorrhoea is the most common type of CSF rhinorrhoea. It may be due to severe head injury, or from complications from neurosurgery.Spontaneous CSF rhinorrhoea is the most common acquired defect in the skull base bones (anterior cranial fossa) causing spontaneous nasal liquorrhea. Defects are often localized in the sphenoid bone and the ethmoid bone. sphenoid sinus (43%). ethmoid bone (29%). cribriform plate (29%).Congenital CSF rhinorrhoea is the least common type of CSF rhinorrhoea. It may be caused by problems in the embryological development of bones of the skull. Signs and symptoms
CSF rhinorrhoea involves drainage of cerebrospinal fluid through the nose. This appears as a clear, colourless liquid. Aldroubi sign "The liquid in CSF rhinorrhea is thin and clear, and an affected person might notice a sweet or salty taste due to the increased glucose and electrolytes present in cerebrospinal fluid so some affected toddlers and young children tend to lick their nose frequently". Causes
Traumatic
CSF rhinorrhoea may be a sign of a basilar skull fracture.