Other signs of a basilar skull fracture include CSF otorrhoea (drainage of CSF through the ear). It can have devastating complications in some patients, as the communication between the nasal cavity, the cerebrospinal fluid and the central nervous system can result in severe bacterial infections.CSF rhinorrhoea may be a complication of neurosurgery, such as functional endoscopic sinus surgery, and hypophysectomy (partial or complete removal of the pituitary gland). Non-traumatic
CSF rhinorrhoea may be caused by the growth of certain cancers (such as pituitary adenoma), congenital problems with bones of the skull, or inflammation that damages the bones of the skull. Diagnosis
Radiology
If a patient has clear, colourless liquid leaking from the nose, then radiographs or CT scans may be used to look for a basilar skull fracture. Biochemistry
Measures of CSF components, such as glucose, have been used in the past, but are neither sensitive nor specific. Beta-2 transferrin has a high positive predictive value of CSF rhinorrhoea. It has also been noted to be characterized by unilateral discharge. Treatment
Surgery
Neurosurgery is usually necessary to prevent the spread of infection to the meninges. Minimally invasive techniques tend to have fewer complications compared to open techniques. Conservative management
Conservative management includes watchful waiting, as some minor CSF leaks often stop spontaneously. See also
Beta-2 transferrin
Meningitis
Traumatic head injury

References


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Retroperitoneal fibrosis or Ormonds disease is a disease featuring the proliferation of fibrous tissue in the retroperitoneum, the compartment of the body containing the kidneys, aorta, renal tract, and various other structures. It may present with lower back pain, kidney failure, hypertension, deep vein thrombosis, and other obstructive symptoms. It is named after John Kelso Ormond, who rediscovered the condition in 1948. Causes
The association of idiopathic retroperitoneal fibrosis with various immune-related conditions and response to immunosuppression led to a search for an autoimmune cause of idiopathic RPF. Many of these previously idiopathic cases can now be attributed to IgG4-related disease, an autoimmune disorder proposed in 2003. Otherwise, one-third of cases are secondary to malignancy, medication (methysergide, hydralazine, beta blockers), prior radiotherapy, or certain infections.Other associations include:

connective tissue disease
Riedels thyroiditis
sclerosing cholangitis
membranous nephropathy
ankylosing spondylitis
inflammatory bowel disease
ANCA-associated vasculitis
autoimmune pancreatitis
sarcoidosis
primary biliary cirrhosis
inflammatory abdominal aortic aneurysm

Diagnosis
The diagnosis of retroperitoneal fibrosis cannot be made on the basis of the results of laboratory studies. CT is the best diagnostic modality: a confluent mass surrounding the aorta and common iliac arteries can be seen. On MRI, it has low T1 signal intensity and variable T2 signal. Malignant retroperitoneal fibrosis usually gives uneven MRI signals, is bulky, extends above the origins of renal arteries, or displaces the aorta anteriorly.