Endoscopic endonasal repair of cerebrospinal fluid leakage caused by a rare traumatic clival fracture

Akihiro Hirayama, Fuminari Komatsu, Kazuko Hotta, Masaaki Imai, Shinri Oda, Masami Shimoda, Mitsunori Matsumae

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


An 89-year-old male presented with cerebrospinal fluid (CSF) rhinorrhea associated with head trauma sustained as a pedestrian in a traffic accident. Computed tomography (CT) showed pneumocephalus and multiple cranial bone fractures, including the clivus. Although the CSF rhinorrhea was treated conservatively for a week, clinical symptoms did not improve and surgical repair was performed. Preoperative thin-sliced bone CT and steady-state magnetic resonance images revealed a bone defect at the middle clivus and a collection of CSF fluid from the clival fistula in the sphenoid sinus. Endoscopic endonasal reconstruction was performed, and the 3-mm diameter dural tear and bone defect at the middle clivus were well visualized. The fistula was repaired using a pedicled nasoseptal mucosal flap. The CSF rhi- norrhea completely disappeared as a result of the endoscopic endonasal surgery. The present report describes a rare case of CSF rhinorrhea caused by a traumatic clival fracture and surgical management by endoscopic endonasal surgery.

Original languageEnglish
Pages (from-to)81-84
Number of pages4
Journalneurologia medico-chirurgica
Issue number2
Publication statusPublished - 15-02-2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


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