Onset of uncomplicated cerebrospinal fluid fistula 27 years after head injury: Case report

Cerebrospinal fluid fistulae complicated by meningitis have been reported to appear as late as 36 years after the causal head injury. We present this 54-year-old woman with a recurrent cerebrospinal fluid rhinorrhea that started 27 years after a road accident. The surgical exploration revealed a linear fracture of the cribriform plate. Once the defect was repaired, the leak ceased, with no recurrence in 2 years of follow-up. A traumatic cerebrospinal fluid leak may appear for the first time after 2-3 decades have elapsed. An operation is indicated in order to localize the site of leakage, when other investigations have failed or are not available, as well as to prevent a secondary infection, when still possible.