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Spontaneous Cerebrospinal Fluid Otorrhea and Rhinorrhea in Idiopathic Intracranial Hypertension Patients

Rosenfeld, Eldar MD; Dotan, Gad MD; Kimchi, Tali J. MD; Kesler, Anat MD

Journal of Neuro-Ophthalmology: June 2013 - Volume 33 - Issue 2 - p 113–116
doi: 10.1097/WNO.0b013e18274b870
Original Contribution

Background: Spontaneous cerebrospinal fluid (CSF) leakage may occur in patients with normal or increased intracranial pressure (ICP). We describe herein spontaneous CSF leakage as a result of chronic increased ICP in 4 patients with idiopathic intracranial hypertension (IIH). Although rhinorrhea previously has been described in IIH patients, to our knowledge this is the first report of otorrhea in these patients.

Methods: Four patients with spontaneous CSF leakage were examined between 2001 and 2011; 3 presented with rhinorrhea and 1 with otorrhea. Clinical settings and manifestations were analyzed.

Results: All patients were found to have IIH. Three had been diagnosed with IIH several years earlier and had been noncompliant with their medical treatment, whereas in 1 patient, CSF rhinorrhea was the presenting symptom of IIH.

Conclusion: CSF leak is a rare complication in IIH patients. We have shown that rhinorrhea can be the presenting sign in these patients and that rhinorrhea and otorrhea can be a late sign of the disease.

Neuro-Ophthalmology Unit, Department of Ophthalmology (ER, GD, TJK, AK) and Neuroradiology Unit (ER, GD, TJK, AK), Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Address correspondence to Eldar Rosenfeld, MD, Neuro-Ophthalmology Unit, Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel; E-mail:

The authors report no conflicts of interest.

© 2013 by North American Neuro-Ophthalmology Society