Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the Literature
Abstract Background Oculorrhea, or cerebrospinal fluid leakage developing from a cranio-orbital fistula, is a rare development following traumatic injury. Case Report A 22-year-old man involved in a motor vehicle accident developed a blowout fracture of the left orbital roo...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2013-05-01
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| Series: | Journal of Neurological Surgery Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1347902 |
| _version_ | 1828471377473044480 |
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| author | Matthew Pease Yvette Marquez Alex Tuchman Alex Markarian Gabriel Zada |
| author_facet | Matthew Pease Yvette Marquez Alex Tuchman Alex Markarian Gabriel Zada |
| author_sort | Matthew Pease |
| collection | DOAJ |
| description | Abstract
Background Oculorrhea, or cerebrospinal fluid leakage developing from a cranio-orbital fistula, is a rare development following traumatic injury.
Case Report A 22-year-old man involved in a motor vehicle accident developed a blowout fracture of the left orbital roof penetrating the frontal lobe, inducing oculorrhea. He underwent a supraorbital craniotomy for removal of the bony fragment and skull base reconstruction using a pericranial flap.
Methods A systematic review of the database was performed to identify all prior cases of traumatic oculorrhea.
Results Twenty-two reported cases met inclusion criteria for subsequent analysis. Oculorrhea developed due to blunt and penetrating head injury in 14 (64%) and 8 patients (36%), respectively. The most common mechanisms were car accidents, stab wounds, falls, and gunshot wounds. Ocular signs and symptoms—including visual loss, ophthalmoplegia, and pupillary dysfunction—were commonly associated findings. Initial conservative management was successful in four patients. Thirteen patients underwent initial surgical intervention, and three additional patients required operative intervention following failed conservative treatment.
Conclusion Although oculorrhea rarely develops following severe orbital trauma, suspicion should nevertheless be maintained to facilitate more prompt diagnosis and management. The decision for conservative versus surgical management often depends on the severity of the fracture and dural injury. |
| first_indexed | 2024-12-11T05:09:51Z |
| format | Article |
| id | doaj.art-aeed047f39b24e5191d0db54c3a97179 |
| institution | Directory Open Access Journal |
| issn | 2193-6358 2193-6366 |
| language | English |
| last_indexed | 2024-12-11T05:09:51Z |
| publishDate | 2013-05-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Journal of Neurological Surgery Reports |
| spelling | doaj.art-aeed047f39b24e5191d0db54c3a971792022-12-22T01:19:57ZengGeorg Thieme Verlag KGJournal of Neurological Surgery Reports2193-63582193-63662013-05-01740105706610.1055/s-0033-1347902Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the LiteratureMatthew Pease0Yvette Marquez1Alex Tuchman2Alex Markarian3Gabriel Zada4Department of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California, USADepartment of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California, USADepartment of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California, USADepartment of Otolaryngology, Keck School of Medicine of USC, Los Angeles, California, USADepartment of Neurosurgery, Keck School of Medicine of USC, Los Angeles, California, USAAbstract Background Oculorrhea, or cerebrospinal fluid leakage developing from a cranio-orbital fistula, is a rare development following traumatic injury. Case Report A 22-year-old man involved in a motor vehicle accident developed a blowout fracture of the left orbital roof penetrating the frontal lobe, inducing oculorrhea. He underwent a supraorbital craniotomy for removal of the bony fragment and skull base reconstruction using a pericranial flap. Methods A systematic review of the database was performed to identify all prior cases of traumatic oculorrhea. Results Twenty-two reported cases met inclusion criteria for subsequent analysis. Oculorrhea developed due to blunt and penetrating head injury in 14 (64%) and 8 patients (36%), respectively. The most common mechanisms were car accidents, stab wounds, falls, and gunshot wounds. Ocular signs and symptoms—including visual loss, ophthalmoplegia, and pupillary dysfunction—were commonly associated findings. Initial conservative management was successful in four patients. Thirteen patients underwent initial surgical intervention, and three additional patients required operative intervention following failed conservative treatment. Conclusion Although oculorrhea rarely develops following severe orbital trauma, suspicion should nevertheless be maintained to facilitate more prompt diagnosis and management. The decision for conservative versus surgical management often depends on the severity of the fracture and dural injury.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1347902oculorrheacranio-orbital fistulacerebrospinal fluidrhinorrheatraumatic brain injurysurgical managementpseudoepiphoracerebrospinal fluid fistula |
| spellingShingle | Matthew Pease Yvette Marquez Alex Tuchman Alex Markarian Gabriel Zada Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the Literature Journal of Neurological Surgery Reports oculorrhea cranio-orbital fistula cerebrospinal fluid rhinorrhea traumatic brain injury surgical management pseudoepiphora cerebrospinal fluid fistula |
| title | Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the Literature |
| title_full | Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the Literature |
| title_fullStr | Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the Literature |
| title_full_unstemmed | Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the Literature |
| title_short | Diagnosis and Surgical Management of Traumatic Cerebrospinal Fluid Oculorrhea: Case Report and Systematic Review of the Literature |
| title_sort | diagnosis and surgical management of traumatic cerebrospinal fluid oculorrhea case report and systematic review of the literature |
| topic | oculorrhea cranio-orbital fistula cerebrospinal fluid rhinorrhea traumatic brain injury surgical management pseudoepiphora cerebrospinal fluid fistula |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0033-1347902 |
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