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Topics in Radiology
June 2, 1978

Spontaneous Rhinorrhea in a 52-Year-Old Woman

Author Affiliations

From the Department of Pathology-Nuclear Medicine, Scripps Memorial Hospital, La Jolla, Calif.

JAMA. 1978;239(22):2375-2376. doi:10.1001/jama.1978.03280490059030

History  A 52-year-old woman was seen for spontaneous rhinorrhea and intermittent headache for ten days. The patient's general health was good, and there was no history of head trauma. Clear fluid dripped from the left nostril, especially when the patient sat up and leaned slightly forward. Results of a neurological examination, including visual fields, were within normal limits.Computerized tomography, brain scan, and tomograms of the cribriform plate of the skull were normal. After pentetate indium trisodium In111 was injected into the cisterna cerebellomedullaris, cisternograms were obtained with the patient sitting up with the head slightly bent forward to encourage rhinorrhea during imaging. Figure 1, left, was obtained three hours after the injection; Fig 1, right, and 2 were obtained at five hours.

Diagnosis  Cerebrospinal rhinorrhea caused by an encephalocele of the left cribriform plate.

Comment  The cisternogram was normal at three hours after injection (Fig 1, left) but became