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July 1982

CSF Rhinorrhea From Untreated Pituitary Adenoma

Author Affiliations

From the Department of Neurology, Arizona Health Sciences Center, Tucson (Drs Rothrock, Laguna, and Reynolds), and the Department of Neurology, Kino Community Hospital, Tucson (Drs Laguna and Rothrock).

Arch Neurol. 1982;39(7):442-443. doi:10.1001/archneur.1982.00510190060021

Cerebrospinal fluid rhinorrhea is a rare complication of untreated pituitary adenoma. The case presented exemplifies many of the features typical of this condition, including the potential for late-developing bacterial meningitis.

REPORT OF A CASE  A 24-year-old man had a five-day history of productive cough, sore throat, and general malaise. On the day of admission to the hospital, he experienced a severe generalized headache, nausea, vomiting, and photophobia. There was a ten-year history of intermittent issue of clear fluid from the nose, attributed to chronic sinusitis.The patient was alert, fully oriented, and in obvious pain from headache. Clear fluid dripped from both nostrils. He was afebrile. There was mild pain with full neck flexion. The examination results were otherwise unremarkable.Lumbar puncture showed clear CSF under a pressure of 170 mm H2O and the following values: glucose, 106 mg/dL; protein, 59 mg/dL; and WBCs, 7/cu mm (82% segmented

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