Work

Resolution of Pulmonary Inflammation and Obstruction Following Repair of Cerebrospinal Fluid Leak: A Case Report and Review of the Literature

Year: 2026

Type: article

Abstract: Objectives: Cerebrospinal fluid (CSF) rhinorrhea involves drainage of CSF through the nasal cavity due to disruption of the skull base, and pneumonitis secondary to CSF aspiration is a lesser-known complication reported. We present the case of a patient whose pulmonary symptoms and function improved after surgical CSF leak repair. Methods: This is a case report with review of the electronic medical record and literature review. Results: A 35-year-old female presented with 1 year of refractory right-sided rhinorrhea and recurrent lower respiratory infections. Nasal drainage was positive for beta-2-transferrin. Sinus CT showed a possible leakage site at the right lateral lamella of the cribriform plate. Chest CT showed upper lobe predominant ground-glass opacities. Following surgical CSF leak repair, chest CT showed resolution of ground-glass opacities and pulmonary function testing showed an increase in spirometric lung volumes. Conclusions: Aspiration pneumonitis from CSF leaks is rarely reported. Studies report resolution of ground-glass opacities on chest CT as well as clinical improvement in symptoms such as cough following surgical leak repair. Proposed mechanisms leading to aspiration pneumonitis include nasopharyngeal bacterial transit; the mechanism of persistent leak may be related to cough-induced increase in intracranial pressure leading to increased CSF flow. In patients with lower airway inflammation and obstruction as well as unexplained aspiration pneumonitis, a high index of suspicion for CSF rhinorrhea is warranted.

Source: Case Reports in Pulmonology

DOI: 10.1155/crpu/9651572

Authors: Ann O. Birmingham, Serban A. Staicu, Isaac L. Schmale, Li-Xing Man

Institutions: University of Rochester Medicine, University of Rochester

Language: English

Topic: Neurosurgical Procedures and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $790