{
  "abstract": "Background Cerebrospinal fluid (CSF) rhinorrhoea in a patient with intracranial Hypertension pose a unique challenge for diagnosis as symptoms and signs are masked and its aetiology is not clearly understoodClinical Case A 66-year-old gentleman with intermittent Lt nostril clear salty rhinorrhoea and postnasal drip in the last 3–4 weeks referred to emergency by his general practitioner. He was diagnosed with spontaneous bilateral cerebral venous sinus thrombosis (CVST) on MR venogram when presented with headache and visual obscuration with papilledema, treated with diamox an apixaban 5mg twice a day which further continued as atrial fibrillation was noted. Flexible nasal endoscopy by ENT didn’t show any CSF leak. Fundoscopy reveals Friesen 1 papilledema, VA 6/9 on Right, 6/6 on Left. MRI skull base showed Focal defects in the anteromedial aspects of middle cranial fossa bilaterally with herniation of associated small encephalocele on the right side and meningoencephalocele on the left side. Brain AVMs usually present between the ages of 10 and 40 years with intracranial haemorrhage, seizure, headache, or focal neurologic deficit; a substantial number are asymptomatic. DSA was performed and successful transvenous coil embolization of the right skull base sigmoid dural AV fistula with no flow in the antegrade occluded distal right sigmoid/internal jugular vein. CSF rhinorrhoea, headache and visual blurring improved during post procedure follow up.Conclusion This is the rare case demonstrating CSF rhinorrhoea resulted from cribriform plate fracture from raised IIH complicated with dural AV fistula and CVST required embolization of dural AV fistula with good response.",
  "authors": [
    {
      "affiliations": [
        "Neurology, Townsville University Hospital, Townsville, QLD, Australia"
      ],
      "name": "Abdul Shaik"
    },
    {
      "affiliations": [
        "Neurology, Cairns Base Hospital, Cairns, QLD, Australia"
      ],
      "name": "Ian Wislon"
    },
    {
      "affiliations": [
        "Neurology, Townsville University Hospital, Townsville, QLD, Australia"
      ],
      "name": "Ravindra Urkude"
    }
  ],
  "title": "3577 Cerebrospinal fluid rhinorrhoea: raised intracranial pressure post c.v.s.t leading to dural arterio-venous fistula and cribriform plate fracture",
  "uid": "3e910365-64fc-5437-b39d-c2873758d246"
}