What is “Spontaneous” Cerebrospinal Fluid Rhinorrhea? Classification of Cerebrospinal Fluid Leaks

Since the first descriptions of nontraumatic cerebrospinal fluid (CSF) leaks of the temporal bone (in the French literature in 1897) and via the nasal passages (in the British literature in 1899), the term CSF has been used extensively in the literature. However, there is a certain degree of confusion concerning CSF leaks when a traumatic cause is not apparent. Careful review of the literature reveals that the term is given different meanings by different authors. Many authors divide CSF leaks into traumatic (surgical or nonsurgical) and spontaneous, and therefore consider a spontaneous CSF leak the same as a nontraumatic one. Others define a spontaneous leak as one not related to trauma, surgery, or neoplasm. According to Lundy et al, a spontaneous CSF leak is one that is not related to infection, trauma, or tumor. May et al consider a CSF leak to be spontaneous if no history of trauma or congenital defect can be elicited. Pappas et al define a spontaneous CSF leak as one without a history of trauma, congenital defect, or infection. Other definitions state that CSF leakage occurs without apparent cause; for some of us, in daily practice, a spontaneous CSF leak is defined as one without a recent cause.