The patient’s family was informed of several points regarding the patient’s current cerebrospinal fluid leak: 1. The patient’s cerebrospinal fluid leak, i.e., the closed cranial cavity is connected to the outside world, inevitably increases the probability of intracranial infection, so prophylactic anti-infective treatment is given to prevent serious intracranial infection, which can be life-threatening. 2. In diagnosis and treatment, there are two points: (1) Qualitative diagnosis, i.e., is it a cerebrospinal fluid nasal leak? Usually the doctor has to make a judgment based on past history, such as history of cranial trauma, history of running nose, history of intracranial infection, and high-resolution CT or MRI of the skull base of the sinuses. And clear water left from the nose for routine and biochemical laboratory tests of cerebrospinal fluid is of great guidance. And if lumbar puncture was performed during intracranial infection hyperthermia (lumbar puncture was previously contraindicated in patients with cerebrospinal fluid nasal leakage, but current clinical observation and practice suggest that lumbar puncture is relatively contraindicated in patients with cerebrospinal fluid nasal leakage), and the extracted cerebrospinal fluid has septic and inflammatory changes, the diagnosis is of greater significance. (2) Localization diagnosis: It mainly relies on high-resolution CT or MRI of the skull base of the sinuses for judgment. Some leaks, with typical features, can be conclusively determined by the doctor at that time. However, some leaks are abnormally small and concealed, so it is difficult to make a definite conclusion on the image. In this case, a careful nasal endoscopy is needed again. If still undetectable, a transnasal endoscopic surgical exploration of the skull base is required. This requires the patient to understand the complex, insidious nature of the disease. This is what is referred to in the opening paragraph as “erratic, seemingly absent”. 3. The presence of cerebrospinal fluid leakage (mainly nasal leakage of cerebrospinal fluid) requires the patient to avoid sneezing (i.e., avoiding colds, irritating odors, and pollen), straining to defecate (which may occur when the patient is bedridden, so mild laxatives are routinely used), and absolute bed rest (meaning that any movement is in bed), with the head of the bed elevated 15-30° as appropriate. 4. If the patient’s cerebrospinal fluid nasal leak does not heal on its own, treatment with lumbar pool drainage may be required. However, lumbar pool drainage is only a method of treating cerebrospinal fluid leak, and it does not completely treat the cerebrospinal fluid leak after application. Cerebrospinal fluid leak may still occur during drainage or continue after drainage tube removal, and treatment with cerebrospinal fluid nasal leak repair is required. All measures are aimed at preventing or reducing cerebrospinal fluid leakage, allowing the leak to heal on its own, changing an open cranial injury to a closed cranial injury, and reducing the chance of intracranial infection, but there is no guarantee that they will be absolutely effective. 6. Cerebrospinal fluid leaks that do not heal in the above manner for 4-8 weeks may require surgical repair. 7. The key to success in treating cerebrospinal fluid nasal leaks is, in my opinion, a true understanding of the disease by the patient and family, empowerment (informed consent), accurate diagnosis by the physician, and repair techniques. For cases that are really “iffy and seemingly non-existent”, you can wait and see. Do not rush into surgery.