A patient called, rhinitis for several years, had sinus surgery, now there is always one side of the nostril constantly flowing clear water, after lying down into the throat, now always headache, could it be caused by allergic rhinitis? Trauma and surgery are the main causes of cerebrospinal fluid nasal leakage, there are two types of traumatic and spontaneous, traumatic is mainly head and facial trauma or head and facial surgery, especially nasal surgery caused by the meninges broken or intracranial pressure increased to “swell through”, more common in life; spontaneous cerebrospinal fluid nasal leakage, that is, the cause is unknown, in a sudden force, such as sneezing, sudden The cerebral membranes rupture naturally when you bend your head down. People say that the brain is surrounded by water, and this water means that the meninges are filled with cerebrospinal fluid. Under normal circumstances, cerebrospinal fluid is continuously generated and absorbed. Once the meninges are ruptured, cerebrospinal fluid will flow through the rupture into the sinus cavity because the skull base is connected to the middle ear and the nasal cavity, and if it flows out through the external ear canal or through the eustachian tube to the pharynx, it will be an ear leak of cerebrospinal fluid. Clinically, some patients with cerebrospinal fluid otolaryngitis are easily misdiagnosed as otitis media, but it is more common for cerebrospinal fluid rhinorrhea to be confused with rhinitis and allergic rhinitis. In general, cerebrospinal fluid leaks occur at the time of trauma, at the time of surgery, or some time after surgery, but in patients with delayed cerebrospinal fluid leaks, such as those described above, it can even be delayed until months or years after surgery. People with a little common sense about cerebrospinal fluid rhinorrhea can actually identify the difference between it and allergic rhinitis. First of all, it is clear water from one nostril, while allergic rhinitis is usually bilateral. Secondly, cerebrospinal fluid leakage tends to show more clear water flowing when one bends down, lowers the head, coughs and other exertions. More importantly, because meningeal spinal fluid contains a large amount of glucose, a quantitative sugar test of the clear water flowing out can confirm the diagnosis. Improper treatment can lead to meningitis. Cerebrospinal fluid leakage does not necessarily cause harm to the body, but it does indicate that the brain tissue is connected to the outside world through a fissure, and if care is not taken, bacteria can easily enter the skull retrogradely through the fissure and cause diseases such as meningitis, which can be life-threatening. Some patients even use cotton balls or toilet paper to block the nostrils in the hope of plugging the leak, which is completely wrong and will increase the chance of reflux of the overflow and more likely to cause intracranial infection. Early detection Most patients with cerebrospinal fluid leaks can be treated conservatively if detected early. The simplest treatment is absolute bed rest, and the meninges can repair themselves. If it does not heal after 4 to 8 weeks of conservative treatment, surgery should be considered. Otherwise, over time, a leak will form at the site of the rupture and the granulation around the leak will proliferate, making infection more likely to occur and also making surgical repair difficult.