CSF rhinorrhoea is the symptom of cerebrospinal fluid (CSF) leakage outside the skull cavity (extracranially ) Fluid leaks into the paranasal sinuses ( air spaces of the skull ), into the nasal cavity, exiting via the anterior nares. It can occur whenever there is a bony or dural defect of the skull base. It can be unilateral or bilateral but primarily one-sided. Unilateral discharge without the feeling of coryza makes the patients anxious. Moreover, the secretion going inside the throat is tasteless against the salty taste of cold coryza. We can divide the causes into two categories. They were acquired and Congenital. In acquired cases, traumatic, tumour, and iatrogenic cause ( medical) surgeries are there. Congenital causes include meningocele, encephalocele, persistent cricopharyngeal canal, etc. Diagnosis is made by CT cisternography to locate the exact site of the CSF leak. It is performed after injecting contrast into the theca (spine); however, this procedure is highly dependent on patient positioning and timing. Fluid leaked from the nose may also serve in diagnosis purpose as normal CSF glucose levels lie between 45–80 mg/dL, whereas in average nasal discharge level is 10 mg/dl. There is another specific lab test for CSF leak. Beta-2-transferrin is a protein found only in CSF and perilymph. Its absence in other body secretions makes its detection invaluable in diagnosing a CSF leak. Here is another Case of CSF rhinorrhea from Churu Rajasthan. He consulted us on 27 September 2021 over a zoom call. Dr Ravi advised him to take online treatment, but he preferred face to face consultation. He visited the clinic on 1 October 2021. He told us that since Dec 2020, he has been suffering from unilateral nasal discharge, which got Diagnosed as CSF rhinorrhea. He Visited the ENT specialist and Surgeons at Jaipur, and they suggested endoscopic surgical repair. His report of CT cisternography date is 28 July 2021 – Small 1.5 mm defect in the right cribriform plate, with evidence of CSF leak in the ethmoid sinus. He came to the clinic with his friend, and it was challenging to convince them about our mode of treatment by Medicine transmission through hair. After a long session, they took the chance. Our Assistant Dr Pratibha Awasthi took the case in detail, and we have selected his medicine. We inserted his hair in a vial containing indicated medicine on 1 October 2021 Dr Ravi talked with the Patient over a zoom call on 14 February 2022. He got cured of his CSF Rhinorrhea trouble. There has been no CSF Rhinorrhea trouble or leakage since December. He is delighted and shared his experience that his colleague still doesn’t believe how a patient can be treated for such a grave condition with a piece of hair. Dr Ravi talked with the Patient over a zoom call to know his well being on 31 December 2021. He is doing 15-20 % better in CSF leaks. On 1 October 2021, he visited the clinic along with his friend. Although he was suggested to take the online treatment, he was puzzled by the disease and out of fear of surgery, he visited the clinic. He had a ray of hope. He heard that Dr Ravi treated chronic diseases through the hair (method of medicine transmission through hair), a seemingly impossible mechanism, so he accompanied his friend. His friend asked many questions about the modus operandi of the medicine transmission through hair. He was a bit sceptical about the mode; he was amazed when he was told that his friend would be treated without any oral medicine for the surgical disease. He inquired about the possible range of medicine transmission. Dr Ravi shared that the RANGE of medicine transmission is across the globe as the patients are getting cured worldwide from his Lucknow centre. In the covid pandemic lockdown, this method was a boon to humanity and medical science. Dr Ravi talked with the Patient over a zoom call on 17 March 2022. He said that there had been no CSF leak since 1 February 2022. He is delighted with the treatment outcome. He wished to stop the treatment; hence, his hair was washed and removed from the medicated vial. Dr Ravi advised him to confirm the prognosis through CT cisternography from the same centre. He promised to share the reports.v
