CSF Oculorrhea Presenting as “Tearing” following the Repair of Fronto-Ethmoidal Encephalocele

Abstract

<b><i>Introduction:</i></b> Cerebrospinal fluid (CSF) oculorrhea is extremely rare, and very few cases have been reported mostly following trauma. There is only 1 case in the published literature where oculorrhea occurred following the repair of fronto-nasal encephalocele. <b><i>Case Description:</i></b> A six-year-old girl presented with gradually increasing fronto-ethmoidal encephalocele with secondary papulo-nodular changes. She underwent bi-frontal craniotomy with excision of encephalocele sac and herniated gliotic brain followed by dural closure using peri-cranial graft. One month later, she presented again with swelling over the operative site and “tearing” from both her eyes. She was diagnosed with CSF oculorrhea. After failing conservative management, lumbar drain was inserted and kept on continuous drainage. Oculorrhea stopped with lumbar drain but restarted with its removal. Therefore, theco-peritoneal shunt was placed, following which oculorrhea stopped. She is doing well at 5 months’ follow-up. <b><i>Conclusion:</i></b> CSF oculorrhea must be considered by the pediatric neurosurgeons in any patient who presents with “tearing” following the repair of an anterior encephalocele.