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How can I suspect the scf lecake in PNS

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I’m not sure what “scf lecake” refers to. Did you mean one of these?
  1. Sciatic nerve lesion in the peripheral nervous system (PNS)
  2. Spinal cord lesion
  3. Subcutaneous lesion
  4. Something else, perhaps a term from your notes
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CsF lekege in pns

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"cerebrospinal fluid leak" AND diagnosis

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CSF rhinorrhea symptoms diagnosis beta-2 transferrin high resolution CT guideline

If by PNS you mean the paranasal sinuses, suspect a cranial CSF leak (CSF rhinorrhea) when there is:
  • Clear, watery discharge from one nostril, often intermittent
  • Discharge that increases on bending forward, straining, coughing, or getting up from bed
  • A persistent salty or metallic taste or fluid dripping into the throat
  • Onset after head trauma, nasal/sinus surgery, skull-base surgery, or sometimes spontaneously in people with raised intracranial pressure
  • Associated headache, especially a new positional headache
Do not rely on the “halo/ring sign” on tissue paper or a urine glucose strip. These are unreliable. The best test to confirm that nasal fluid is CSF is beta-2 transferrin (or beta-trace protein where available). After confirmation, high-resolution CT of the skull base/PNS is usually the first study to identify the bony defect; MR cisternography can help if CT is unclear. This is supported by an evidence-based diagnostic review and a more recent diagnostic review.
Urgent assessment is needed if there is fever, neck stiffness, severe headache, altered consciousness, or photophobia, because an untreated CSF leak can lead to meningitis. Avoid forceful nose blowing, straining, or inserting anything into the nose until reviewed by ENT/neurosurgery.
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