The modern view on сomplex diagnostics of the liquorrhea

A modern approach to the complex diagnosis of liquorrhea, both transcranial and nasal, is considered. The terminology and the most common and used variants of classification of liquorrhea are given. An epidemiology and causes of liquorrhea according to the modern literature are described. The history of the study of cerebrospinal fluid and various methods of its study are briefly presented. Special attention is paid to the review of modern methods of diagnosis of liquorrhea which were described in the literature. Both simple samples of «halo-test» and «handkerchief» and high-tech endoscopic methods of visual diagnostics are considered. The data of various authors on the effectiveness of intrathecal administration of fluorescein, indigocarmin and other dyes is presented, their shortcomings are noted. The methods of laboratory diagnosis of liquorrhea by determining the level of glucose, protein and specific for cerebrospinal fluid biomarkers β -transferrin and β-TP are described. The role of neuroimaging methods of examination, such as multispiral computer tomography, cisternography, magnetic resonance imaging and radionuclide studies, in the diagnosis of liquorrhea was determined. Based on the analysis of the literature data and their own experience, the authors present an improved algorithm of complex diagnosis of liquorrhea, including the collection of complaints and anamnesis of the disease, general laboratory diagnostic complex, objective examination (including rhinoscopy), consultations by other specialists, bedside methods of diagnosis of liquorrhea, laboratory methods of verification of cerebrospinal fluid and radiation diagnostic techniques.

cerebrospinal fluid, liquorrhea, base of the skull, rhinoscopy, computer-tomographic cisternography, fluorescein, indigocarmine, β -transferrin