» Articles » PMID: 39926457

Cerebrospinal Fluid Oculorrhea: A Rare Complication After Orbital Exenteration for Cavernous Sinus Meningioma with Orbital Extension and Radiation-induced Hydrocephalus

Overview
Journal Surg Neurol Int
Date 2025 Feb 10
PMID 39926457
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Cavernous sinus meningiomas are rare, and radiotherapy is considered because the risk of postoperative complications is high. Radiotherapy is useful for short-term control of meningiomas, but hydrocephalus may appear as a long-term complication.

Case Description: A 71-year-old male patient suffered from a cavernous sinus meningioma with orbital involvement and communicating hydrocephalus. Radiotherapy was administered thrice due to tumor progression. Right intraorbital meningioma increased markedly, and right eye bulging and visual deterioration were aggravating. Tumor removal with orbital exenteration was performed to prevent left visual impairment due to tumor progression. The pathology was atypical meningioma (WHO grade 2). Postoperative cerebrospinal fluid (CSF) leakage from the right orbit, so-called oculorrhea, was difficult to repair due to hydrocephalus, requiring eyelid sutures and a lumboperitoneal shunt. The tumor never developed into the opposite cavernous sinus.

Conclusion: Radiation-induced hydrocephalus can lead to intractable postoperative CSF leakage from orbit after tumor removal with orbital exenteration and require surgery. In these cases, hydrocephalus treatment may lead to a cure for intractable CSF oculorrhea.

References
1.
Yuen H, Cheng A, Auyeung K . Late-onset occult cerebrospinal fluid leakage after orbital exenteration. Ophthalmic Plast Reconstr Surg. 2008; 24(3):238-40. DOI: 10.1097/IOP.0b013e3181706ccd. View

2.
Powers W, OGURA J, Palmer L . Radiation therapy and wound healing delay. Animals and man. Radiology. 1967; 89(1):112-5. DOI: 10.1148/89.1.112. View

3.
Massoud V, Fay A, Yoon M . Cerebrospinal fluid leak as a complication of oculoplastic surgery. Semin Ophthalmol. 2014; 29(5-6):440-9. DOI: 10.3109/08820538.2014.959187. View

4.
De Conciliis C, Bonavolonta G . Incidence and treatment of dural exposure and CSF leak during orbital exenteration. Ophthalmic Plast Reconstr Surg. 1987; 3(2):61-4. DOI: 10.1097/00002341-198703020-00001. View

5.
Dawley T, Rana Z, Abou-Al-Shaar H, Goenka A, Schulder M . Major complications from radiotherapy following treatment for atypical meningiomas. Neurosurg Focus. 2019; 46(6):E5. DOI: 10.3171/2019.3.FOCUS1930. View