BMJ Case Reports 2018; doi:10.1136/bcr-2017-221461
  • Unusual presentation of more common disease/injury

Penetrating trauma causing cerebrospinal fluid leak without nerve root damage

Editor's Choice
  1. Roland Fernandes
  1. Department of Surgery, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
  1. Correspondence to Dr Holly Carpenter, holly.carpenter3{at}
  • Accepted 13 April 2018
  • Published 14 May 2018


A 19-year-old man with a stab injury to the lower back presented with no focal neurology or haemodynamic instability. He complained of a headache that was improved by lying flat and underwent imaging to look for damage to local structures. He was found to have air in his intraspinal space. Initially this case was managed conservatively; however, 2 weeks after discharge, he presented with cerebrospinal fluid leak from his wound. This was managed with neurosurgical intervention and watertight closure of fascia. There were no further complications.


  • Contributors This patient was admitted by and cared for by RF, HC wrote the body of the report and AA and K-HH provided editorial comments and literature review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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