A 32-year-old man develops clear watery nasal discharge after head trauma. The fluid tests positive for beta-2 transferrin. This finding confirms leakage of which fluid, and what is the usual initial management if there is no associated meningitis or significant intracranial injury?
- A CSF, conservative management with head elevation and lumbar drain consideration ✓
- B Serous otitis media, myringotomy with grommet insertion
- C Nasal secretions, topical anticholinergic spray
- D CSF, immediate craniotomy and dural repair
Correct answer: A. CSF, conservative management with head elevation and lumbar drain consideration
Explanation
Beta-2 transferrin is highly specific for CSF and confirms traumatic CSF rhinorrhea. Most post-traumatic leaks without complicating injury stop spontaneously within one to two weeks with bed rest, head elevation, avoidance of straining, and stool softeners. Immediate surgery is reserved for persistent leaks, large defects, or associated intracranial pathology, which rules out option D as first-line care.
Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.