A Nurse's Guide to Identifying Cerebrospinal Fluid Leakage

A nurse is caring for a client with a head injury who has fluid leaking from the nose and ears. How should the nurse determine if this fluid is cerebral spinal fluid?

Leakage of cerebrospinal fluid from the ears or nose may accompany basilar skull fracture. CSF can be distinguished from other body fluids because the drainage will separate into bloody and yellow concentric rings on the dressing material, called a halo sign. The fluid also tests positive for glucose.

Cerebrospinal fluid

All vertebrates have cerebrospinal fluid, which is a clear, colorless bodily fluid that is present in the tissue that covers their brains and spinal cords. Specialized ependymal cells in the choroid plexus of the brain's ventricles create CSF, which is then absorbed in arachnoid granulations.

The ventricular system and subarachnoid space, which are located surrounding and inside the brain and spinal cord, respectively, are occupied by CSF. It fills the spinal cord's central canal as well as the brain's ventricles, cisterns, and sulci.

How can a nurse determine if the fluid leaking from a client's nose and ears is cerebrospinal fluid? The nurse can determine if the fluid is cerebrospinal fluid by observing the separation of bloody and yellow concentric rings on the dressing material, known as the halo sign, and by testing the fluid for glucose, as CSF will test positive for glucose.
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